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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 2025, 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 2025.
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 $340.00 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 $3900.00 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 has a $340.00 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance for your prescriptions, depending on the drug tier and pharmacy. For example, you will pay no copay for preferred generic drugs at a standard pharmacy, a $47.00 copay for standard generic drugs, and a $100.00 copay for preferred brand drugs at a standard pharmacy. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) plan offers comprehensive coverage with a focus on outpatient services. Many services have no copay, including primary care visits, preventive services, hearing exams, eye exams, and dental services like oral exams and X-rays. Emergency, inpatient, and outpatient services are covered, with varying copays. The plan includes additional benefits like home health services, and home infusion. This plan also provides coverage for a range of other services, including hearing aids, vision, dental, and diagnostic services. However, certain services like transportation, and some dental procedures, may have cost-sharing through copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $75 for days 1-5 and no copay for days 6-90 for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Additional days for Inpatient Hospital-Acute have no copay, while Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services are covered by the AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) plan, including outpatient hospital services with a copay between $0 and $75, observation services with a $75 copay, ambulatory surgical center services with no copay, individual outpatient substance abuse sessions with a copay between $0 and $25, group outpatient substance abuse sessions with a $15 copay, and outpatient blood services with no copay. Prior authorization and a doctor referral are required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance Services are covered with a $275 copay for both ground and air ambulance services, and no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services has a $140 copay, while Urgently Needed Services has a copay between $0 and $65; there is no coinsurance for either. Worldwide Emergency Services has a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services are covered with a $20 copay, but Routine Chiropractic Care is not covered. Occupational Therapy Services are covered with a copay ranging from $0 to $15. Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy, Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered with varying copays.
Preventive Services See details
Preventive services include no copay for an annual physical exam, Medicare-covered preventive services, and additional preventive services like Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other services are not covered.
Hearing Services See details
Hearing Services include hearing exams with no copay, routine hearing exams with no copay, and OTC hearing aids with a copay between $99 and $829. Prescription Hearing Aids are partially covered with a copay between $199 and $1249, while fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear benefits include contact lenses, eyeglass lenses, and eyeglass frames with no copay, with a combined maximum benefit of $200 every two years; however, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Other Dental Services have a $1500 maximum plan benefit, with oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, oral and maxillofacial surgery covered with a $0 copay. Prosthodontics, removable and prosthodontics, fixed have a coinsurance between 0% and 50%. Implants and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered. The plan has a $35 copay for Medicare Part B Insulin Drugs. The coinsurance for all services is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) plan, but require prior authorization and a doctor's referral. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and authorization required, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services with a $40 copay, and lab services with no copay. Diagnostic Radiological Services have a maximum copay of $225, Therapeutic Radiological Services have at least 20% coinsurance, and Outpatient X-Ray Services have a $20 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) plan 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 with prior authorization and a doctor referral, but the plan does not cover any specific services, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. There is a copay for these services, but the specific amount is not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) plan. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) plan's other services include over-the-counter items and meal benefits, with no copay for either. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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