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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 2026, 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 2026.
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 $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 $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 features an annual drug deductible of $440. For Tier 1 preferred generic drugs, you pay no copay for a 1-month or 3-month supply at standard pharmacies and through mail-order services. Tier 2 generic drugs have a $7 copay for a 1-month supply at standard pharmacies, but you can access a 3-month supply with no copay through preferred mail order. Tier 3 preferred brand drugs require a 17% coinsurance for both standard pharmacies and mail-order options. Higher tiers carry higher costs, with Tier 4 non-preferred drugs requiring a 40% coinsurance and Tier 5 specialty drugs requiring a 28% coinsurance for a 1-month supply. This prescription drug plan provides clear cost-sharing details to help you estimate your annual out-of-pocket medication expenses.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, telehealth, and preventive services. Specialist visits feature a low copay of $0 to $25, while inpatient hospital stays require 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 upon admission, and outpatient hospital services range from no copay to a $325 copay. Routine dental cleanings, annual eye exams, and yearly hearing tests are fully covered with no copay or coinsurance. The plan also provides a $150 eyewear allowance every two years and covers hearing aids with copays starting at $199. Other key benefits like home health services and laboratory tests feature no copay and no coinsurance, while medical equipment and dialysis require a 20% coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) covers inpatient hospital stays with no coinsurance, requiring a $325 daily copay for days 1-6 and no copay for days 7 through 90. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient Services are covered by AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) with no coinsurance for all services, including no copay for ambulatory surgical center and outpatient blood services. Patients will pay a copay of $0 to $325 for outpatient hospital services, $325 for observation services, and $0 to $25 for outpatient substance abuse services.
Partial Hospitalization See details
Partial hospitalization is covered by AARP Medicare Advantage Essentials from UHC TX-22 (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-22 (HMO-POS) covers ground and air ambulance services with a $275 copay and no coinsurance, which requires prior authorization and is not waived upon hospital admission. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services under the AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) plan are covered with a $150 copay, which is waived if you are admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature a copay of $0 to $65 with no coinsurance, and worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) offers primary care and telehealth visits with no copay and no coinsurance, while specialist visits range from a $0 to $25 copay with no coinsurance. Physical, occupational, speech, and podiatry services require a $25 copay and no coinsurance, whereas chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes training. Additional preventive benefits are partially covered with no copay and no coinsurance for fitness programs and home safety devices, while health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation counseling, disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) partially covers hearing services, providing one routine hearing exam per year with no copay or coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids (copay of $199 to $1,249) and OTC hearing aids (copay of $199 to $829) are covered for up to two devices annually with no coinsurance, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) covers annual routine eye exams with no copay, no coinsurance, and no deductible, though other eye exams are not covered. Eyewear is covered up to a $150 maximum every two years with no coinsurance or deductible, offering no copay for contact lenses and frames, and a copay of $0.00 to $153.00 for lenses, while upgrades and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered under AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS), featuring Medicare-covered dental care with no copay and a 20% coinsurance. Preventive dental services like exams, cleanings, X-rays, and fluoride are covered with no copay and no coinsurance, but restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) with no copay and no coinsurance, subject to prior authorization. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance of no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
AARP Medicare Advantage Essentials from UHC TX-22 (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
AARP Medicare Advantage Essentials from UHC TX-22 (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 require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS), with prior authorization and referrals required. Diagnostic tests require a $60 copay with no coinsurance, lab services have no copay or coinsurance, outpatient X-rays require a $30 copay plus coinsurance, diagnostic radiology copays start at $0, and therapeutic radiology requires a copay and a minimum 20% coinsurance.
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. To receive these services, both a referral and prior authorization are required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) with no copay and no coinsurance, though prior authorization and referrals are required. While some services are covered, specific sub-services including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) covers Skilled Nursing Facility (SNF) services 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 additional days beyond the Medicare-covered limit not covered.
Other Services See details
AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) offers partial coverage for other services, featuring over-the-counter (OTC) items with no copay and no coinsurance. While OTC items like nicotine replacement therapy and naloxone are covered, acupuncture, meal benefits, and dual-eligible SNP services are not covered.
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