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AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx TX-MA03 (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 Patriot No Rx TX-MA03 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx TX-MA03 (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 Patriot No Rx TX-MA03 (HMO-POS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage Patriot No Rx TX-MA03 (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 Patriot No Rx TX-MA03 (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. Additionally, this plan comes with a Part B Premium reduction of $80.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6700.00 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 Patriot No Rx TX-MA03 (HMO-POS)
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Drug Coverage
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) plan offers strong core medical coverage with no copays and no coinsurance for primary care visits, annual routine physicals, and home health services. For more specialized care, members can expect copays of $0 to $55 for specialists, $130 for emergency room visits, and a $455 daily copay for the first several days of inpatient hospital stays. Diagnostic services such as lab tests require no copay, while durable medical equipment and dialysis services carry a 20% coinsurance. Supplemental benefits include no copay for annual routine vision and hearing exams, as well as preventive dental services up to a $1,500 maximum. Prescription and over-the-counter hearing aids are covered with copays ranging from $199 to $1,249, while comprehensive dental care requires a 50% coinsurance. It is important to note that this plan does not cover routine transportation, acupuncture, over-the-counter products, or standard eyewear like eyeglasses and contact lenses.
Inpatient Hospital See details
Inpatient hospital care is partially covered by the AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) plan with no coinsurance, requiring prior authorization and referrals. For acute stays, there is a $455 daily copay for days 1 to 6 and no copay for days 7 and beyond, while psychiatric stays charge a $455 daily copay for days 1 to 5 and no copay for days 6 to 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services at no copay. Outpatient hospital services require a copay of $0 to $455, observation services cost a $455 daily copay, and outpatient substance abuse sessions have copays up to $25.
Partial Hospitalization See details
AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization and a referral are required for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) covers Medicare-covered ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. Transportation services to plan-approved or any health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay ranging from $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Primary care benefits under the AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) plan feature no copay and no coinsurance for primary care visits, telehealth, and opioid treatment. Specialist visits require a $0 to $55 copay and no coinsurance, while chiropractic services are partially covered because routine and other chiropractic services are not covered. Physical, occupational, and speech therapies require a $50 to $55 copay and no coinsurance.
Preventive Services See details
AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) covers preventive services like annual physical exams, kidney disease education, and a fitness benefit with no copay and no coinsurance. However, this benefit is only partially covered, as supplemental services such as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, remote access, home safety modifications, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS), featuring one annual routine hearing exam with no copay and no coinsurance, while fitting and evaluation exams are not covered. For prescription hearing aids, some services are covered with a $199 to $1,249 copay and no coinsurance for up to two devices per year, but inner ear, outer ear, and over-the-ear models are not covered. Up to two OTC hearing aids are also covered per year with a $199 to $829 copay and no coinsurance.
Vision Services See details
Vision services are covered by AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) with no copay, no coinsurance, and no deductible for one routine eye exam annually, though other eye exams are not covered. Some eyewear services are covered, but contact lenses, eyeglasses, lenses, frames, and upgrades are not covered in practice.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS), excluding implant services and orthodontics. Preventive and diagnostic services feature no copay and no coinsurance up to a $1,500 annual maximum, while covered comprehensive services require no copay and 50% coinsurance, and Medicare-covered dental services have no copay and 20% coinsurance.
Home Infusion bundled Services See details
AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization and a referral are required to access these services.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) with prior authorization and referrals required. Members pay a $50 copay and no coinsurance for diagnostic tests, no copay and no coinsurance for lab services, a $30 copay for X-rays, copays starting at $0 for diagnostic radiology, and 20% coinsurance for therapeutic radiology.
Home Health Services See details
AARP Medicare Advantage Patriot No Rx TX-MA03 (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 Patriot No Rx TX-MA03 (HMO-POS) with no copay and no coinsurance, requiring both a referral and prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization and referrals are required, and additional days beyond the standard Medicare-covered 100-day limit are not covered.
Other Services See details
Other services are partially covered by AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS), featuring a chronic illness meal benefit with no copay and no coinsurance, subject to prior authorization. Acupuncture, over-the-counter (OTC) items, and other supplemental services are not covered.
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