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AARP Medicare Advantage from UHC CA-010P (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC CA-010P (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on AARP Medicare Advantage from UHC CA-010P (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC CA-010P (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Santa Clara County. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC CA-010P (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage from UHC CA-010P (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For AARP Medicare Advantage from UHC CA-010P (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $340.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2500.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The AARP Medicare Advantage from UHC CA-010P (HMO-POS) plan has a $340 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance for your medications depending on the drug tier and pharmacy. For example, you will pay an $8 copay for preferred generic drugs at a standard pharmacy, while standard generic drugs have a $47 copay. Preferred brand drugs have a $100 copay, and non-preferred drugs have 29% coinsurance. After your yearly out-of-pocket drug costs reach $2000, you will pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC CA-010P (HMO-POS) plan offers a range of benefits, including inpatient and outpatient hospital services, with varying copays. You'll find coverage for primary care, preventive, hearing, vision, and dental services, often with no copay for routine services. This plan also covers ambulance, emergency, and home health services. This plan provides additional benefits such as home infusion, dialysis, medical equipment, and diagnostic services, with copays and coinsurance depending on the specific service. Additionally, the plan covers skilled nursing facility stays, cardiac rehabilitation, and other services such as over-the-counter items. Prior authorization is required for some services, and some services are not covered.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered, but require prior authorization and a doctor referral. For days 1-5, the copay is $95, and there is no copay for days 6-90. Additional days for inpatient hospital-acute have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered with a copay of $0 to $95 depending on the service, and observation services have a $95 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Outpatient Substance Abuse Services have copays between $0 and $25 for individual sessions, and a $15 copay for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered, requiring prior authorization and a doctor referral. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground and Air Ambulance Services have a $120 copay, with no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $140 copay, while Urgently Needed Services have a copay between $0 and $30, and Worldwide Emergency Services have no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage from UHC CA-010P (HMO-POS) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, physician specialist services, physical therapy and speech-language pathology services, and additional telehealth benefits have no copay. Mental health specialty services have a copay between $0 and $25 for individual sessions, and $15 for group sessions. Psychiatric services have a copay between $0 and $25 for individual sessions, and $15 for group sessions. Podiatry services have a copay of $0, and other health care professional services have a copay of $0.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, annual physical exams, and additional preventive services. Annual physical exams have no copay, while additional preventive services have a copay, and some specific services are not covered, including health education, in-home safety assessment, personal emergency response system, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefit, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, and counseling services. Other services such as Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with no copay.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are limited to one per year. Prescription hearing aids are covered with a copay between $199 and $1249, and OTC hearing aids have a copay between $99 and $829. Fitting/evaluation for hearing aids, and prescription hearing aids for inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The AARP Medicare Advantage from UHC CA-010P (HMO-POS) plan covers vision services, including routine eye exams and eyewear. Routine eye exams, contact lenses, and eyeglass frames have no copay, while eyeglass lenses may have a copay of $0-$153. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC CA-010P (HMO-POS) plan covers various dental services, including oral exams, dental x-rays, and cleanings with no copay. Other services such as Prosthodontics, fixed, may have a coinsurance of 0% - 50%, and implant services and orthodontics are not covered. There is a maximum benefit of $1250 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Insulin has a $35 copay, and coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC CA-010P (HMO-POS) plan, but require prior authorization and a doctor's referral. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a copay for Medicare-covered diagnostic procedures/tests, and Medicare-covered lab services, and a $25 copay for diagnostic procedures/tests. Radiological Services include coverage for diagnostic radiological services with a copay of at most $150, therapeutic radiological services with at least 20% coinsurance, and outpatient X-ray services with a $15 copay.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC CA-010P (HMO-POS) with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but all listed sub-services are not covered. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC CA-010P (HMO-POS) plan, requiring prior authorization and a doctor's referral. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items with no copay; however, acupuncture, meal benefits, and several other services are not covered.
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