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AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Essentials ValueRx NV-5 (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 ValueRx NV-5 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Clark and Nye Counties. 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 ValueRx NV-5 (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 ValueRx NV-5 (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 ValueRx NV-5 (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 $270.00 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 $900.00 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:
Sign up for AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) plan features an annual drug deductible of $270. For Tier 1 preferred generics and Tier 2 generics, members pay no copay for a 1-month or 3-month supply at preferred pharmacies, as well as for a 3-month supply through preferred mail order. Standard pharmacies and standard mail order options charge a copay ranging from $10 to $15 for a 1-month supply and $30 to $45 for a 3-month supply of these generic medications. For brand-name and specialty medications, costs transition to coinsurance. Tier 3 preferred brands require an 18% coinsurance across all pharmacy types, while Tier 4 non-preferred drugs carry a 37% coinsurance. Tier 5 specialty drugs have a 30% coinsurance for a 1-month supply at preferred, standard, and mail-order pharmacies.
Additional Benefits
The AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) plan offers comprehensive medical coverage with no copay and no coinsurance for inpatient hospital stays, primary care, specialist visits, and home health services. Outpatient hospital visits, lab tests, and annual preventive screenings are also covered with no copays or coinsurance, keeping your everyday healthcare costs highly predictable. For urgent and emergency medical needs, emergency room visits require a $150 copay, while ambulance transportation has a $290 copay. This plan also features valuable dental, vision, and hearing benefits, including routine dental, vision, and hearing exams with no copay. Comprehensive dental services are covered with a 50% coinsurance and no copay, while prescription hearing aids carry copays ranging from $199 to $1,249. Additionally, durable medical equipment, diabetic supplies, and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Inpatient hospital services are covered by AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) with no copay and no coinsurance for both acute and psychiatric stays. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered under the AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) plan with no coinsurance and no copays for outpatient hospital visits, observation services, ambulatory surgical center services, and blood services. Outpatient substance abuse services also feature no coinsurance, with copays ranging from $0 to $15 for individual sessions and a $10 copay for group sessions.
Partial Hospitalization See details
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) covers partial hospitalization with a $55.00 copay and no coinsurance. Prior authorization and a referral are required for these covered services.
Ambulance and Transportation Services See details
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) covers ground and air ambulance services with a $290 copay and no coinsurance. Transportation services are partially covered, offering up to 12 one-way trips per year to plan-approved locations with no copay and no coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
AARP Medicare Advantage Essentials ValueRx NV-5 (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 no coinsurance and a copay ranging from no copay to $10, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) covers primary care, specialist visits, physical therapy, and telehealth services with no copay and no coinsurance, though routine and other chiropractic services are not covered. Mental health and psychiatric services require no coinsurance, with copays ranging from $0 to $15 for individual sessions and a flat $10 copay for group sessions.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) with no copayments and no coinsurance, including annual physical exams, kidney disease education, and glaucoma screenings. Additional preventive services are partially covered, providing fitness benefits and home safety devices with no copay or coinsurance, while sub-services such as health education, personal emergency response systems, and nutritional therapy are not covered.
Hearing Services See details
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) partially covers hearing services, offering one routine hearing exam per year with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered up to two per year with no coinsurance and copays ranging from $199 to $1,249, but 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 ValueRx NV-5 (HMO-POS) with no coinsurance and no deductibles. Covered benefits include annual routine eye exams, contact lenses, and eyeglass frames with no copay, as well as eyeglass lenses with a $0 to $153 copay up to a $250 maximum limit every two years, while other eye exam services, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS), as implant services and orthodontics are not covered. Preventive and diagnostic services are offered with no copay and no coinsurance up to a $3,000 annual limit, while covered comprehensive services require no copay and a 50% coinsurance.
Home Infusion bundled Services See details
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Covered Medicare Part B chemotherapy, radiation, and other drugs carry no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
Medical equipment benefits under the AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) plan are covered with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and diabetic supplies. Diabetic therapeutic shoes and inserts also require a 20% coinsurance, and prior authorization is required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) plan with no copay and no coinsurance for lab services, diagnostic tests, and diagnostic radiology. Outpatient x-rays require a $5 copay, while therapeutic radiological services are subject to a 20% coinsurance.
Home Health Services See details
Home health services are covered by the AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) plan with no copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) covers cardiac rehabilitation services with no copay and no coinsurance, although referrals and prior authorization are required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) with no coinsurance, requiring prior authorization and a referral. There is no copay for days 1 to 20 and a $218 daily copay for days 21 to 100, though additional days beyond the standard Medicare limit are not covered.
Other Services See details
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and other miscellaneous services under this benefit are not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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