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AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Essentials from UHC CO-4 (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 Essentials from UHC CO-4 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Colorado. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage Essentials from UHC CO-4 (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 Essentials from UHC CO-4 (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 Essentials from UHC CO-4 (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 $520.00 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 $4200.00 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 Essentials from UHC CO-4 (HMO-POS) plan features an annual prescription drug deductible of $520. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies and through mail-order services. Tier 2 generic drugs are available for an $8 copay for a 1-month standard pharmacy supply, while a 3-month preferred mail-order supply features no copay. For higher-tier medications, cost-sharing transitions from flat copays to coinsurance. Tier 3 preferred brand drugs require a 16% coinsurance for standard pharmacy and mail-order options. Tier 4 non-preferred drugs carry a 37% coinsurance, while Tier 5 specialty drugs require a 27% coinsurance, both for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) plan offers comprehensive coverage with no copay for primary care visits, telehealth, and annual physicals, while specialist visits require a copay of up to $35. For inpatient hospital stays, members pay a $325 daily copay for the first six days and no copay for days seven through 90. Emergency room visits carry a $150 copay, which is waived if admitted, and urgent care copays range from no copay to $65. Routine vision and hearing exams are available with no copay, alongside a $300 biennial eyewear allowance and hearing aid copays starting at $199. Preventive dental care features no copay, but Medicare-covered dental, dialysis, and durable medical equipment require a 20% coinsurance. Skilled nursing facility stays have no copay for the first 20 days, followed by a $218 daily copay, though routine transportation, acupuncture, and over-the-counter items are not covered.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $325 daily copay for days 1-6 and no copay for days 7-90. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services carry a copay of $0 to $325, observation services require a $325 daily copay, and outpatient substance abuse sessions range from a $0 to $25 copay, with prior authorization required for most benefits.
Partial Hospitalization See details
Partial hospitalization is covered by AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) with a $55.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance services are covered by AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) with a $290 copay and no coinsurance for both ground and air transportation, subject to prior authorization. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay ranging from $0 to $65 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) provides primary care, telehealth, and opioid treatment services with no copay and no coinsurance. Specialist visits require a $0 to $35 copay, therapy services have a $20 copay, and chiropractic benefits are partially covered with a $10 copay for routine care (all with no coinsurance) while other chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) provides partially covered preventive services with no copay and no coinsurance for covered options like annual physicals, fitness benefits, kidney disease education, and screenings. Sub-services that are not covered under this plan include health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access technologies, safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS), which provides routine hearing exams with no copay and no coinsurance, while fitting and evaluation exams are not covered. Covered prescription hearing aids require a copay of $199.00 to $1,249.00 with no coinsurance, and OTC hearing aids have a copay of $199.00 to $829.00 with no coinsurance, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS), featuring routine eye exams with no copay and no coinsurance, and a $300 eyewear allowance every two years with no coinsurance and copays ranging from no copay to $153. Other eye exam services, upgrades, and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services are partially covered by the AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) plan, offering Medicare-covered dental with no copay and 20% coinsurance, and preventive services like cleanings and exams with no copay and no coinsurance. However, restorative, endodontic, periodontic, prosthodontic, orthodontic, oral surgery, and implant services are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs are covered with no copay and no coinsurance to 20% coinsurance, while Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) covers durable medical equipment, prosthetic devices, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts have a 20% coinsurance and no copay, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS), with prior authorization required. Lab services and diagnostic radiological services feature no copay and no coinsurance, while diagnostic tests require a $50 copay, outpatient X-rays carry a $30 copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
The AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) plan covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered with no copay and no coinsurance under the AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) plan, but in practice, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance and no prior three-day hospital stay requirement, subject to prior authorization. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard 100 days are not covered.
Other Services See details
Other Services are not covered under the AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) plan, as acupuncture, over-the-counter (OTC) items, and meal benefits are all excluded from coverage.
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