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AARP Medicare Advantage Essentials from UHC NJ-1 (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 NJ-1 (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 NJ-1 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in New Jersey. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage Essentials from UHC NJ-1 (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 NJ-1 (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 NJ-1 (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 $520.00 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 $6700.00 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 NJ-1 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) plan features an annual prescription drug deductible of $520. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic medications carry a $12 copay for a 1-month supply at standard pharmacies, though you can save with no copay on a 3-month supply when using preferred mail order. Higher-tier medications under this plan transition to coinsurance costs rather than flat copayments. Tier 3 preferred brand drugs require a 16% coinsurance for standard pharmacy and mail-order fills. Tier 4 non-preferred drugs carry a 33% coinsurance, while Tier 5 specialty tier drugs require a 27% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) offers affordable medical coverage with no copay and no coinsurance for primary care, preventive services, and home health care. For inpatient hospital stays, members pay a $445 daily copay for days 1 through 5 and no copay for days 6 through 90. Outpatient hospital services feature copays ranging from no copay up to $445, while emergency room visits carry a $130 copay with no coinsurance. Routine vision and hearing exams are fully covered with no copay and no coinsurance, and the plan includes a $300 eyewear allowance every two years. Preventive dental care also requires no copay and no coinsurance, whereas Medicare-covered dental, dialysis, and durable medical equipment require a 20% coinsurance with no copay. Prescription hearing aids are covered with copays ranging from $199 to $1,249 with no deductible.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring prior authorization, a $445 daily copay for days 1-5, and no copay for days 6-90. Unlimited additional acute days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) covers outpatient services with no coinsurance, featuring outpatient hospital copays from $0 to $445 and observation services at a $445 daily copay. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions carry a copay of $0 to $25.
Partial Hospitalization See details
Partial hospitalization is covered by AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) with a $55 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under the AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) plan, with a $275 copay and no coinsurance for Medicare-covered ground and air ambulance services. While some transportation services are covered, transportation to plan-approved health-related locations and any other health-related locations is not covered.
Emergency Services See details
AARP Medicare Advantage Essentials from UHC NJ-1 (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 require a copay of up to $50 with no coinsurance, and worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care and telehealth services are covered by AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) with no copay and no coinsurance. Specialist visits, physical therapy, and mental health services require no coinsurance and copays ranging from $0 to $40, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Preventive services are partially covered under the AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) plan with no copay and no coinsurance for covered services like annual exams, kidney disease education, select screenings, and fitness benefits. However, many supplemental benefits are not covered, including health education, personal emergency response systems, in-home safety assessments, and nutritional training.
Hearing Services See details
Hearing services are covered by AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) with no deductible, offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids are partially covered for up to two devices per year with a copay of $199.00 to $1,249.00 and no coinsurance, excluding inner ear, outer ear, and over-the-ear models. Up to two OTC hearing aids are also covered annually with a copay of $199.00 to $829.00 and no coinsurance.
Vision Services See details
AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) provides partial coverage for vision services, featuring one routine eye exam per year with no copay and no coinsurance, while other eye exams are not covered. Eyewear is covered up to a $300 combined limit every two years with no coinsurance, offering contact lenses and frames with no copay and lenses with a $0 to $153 copay, though upgrades and combined eyeglasses are not covered.
Dental Services See details
AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) partially covers dental services, offering Medicare-covered dental with no copay and a 20% coinsurance, and preventive services with no copay and no coinsurance. Comprehensive treatments, including restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy and other Part B drugs have no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) covers medical equipment, including durable medical equipment, prosthetics, and diabetic therapeutic shoes, with no copay and a 20% coinsurance. Diabetic supplies are also covered with no copay and no coinsurance, though manufacturer limits and prior authorization requirements apply.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) with prior authorization required. Diagnostic tests require a $50 copay and no coinsurance, lab services have no copay and no coinsurance, and radiological services range from a $30 copay for X-rays to a 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home health services are covered under the AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) plan with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) with no coinsurance, but only some services are covered as Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) with no coinsurance and requires prior authorization, with no prior three-day hospital stay required. There is no copay for days 1 through 20, a $218 copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage Essentials from UHC NJ-1 (HMO-POS) partially covers other services, providing a meal benefit for chronic illness with no copay, no coinsurance, and prior authorization required. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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