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AARP Medicare Advantage Essentials from UHC TX-21 (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 TX-21 (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 TX-21 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Texas. 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 TX-21 (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 TX-21 (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 TX-21 (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 $440.00 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:
Sign up for AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) plan features an annual prescription drug deductible of $440. For Tier 1 preferred generic and Tier 2 generic medications, members pay no copay for a 1-month or 3-month supply at standard pharmacies, as well as for a 3-month supply through standard mail order. This makes managing everyday prescriptions highly affordable under this plan. Higher-tier medications are subject to coinsurance rather than set copays during the initial coverage phase. Tier 3 preferred brands require a 15% coinsurance for standard pharmacy and mail-order fills, while Tier 4 non-preferred drugs carry a 40% coinsurance for a 1-month supply. Specialty drugs in Tier 5 are covered with a 28% coinsurance for a 1-month supply at standard pharmacies and through standard mail order.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) plan offers affordable healthcare coverage featuring no copays and no coinsurance for primary care visits, preventive screenings, and home health care. For hospital stays, members pay no coinsurance and a $150 daily copay for the first six days, followed by no copay for days seven through ninety. Emergency room visits carry a $150 copay that is waived if admitted, while outpatient services range from no copay up to $150. Supplemental benefits include routine vision and hearing exams with no copay, plus up to $1,000 in preventive dental care with no copay or coinsurance. Skilled nursing facility care is also highly accessible, requiring no copay for the first 20 days of a stay. Additionally, durable medical equipment is covered with a 20% coinsurance and no copay, and members can access select over-the-counter items and chronic illness meals at no cost.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) covers inpatient hospital care with no coinsurance, requiring a $150 daily copay for days 1-6 and no copay for days 7 through 90 per stay. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days beyond 90 days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) with no coinsurance, including no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital service copays range from $0 to $150 (with a $150 daily copay for observation services), and outpatient substance abuse sessions cost a $0 to $25 copay, with prior authorization and referrals required.
Partial Hospitalization See details
Partial hospitalization services are covered by the AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) covers Medicare-approved ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required. Some transportation services are covered, but transportation to plan-approved health-related locations and any other health-related locations is not covered.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) with a $150 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. 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 copay and no coinsurance.
Primary Care See details
Primary care services under the AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) are covered with no copay and no coinsurance, including telehealth and opioid treatment. Specialist visits, physical and occupational therapy, and mental health services are covered with copays ranging from $0 to $25 and no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive Services are covered by AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) with no copay and no coinsurance for annual physical exams, kidney disease education, glaucoma screenings, and diabetes self-management training. Additional preventive benefits are partially covered with no copay or coinsurance for fitness benefits and home safety devices, while services like health education, weight management, and nutritional counseling are not covered.
Hearing Services See details
AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) partially covers hearing services, offering one annual routine hearing exam with no copay and no coinsurance. Covered hearing aids include up to two OTC models (copay of $199.00 to $829.00) and two prescription models (copay of $199.00 to $1,249.00) per year with no coinsurance, though hearing aid fitting and evaluation exams, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) provides partially covered vision services with no deductible and no coinsurance. Yearly routine eye exams are covered with no copay, though other eye exam services are not covered. Eyewear is also partially covered up to a $150 limit every two years with no coinsurance, featuring no copay for contact lenses and frames, and a $0 to $153 copay for lenses, while upgrades and complete eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services are partially covered by AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS), excluding implant services and orthodontics. Preventive and diagnostic care features no copay and no coinsurance up to a $1,000 annual limit, while Medicare-covered dental services carry no copay and a 20% coinsurance, and covered comprehensive services require no copay and a 50% coinsurance.
Home Infusion bundled Services See details
AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) covers Home Infusion bundled Services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Part B insulin is covered with 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 TX-21 (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive coverage for these services.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts carry a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services covered by AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) require referrals and prior authorization. Diagnostic services have no coinsurance, featuring a $50 copay for tests and no copay for lab work, while radiological services require a $30 copay for X-rays, 20% coinsurance for therapeutic services, and no copay for diagnostic radiology.
Home Health Services See details
AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) covers Home Health Services with no copay and no coinsurance. Prior authorization and a referral are required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) with no copay and no coinsurance, though some services are covered while cardiac, intensive cardiac, pulmonary, and supervised exercise therapy for peripheral artery disease rehabilitation services are not covered. Prior authorization and referrals are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) with no coinsurance, though prior authorization and a referral are required. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage provided for additional days.
Other Services See details
AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, though prior authorization is required for meals. Acupuncture and other miscellaneous services under this benefit category are not covered.
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