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AARP Medicare Advantage from UHC CA-026P (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-026P (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-026P (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC CA-026P (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in San Diego County. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC CA-026P (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-026P (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-026P (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 $355.00 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 $10000.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10000.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $2900.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10000.00 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-026P (HMO-POS) prescription drug plan features an annual deductible of $355.00. During the initial coverage phase, you will benefit from no copay for Tier 1 preferred generic drugs at standard pharmacies. For other drug tiers at standard pharmacies, you will pay a 21% coinsurance for Tier 2 standard generics, 35% coinsurance for Tier 3 preferred brands, and 29% coinsurance for Tier 4 non-preferred drugs. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase where you pay nothing for covered Part D prescriptions. Furthermore, individuals who qualify for the low-income subsidy can see their Part D costs reduced to zero.
Additional Benefits
The AARP Medicare Advantage from UHC CA-026P (HMO-POS) plan offers robust medical coverage featuring no copay and no coinsurance for primary care, specialist, and telehealth visits. For inpatient hospital stays, members pay a $260 daily copay for days 1 to 7, followed by no copay for days 8 through 90. Emergency room visits carry a $150 copay, which is waived if admitted, while routine services like home health and dialysis require no copay or coinsurance. Routine dental, vision, and hearing exams are fully covered with no copay, and the plan provides a $150 eyewear allowance alongside coverage for hearing aids. Durable medical equipment carries a 20% coinsurance, whereas diagnostic lab tests, acupuncture, and over-the-counter items are available with no copay. This combination of predictable copays and extensive no-cost preventive services makes it easier to manage overall healthcare expenses.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by AARP Medicare Advantage from UHC CA-026P (HMO-POS), with upgrades, non-Medicare-covered stays, and additional psychiatric days not covered. Covered acute and psychiatric stays require a $260 daily copay for days 1 to 7, no copay for days 8 to 90 (as well as days 91 to 999 for acute stays), and no coinsurance.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC CA-026P (HMO-POS) with no coinsurance and no copay for ambulatory surgical center and blood services. Medicare-covered outpatient hospital, daily observation, and outpatient substance abuse services require prior authorization and carry copays ranging from $0 to $100.
Partial Hospitalization See details
Partial hospitalization benefits are covered by AARP Medicare Advantage from UHC CA-026P (HMO-POS) with a $55 copay and no coinsurance. Prior authorization and a doctor referral are required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services under AARP Medicare Advantage from UHC CA-026P (HMO-POS) include ground and air ambulance coverage with a $275 copay and no coinsurance. Transportation services to health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC CA-026P (HMO-POS) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of up to $30 and no coinsurance, while worldwide emergency, urgent, and transportation services are fully covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits are partially covered by AARP Medicare Advantage from UHC CA-026P (HMO-POS), as podiatry services are not covered. There is no copay and no coinsurance for primary care, specialist, and telehealth visits, while therapy services require a $35 copay and mental health sessions have a $0 to $25 copay, both with no coinsurance.
Preventive Services See details
Preventive Services are covered under the AARP Medicare Advantage from UHC CA-026P (HMO-POS) plan with no copay and no coinsurance for services like annual physicals, kidney disease education, and glaucoma screenings. However, additional preventive services are only partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
AARP Medicare Advantage from UHC CA-026P (HMO-POS) offers partially covered hearing services, including one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered up to two devices yearly with no coinsurance and copays ranging from $199 to $1,249, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC CA-026P (HMO-POS) with no coinsurance, featuring no copay for annual routine eye exams. Eyewear is covered up to $150 every two years with no copay for contact lenses and frames, and a $0 to $153 copay for eyeglass lenses, while upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC CA-026P (HMO-POS) partially covers dental services, offering Medicare-covered dental care and preventive services with no copay and no coinsurance. However, restorative, endodontic, periodontic, prosthodontic, implant, orthodontic, and oral surgery services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by AARP Medicare Advantage from UHC CA-026P (HMO-POS) with prior authorization, though Part D home infusion drugs are not covered under this benefit. Covered Part B insulin drugs require a $35 copay and between no coinsurance and 20% coinsurance, while chemotherapy and other Part B drugs have no copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC CA-026P (HMO-POS) covers Dialysis Services with no copay and no coinsurance. Prior authorization and a doctor referral are required to receive these covered services.
Medical Equipment See details
AARP Medicare Advantage from UHC CA-026P (HMO-POS) covers durable medical equipment, prosthetics, and diabetic therapeutic shoes with a 20% coinsurance and no copay. Diabetic supplies are covered with no copay and no coinsurance, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC CA-026P (HMO-POS) covers diagnostic and radiological services with prior authorization and doctor referrals. Diagnostic tests, procedures, and lab services have no copay and no coinsurance, while outpatient X-rays have a $10 copay, diagnostic radiology has a copay of up to $95, and therapeutic radiology requires a 20% coinsurance with no copay.
Home Health Services See details
AARP Medicare Advantage from UHC CA-026P (HMO-POS) covers Home Health Services with no copay and no coinsurance. To access this benefit, a doctor referral and prior authorization are required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC CA-026P (HMO-POS) does not cover Cardiac Rehabilitation Services, meaning there is no copay or coinsurance. This exclusion applies to all related options, including intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by AARP Medicare Advantage from UHC CA-026P (HMO-POS), with no coverage provided for additional days beyond the Medicare-covered limit. There is no copay and no coinsurance for days 1 through 20, and a $218 daily copay with no coinsurance for days 21 through 100, subject to prior authorization and a doctor referral.
Other Services See details
Other Services are partially covered by AARP Medicare Advantage from UHC CA-026P (HMO-POS), offering acupuncture, over-the-counter items, and meal benefits with no copay and no coinsurance. Dual Eligible SNPs with Highly Integrated Services are not covered under this plan.
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