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AARP Medicare Advantage from UHC TX-0042 (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-0042 (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-0042 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC TX-0042 (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 from UHC TX-0042 (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-0042 (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-0042 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.00. 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 from UHC TX-0042 (HMO-POS) plan features an annual prescription drug deductible of $440. Under this plan, you will enjoy no copay for Tier 1 preferred generic and Tier 2 generic drugs when filled as a 1-month or 3-month supply at a standard pharmacy, or as a 3-month supply through standard mail order. For higher-tier medications, your costs are determined by coinsurance during the initial coverage phase. You will pay a 19% coinsurance for Tier 3 preferred brand drugs, a 40% coinsurance for Tier 4 non-preferred drugs, and a 28% coinsurance for Tier 5 specialty drugs.
Additional Benefits
The AARP Medicare Advantage from UHC TX-0042 (HMO-POS) plan offers comprehensive coverage with no copays for primary care visits, telehealth, and annual preventive exams. Members also benefit from robust dental coverage featuring no copay on preventive services up to a $5,000 annual limit, alongside routine vision and hearing exams with no copay. Additionally, the plan provides a $250 eyewear allowance every two years and covers over-the-counter items and up to 24 one-way transportation trips per year with no copay. For major medical needs, inpatient hospital stays require a $295 daily copay for the first six days and no copay for days 7 through 90, while skilled nursing facility stays feature no copay for the first 20 days. Emergency room visits carry a $150 copay, which is waived upon admission, while outpatient lab services and diagnostic radiology are available with no copay. Other specialized services, such as durable medical equipment and dialysis, require a 20% coinsurance and no copay.
Inpatient Hospital See details
AARP Medicare Advantage from UHC TX-0042 (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $295 daily copay for days 1 through 6 and no copay for days 7 through 90. The benefit is partially covered because non-Medicare-covered stays, upgrades, and additional psychiatric days beyond 90 days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC TX-0042 (HMO-POS) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services which feature no copays. Outpatient hospital services require a copay of $0 to $295 (including $295 daily for observation services), and outpatient substance abuse services carry a copay of $0 to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
Partial hospitalization is covered under the AARP Medicare Advantage from UHC TX-0042 (HMO-POS) plan 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 from UHC TX-0042 (HMO-POS) covers ground and air ambulance services with a $275 copay and no coinsurance. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC TX-0042 (HMO-POS) covers emergency services with a $150 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $65 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Primary care benefits are covered by AARP Medicare Advantage from UHC TX-0042 (HMO-POS) with no copay and no coinsurance for primary care doctor visits and telehealth. Specialist visits, mental health, and physical therapy services feature copays ranging from $0 to $25 with no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Preventive Services are covered by AARP Medicare Advantage from UHC TX-0042 (HMO-POS) with no copay and no coinsurance for services such as annual exams, kidney disease education, and fitness benefits. However, this benefit is only partially covered, as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, smoking cessation counseling, disease management, telemonitoring, remote access technologies, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC TX-0042 (HMO-POS), offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams along with inner ear, outer ear, and over-the-ear prescription hearing aids are not covered. Covered prescription hearing aids carry a copay of $199.00 to $1,249.00, and OTC hearing aids have a copay of $199.00 to $829.00, both with no coinsurance and a limit of two devices per year.
Vision Services See details
Vision Services are partially covered by AARP Medicare Advantage from UHC TX-0042 (HMO-POS), featuring one routine eye exam per year and contact lenses with no copay and no coinsurance. Eyewear coverage includes a $250 maximum benefit every two years with no coinsurance, offering eyeglass frames with no copay and eyeglass lenses with a copay of $0 to $153, though other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services are partially covered by AARP Medicare Advantage from UHC TX-0042 (HMO-POS), with implant services and orthodontics being excluded from coverage. Preventive services feature no copay and no coinsurance up to a $5,000 annual limit, while Medicare-covered services require no copay and 20% coinsurance, and comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC TX-0042 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Under this plan, chemotherapy and other Medicare Part B 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
AARP Medicare Advantage from UHC TX-0042 (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization and a referral are required to access these covered services.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC TX-0042 (HMO-POS) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic services. Prior authorization is required for these covered benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC TX-0042 (HMO-POS), with no copay or coinsurance for lab services and diagnostic radiology. Diagnostic procedures and tests require a $60 copay with no coinsurance, outpatient X-rays have a $30 copay, and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home health services are covered by AARP Medicare Advantage from UHC TX-0042 (HMO-POS) with no copay and no coinsurance, although prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered under AARP Medicare Advantage from UHC TX-0042 (HMO-POS) with no copay and no coinsurance, although prior authorization and referrals are required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC TX-0042 (HMO-POS) with no coinsurance, though prior authorization and referrals are required. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with no prior three-day hospital stay required and no coverage for additional days.
Other Services See details
AARP Medicare Advantage from UHC TX-0042 (HMO-POS) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
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