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AARP Medicare Advantage from UHC TX-0026 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC TX-0026 (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 from UHC TX-0026 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC TX-0026 (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 from UHC TX-0026 (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 from UHC TX-0026 (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 from UHC TX-0026 (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 $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:
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Drug Coverage
The AARP Medicare Advantage from UHC TX-0026 (HMO-POS) plan has a $340 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs at a standard pharmacy, you will pay a $14 copay, while standard generic drugs have a $47 copay. Preferred and standard brand drugs have a $100 copay, and non-preferred drugs have a 29% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC TX-0026 (HMO-POS) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays. It also covers preventive, hearing, vision, and dental services, often with no copay or a small copay, but with some limitations. This plan includes additional benefits like ambulance services, emergency care, and home health services with specific copays or coinsurance amounts.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered with a copay of $330 for days 1-5 and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered with no copay for days 91-999, while non-Medicare covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $330, Observation Services have a $330 copay, Ambulatory Surgical Center Services have no copay, Individual Sessions for Outpatient Substance Abuse have a copay between $0 and $25, Group Sessions for Outpatient Substance Abuse have a $15 copay, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with a $55 copay. Prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC TX-0026 (HMO-POS) plan. Ground and Air Ambulance Services have a $275 copay, and there is no coinsurance. 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 this plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $45; all other services have no copay.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services require prior authorization and a referral, with a $20 copay. Occupational Therapy Services are covered, with a copay between $0 and $30. Physician Specialist Services require prior authorization and a referral, with a copay between $0 and $35. Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services and Opioid Treatment Program Services have varying copays. Additional Telehealth Benefits are covered with no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional services such as Fitness Benefit, and Home and Bathroom Safety Devices and Modifications. Other preventive services such as Health Education, In-Home Safety Assessment, and others are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are limited to one per year. Prescription hearing aids (all types) are covered with a copay between $199 and $1249 for two hearing aids every year, but fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered. Over-the-counter (OTC) hearing aids are covered with a copay between $99 and $829 for two hearing aids every year.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams, including routine eye exams, have no copay. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, with contact lenses and eyeglass frames having no copay. Eyeglasses (lenses and frames) and upgrades are not covered. There is a combined maximum plan benefit coverage amount of $200 for all eyewear every two years.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with a 20% coinsurance. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay, but have visit limits. Restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, prosthodontics (removable and fixed), and oral and maxillofacial surgery have no copay, but have visit limits and require prior authorization. Orthodontic and implant services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered. You will pay a $35 copay for Medicare Part B Insulin Drugs, with a coinsurance between 0% and 20% for all other drugs.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC TX-0026 (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 is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Equipment is covered, with no copay for Diabetic Supplies, and 20% coinsurance for Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $50 copay, lab services with no copay, all radiological services, diagnostic radiological services with a copay up to $250, therapeutic radiological services with 20% coinsurance, and outpatient X-ray services with a $25 copay. Prior authorization and a doctor referral are required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC TX-0026 (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 plan does not cover any of the sub-services, so you will not receive coverage for this benefit. Prior authorization and a doctor referral are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered with prior authorization and a doctor's referral. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other services include Over-the-Counter (OTC) Items and Meal Benefit coverage. Over-the-Counter (OTC) Items have no copay, and Meal Benefits also have no copay, but require 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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