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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 2025, 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 3 out of 5 stars in 2025.
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 $255.00 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) plan has a $255 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay a $0 copay for preferred generic drugs at a standard pharmacy. Standard generic drugs have a $47 copay, and preferred brand drugs have a $100 copay. Non-preferred drugs have a 30% coinsurance. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC CA-026P (HMO-POS) plan offers a wide range of benefits, including inpatient and outpatient hospital care, with varying copays. Emergency, primary care, preventive, hearing, and vision services are also covered, often with no copays. Dental services are covered with no copays, and home health services have no copay. This plan provides coverage for ambulance, partial hospitalization, and skilled nursing facility services. It also includes benefits for medical equipment, diagnostic and radiological services, and other services like acupuncture, over-the-counter items, and a meal benefit. The plan also includes coverage for Home Infusion bundled Services, Dialysis Services, and Cardiac Rehabilitation Services.
Inpatient Hospital See details
Inpatient Hospital benefits include Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization and a doctor's referral. For Inpatient Hospital-Acute, the copay is $260 for days 1-7, and no copay for days 8-90, while additional days have no copay. For Inpatient Hospital Psychiatric, the copay is $260 for days 1-7, and no copay for days 8-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $100, and observation services with a $100 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay. Outpatient Substance Abuse Services are covered with a copay 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's referral. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the AARP Medicare Advantage from UHC CA-026P (HMO-POS) plan. Both ground and air ambulance services require a $125 copay, with no coinsurance, while transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under this plan. Emergency Services have a $120 copay, while Urgently Needed Services have a copay between $0 and $30; both have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
Primary Care benefits include no copay for Primary Care Physician Services, Chiropractic Services, and Routine Chiropractic Care. Occupational Therapy Services have a copay between $0 and $35, while Physician Specialist Services have no copay. Mental Health Specialty Services and Psychiatric Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Other Health Care Professional and Additional Telehealth Benefits have no copay, and Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $35.
Preventive Services See details
Preventive Services include an annual physical exam with no copay. The plan also covers additional preventive services including Fitness Benefit, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing Services are covered, including hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have no copay, and routine hearing exams are covered once per year. Prescription Hearing Aids (all types) have a copay between $199 and $1249 per year, and OTC hearing aids have a copay between $99 and $829.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and eyewear has no copay. However, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC CA-026P (HMO-POS) plan covers a variety of dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services, all with no copay. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, with coinsurance between 0% and 20%. Other Medicare Part B drugs, as well as Chemotherapy/Radiation Drugs, have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC CA-026P (HMO-POS) plan, with no copay. Prior authorization and a doctor referral are required.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and lab services with no copay, and outpatient x-ray services with a $10 copay. Diagnostic radiological services have a copay of at most $95, and therapeutic radiological services have 20% coinsurance.
Home Health Services See details
Home Health Services are covered with no copay and no coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. 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-026P (HMO-POS) plan, requiring prior authorization and a doctor's referral. You will have no copay for days 1-20, and a $203 copay for days 21-100, while additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services includes coverage for acupuncture, over-the-counter items, and a meal benefit. Acupuncture has no copay, and is limited to 12 treatments per year. Over-the-counter items have no copay and include nicotine replacement therapy and Naloxone. The meal benefit also has no copay and is for a chronic illness. Several additional services are not covered.
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