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AARP Medicare Advantage Essentials from UHC TX-22 (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-22 (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-22 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC TX-22 (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-22 (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-22 (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-22 (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:
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Drug Coverage
The AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) plan has a $340 deductible for prescription drugs. After the deductible, you will pay a copay for your prescriptions depending on the drug tier and pharmacy. For example, you will pay a $7 copay for a standard generic drug at a standard pharmacy. For preferred brand drugs, you will pay a $100 copay, regardless of the pharmacy. After your total drug costs reach $2000, you will enter the catastrophic coverage phase and pay nothing for your drugs.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) plan offers comprehensive coverage with varying costs. You'll find no copay for primary care visits, preventive services, and many outpatient services. The plan includes coverage for inpatient hospital stays, with a $250 copay for the first few days, and also covers emergency services with a $100 copay. Additional benefits include coverage for hearing and vision services, with no copay for hearing exams and eye exams. Dental services are covered with no copay for preventive services, and 20% coinsurance for Medicare dental services. The plan also covers home health services, and skilled nursing facility services with a copay after the first 20 days.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care, with a $250 copay for days 1-5 and no copay for days 6-90. Additional days for inpatient hospital acute have no copay, but non-Medicare covered stays and upgrades for inpatient hospital acute and psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $250, observation services with a $250 copay, and ambulatory surgical center (ASC) services with no copay. Outpatient substance abuse services are covered with copays ranging from $0 to $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services are covered with no copay.
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 and Transportation Services are covered, with no coinsurance for any services. Ground and Air Ambulance Services have a $125 copay. 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 by the AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) plan. Emergency Services have a $100 copay, while Urgently Needed Services have a copay between $0 and $65; all services have no coinsurance.
Primary Care See details
The AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) plan covers primary care physician services with no copay, and chiropractic services with a $20 copay. Occupational therapy services have a copay between $0 and $15, and physician specialist services have a copay between $0 and $15. Mental health and psychiatric services have varying copays depending on the service. Podiatry services have a $15 copay, and other health care professional services have a copay between $0 and $15. Physical therapy and speech-language pathology services have a copay between $0 and $15, and additional telehealth benefits have no copay. Opioid treatment program services have no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other services like glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit with no copay. Additional preventive services such as fitness benefits and home and bathroom safety devices and modifications are covered with no copay. Other services such as health education, in-home safety assessments, and more are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams have no copay. Prescription hearing aids have a copay between $199 and $1249, and over-the-counter hearing aids have a copay between $99 and $829. Fitting/evaluation for hearing aids, inner ear prescription hearing aids, outer ear prescription hearing aids, and over-the-ear prescription hearing aids 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 has no copay, and includes contact lenses, eyeglass lenses, and eyeglass frames, 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 includes coverage for Medicare Dental Services with 20% coinsurance, Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services 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, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and 0-20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 0-20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) plan, but require prior authorization and a doctor referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services, are covered. Diagnostic Procedures/Tests have a $60 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $200, while Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS), but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization and a doctor referral are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) plan, but require prior authorization and a doctor's referral. You will have no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
Other Services includes coverage for over-the-counter (OTC) items with no copay, but acupuncture, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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