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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 2025, 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 2025.
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 $60.00. 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 $5900.00 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 a variety of benefits with varying costs. Inpatient hospital stays have a copay, and outpatient services may have copays depending on the service. The plan also covers primary care, preventive services, hearing, vision, and dental services, often with no copay, though hearing aids have a copay. Additional benefits include ambulance and transportation services, emergency services, and home health services, with some services having a copay or coinsurance. The plan also covers home infusion, dialysis, medical equipment, and diagnostic services with copays or coinsurance. Other services like OTC items and a meal benefit have no copay.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $395 copay for days 1-7, and no copay for days 8-90, while Additional Days for Inpatient Hospital-Acute have no copay for days 91-999; Non-Medicare-covered Stay and Upgrades are not covered. For Inpatient Hospital Psychiatric, you will pay a $395 copay for days 1-5, and no copay for days 6-90, while Additional Days and Non-Medicare-covered Stay are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $395, while observation services have a copay of $395. Ambulatory surgical center (ASC) services and outpatient blood services have no copay, and outpatient substance abuse services have copays of $0-$25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay. Prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services with a $275 copay, and transportation services to a plan-approved health-related location with no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered by the AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) plan. Emergency Services have a $125 copay, and no coinsurance, while Urgently Needed Services have a copay between $0 and $55 with no coinsurance. Worldwide Emergency, Urgent Coverage, and Transportation all have no copay and no coinsurance.
Primary Care See details
The AARP Medicare Advantage Patriot No Rx TX-MA03 (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 $45, while physician specialist services have a copay between $0 and $55. Mental health individual sessions have a copay between $0 and $25, and group sessions have a $15 copay. Podiatry services and other health care professional services have a copay between $45 and $55, and psychiatric services have a copay between $0 and $25 for individual sessions, and $15 for group sessions. Physical therapy and speech-language pathology services have a copay between $0 and $50. Additional telehealth benefits have no copay, and opioid treatment program services have no copay.
Preventive Services See details
Preventive Services are covered, including an annual physical exam with no copay. Additional preventive services are covered, including Medicare-covered Glaucoma Screening, Medicare-covered Diabetes Self-Management Training, Medicare-covered Barium Enemas, Medicare-covered Digital Rectal Exams, and Medicare-covered EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year with no copay. Prescription hearing aids are covered with a copay between $199 and $1249, up to two per year, and OTC hearing aids are covered with a copay between $99 and $829 per year. Fitting/evaluation for hearing aids, and prescription hearing aids (inner ear, outer ear, and over the ear) are not covered.
Vision Services See details
Vision services include eye exams with no copay, and routine eye exams with no copay, but eyewear is partially covered, with contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades not covered. Prior authorization and a doctor referral are required for some services.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare Dental Services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay, while prosthodontics (removable and fixed) are covered with a 0-50% coinsurance. Orthodontic and implant services 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 coinsurance ranges from 0% to 20%. For Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, the coinsurance ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered by AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS), including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a $50 copay, and lab services with no copay. Radiological services include a copay of up to $250 for diagnostic services, a 20% coinsurance for therapeutic services, and a $25 copay for outpatient X-rays.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Patriot No Rx TX-MA03 (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, but the specific services of Medicare-covered Intensive Cardiac Rehabilitation, Medicare-covered Pulmonary Rehabilitation, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD), and Additional Cardiac Rehabilitation Services are not covered. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Patriot No Rx TX-MA03 (HMO-POS) plan, but require prior authorization and a doctor referral. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other services include coverage for Over-the-Counter (OTC) items and a meal benefit. OTC items have no copay, and the meal benefit also has no copay, but requires prior authorization. Acupuncture, 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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