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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 2025, 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 2025.
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 $29.00. 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 $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 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 example, you pay no copay for preferred generic drugs at a standard pharmacy. For standard generic drugs, you pay a $47 copay. Preferred brand drugs have a $100 copay, and non-preferred drugs have 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-0042 (HMO-POS) plan offers comprehensive coverage, including inpatient hospital stays with a copay, outpatient services with varying copays, and emergency services with a copay. You'll have no copay for primary care visits, preventive services, eye exams, and many dental services like oral exams and X-rays. This plan also includes coverage for hearing exams, prescription hearing aids, and vision services with no copay for eye exams. Additionally, the plan covers ambulance, home health, and skilled nursing facility services. However, certain services like acupuncture, private duty nursing, and some vision and dental upgrades are not covered.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric services, with a $195 copay for days 1-5 and no copay for days 6-90. Additional days for inpatient hospital-acute are covered with no copay, while non-Medicare-covered stays and upgrades for inpatient hospital-acute and psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $195, and observation services have a $195 copay, while ambulatory surgical center services and outpatient blood services have no copay. Individual outpatient substance abuse sessions have a copay between $0 and $25, while group sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC TX-0042 (HMO-POS) plan, and requires prior authorization and a doctor referral. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $275 copay. Transportation Services to a plan-approved health-related location are covered with no copay, up to 24 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the AARP Medicare Advantage from UHC TX-0042 (HMO-POS) plan. Emergency Services have a $140 copay, and Urgently Needed Services have a copay between $0 and $65; both have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
The AARP Medicare Advantage from UHC TX-0042 (HMO-POS) plan covers primary care physician services with no copay. Chiropractic services have a $20 copay, but routine care is not covered. Occupational therapy services have a copay between $0 and $15. Physician specialist services have a copay between $0 and $15. Mental health specialty services, podiatry services, other health care professional services, psychiatric services, and physical therapy and speech-language pathology services have varying copays. Additional telehealth benefits have no copay. Opioid treatment program services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, an annual physical exam with no copay, and additional preventive services including Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with no copay. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, and Counseling Services are not covered.
Hearing Services See details
The AARP Medicare Advantage from UHC TX-0042 (HMO-POS) plan covers hearing exams with no copay, and routine hearing exams with no copay for one exam per year. Prescription hearing aids are covered with a copay between $199 and $1249 for two hearing aids per year, and OTC hearing aids are covered with a copay between $99 and $829 for two hearing aids per year. 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.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and include routine eye exams. Eyewear has a combined maximum plan benefit of $300 every two years, with no copay for contact lenses and eyeglass frames. Eyeglass lenses have a copay between $0 and $153, and eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with 20% coinsurance. Other Dental Services includes Oral Exams with no copay, Dental X-Rays with no copay, Other Diagnostic Dental Services with no copay, Prophylaxis (Cleaning) with no copay, Fluoride Treatment with no copay, Other Preventive Dental Services with no copay, Restorative Services with no copay, Adjunctive General Services with no copay, Endodontics with no copay, Periodontics with no copay, Maxillofacial Prosthetics with no copay, Prosthodontics removable with 0% - 50% coinsurance, and Prosthodontics fixed with 0% - 50% coinsurance. Orthodontic Services are covered under Diagnostic and Preventive Dental. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC TX-0042 (HMO-POS) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME) with a 20% coinsurance and no copay, Prosthetics and Medical Supplies with a 20% coinsurance and no copay, and Diabetic Equipment. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a doctor referral and prior authorization required. Diagnostic Procedures/Tests have a $60 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $220, and Therapeutic Radiological Services have 20% coinsurance. Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered 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 the services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization and a doctor referral. You will have no copay for days 1-20, and a $203 copay per day for days 21-100.
Other Services See details
Other Services with AARP Medicare Advantage from UHC TX-0042 (HMO-POS) covers Over-the-Counter (OTC) Items with no copay, but does not cover Acupuncture, Meal Benefit, 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.
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