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AARP Medicare Advantage Essentials from UHC TX-26 (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-26 (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-26 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC TX-26 (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-26 (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-26 (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-26 (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 $355.00 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 $4900.00 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-26 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) plan features an annual drug deductible of $355. Tier 1 preferred generic drugs offer excellent savings with no copay for standard pharmacy and mail-order fills. Tier 2 generic drugs carry a $14 copay for a 1-month standard pharmacy supply, but you can save with no copay on a 3-month supply through preferred mail order. For higher-tier medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require an 18% coinsurance for both standard pharmacy and mail-order fills. Tier 4 non-preferred drugs and Tier 5 specialty drugs incur coinsurance rates of 40% and 29% respectively for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, routine annual physicals, and home health services. Specialist visits, outpatient mental health, and urgent care are highly affordable, featuring low copays ranging up to $40 or $50 and no coinsurance. For more intensive care, inpatient hospital stays require a $375 daily copay for the first six days, while emergency room visits carry a $130 copay that is waived if you are admitted. Members also benefit from routine dental, vision, and hearing exams with no copay, alongside a $300 eyewear allowance every two years. While comprehensive dental treatments and cardiac rehabilitation are not covered, the plan provides diagnostic lab services with no copay and durable medical equipment with a 20% coinsurance. Additionally, prescription hearing aids, skilled nursing facility stays, and select Medicare Part B drugs are covered with predictable copays or coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $375 daily copay for days 1-6 and no copay for subsequent days. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0.00 to $375.00, outpatient substance abuse sessions carry a copay of up to $25.00, and daily observation services cost $375.00.
Partial Hospitalization See details
AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) covers partial hospitalization services 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-26 (HMO-POS) covers ground and air ambulance services with a $275 copay per trip and no coinsurance, with prior authorization required. Transportation services to plan-approved or any health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a copay ranging from $0 to $50 and no coinsurance, while 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-26 (HMO-POS) covers primary care, telehealth, and opioid treatment services with no copay and no coinsurance. Specialist, podiatry, mental health, and therapy services are also covered with no coinsurance and copays ranging from $0 to $40, while chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) covers preventive services—including annual physicals, fitness benefits, home safety devices, and kidney disease education—with no copay and no coinsurance. However, additional preventive benefits are only partially covered, with no coverage for health education, PERS, in-home safety assessments, medical nutrition therapy, 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, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS), offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids are covered up to two per year with copays ranging from $199.00 to $1,249.00 and no coinsurance, but inner ear, outer ear, and over-the-ear types are not covered. OTC hearing aids are also covered up to two per year with copays from $199.00 to $829.00 and no coinsurance.
Vision Services See details
Vision Services are partially covered by AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS), featuring no copay and no coinsurance for annual routine eye exams, contact lenses, and eyeglass frames, though eyeglass lenses have a copay of $0 to $153 with no coinsurance. A $300 combined maximum benefit applies every two years for eyewear, while other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) provides partially covered dental services, including preventive care like cleanings and oral exams with no copay and no coinsurance. Medicare-covered dental services are available with no copay and a 20% coinsurance, but comprehensive treatments such as restorative services, endodontics, periodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) with no copay and require prior authorization. Covered Part B chemotherapy, radiation, and other drugs have no coinsurance to 20% coinsurance, while Part B insulin is subject to a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC TX-26 (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 the AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) plan, with prior authorization and referrals required. Diagnostic procedures and tests have a $50 copay with no coinsurance, outpatient X-rays carry a $30 copay, and therapeutic radiology requires 20% coinsurance, while lab services and diagnostic radiology are offered with no copay.
Home Health Services See details
Home health services are covered under the AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) plan 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 not covered under the AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) plan. While the plan technically features no copay and no coinsurance, individual services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is covered by AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) with no coinsurance, requiring prior authorization and a referral. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services under the AARP Medicare Advantage Essentials from UHC TX-26 (HMO-POS) are partially covered, featuring over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. However, prior authorization is required for the meal benefit, and acupuncture is not covered.
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