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AARP Medicare Advantage from UHC NJ-0003 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NJ-0003 (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 NJ-0003 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC NJ-0003 (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 from UHC NJ-0003 (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 NJ-0003 (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 NJ-0003 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $95.00. 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 $420.00 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 $6500.00 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 NJ-0003 (HMO-POS) plan features an annual drug deductible of $420. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies and for 3-month mail orders. Tier 2 generic drugs carry a $10 copay for a 1-month standard pharmacy supply, but there is no copay for a 3-month supply filled through preferred mail order. For brand-name and higher-tier medications, costs transition to coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 15% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 41% and 28% coinsurance respectively. This clear cost-sharing structure helps you budget for your prescription medication needs throughout the plan year.
Additional Benefits
The AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) plan offers comprehensive medical coverage with no copays or coinsurance for primary care visits, telehealth, and preventive services. For specialist visits, copays range from no copay up to $25, while inpatient hospital stays require a $345 daily copay for the first five days and no copay thereafter. Emergency room visits carry a $130 copay, which is waived if you are admitted, and urgent care visits range from no copay up to $50. Routine vision and hearing exams are covered with no copays, and the plan features a $300 eyewear allowance every two years alongside coverage for hearing aids with copays between $199 and $1,249. Preventive dental care is available with no copay, whereas Medicare-covered dental services and durable medical equipment require a 20% coinsurance. Home health services are fully covered with no copay, and skilled nursing facility stays have no copay for the first 20 days.
Inpatient Hospital See details
AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $345 daily copay for days 1 through 5 and no copay for days 6 and beyond for acute stays. Psychiatric stays share this copay structure up to 90 days, but upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) covers outpatient hospital services with no coinsurance and copays ranging from $0 to $345, and daily observation services with a $345 copay and no coinsurance. Ambulatory surgical and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services feature no coinsurance and copays ranging from $0 to $25.
Partial Hospitalization See details
Partial hospitalization is covered under the AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) plan with a $55.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) covers ground and air ambulance services with a $275.00 copay and no coinsurance, subject to prior authorization. Transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a copay of $0 to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are available with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) covers primary care provider visits, telehealth services, and opioid treatment with no copay and no coinsurance. Other services like specialist visits, mental health sessions, and physical, occupational, and speech therapies are covered with copays ranging from $0 to $25 and no coinsurance, while chiropractic care is not covered.
Preventive Services See details
Preventive Services are partially covered by AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) with no copay and no coinsurance for covered benefits such as annual physical exams, fitness benefits, kidney disease education, and glaucoma screenings. Sub-services that are not covered under this plan include health education, in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, home and bathroom safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC NJ-0003 (HMO-POS), offering one routine hearing exam per year with no copay and no coinsurance, while hearing aid fittings and evaluations are not covered. The plan also covers up to two prescription or OTC hearing aids per year with no coinsurance and copays ranging from $199.00 to $1,249.00, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) covers vision services with no deductible, offering one routine eye exam annually with no copay and no coinsurance. Eyewear is covered up to a $300 limit every two years with no coinsurance, featuring no copay for contact lenses and frames, and a $0 to $153 copay for eyeglass lenses, while other eye exams, upgrades, and combined eyeglasses are not covered.
Dental Services See details
AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) offers partially covered dental services, which include Medicare-covered dental care with no copay and 20% coinsurance, and preventive care with no copay and no coinsurance. However, restorative, orthodontic, endodontic, periodontic, prosthodontic, implant, oral surgery, maxillofacial prosthetics, and adjunctive general services are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Covered Part B chemotherapy and other drugs carry no copay and range from no coinsurance to 20% coinsurance, while covered insulin requires a $35 copay and ranges from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay, and prior authorization is required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) with prior authorization required. Diagnostic procedures and outpatient X-rays require a $30 copay, therapeutic radiological services require a 20% coinsurance, and lab services and diagnostic radiology are covered with no copay and no coinsurance.
Home Health Services See details
The AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) plan covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) plan. In practice, this plan does not cover any related sub-services, including standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC NJ-0003 (HMO-POS) with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not necessary, and additional days beyond the standard 100 days are not covered.
Other Services See details
Other services are partially covered by AARP Medicare Advantage from UHC NJ-0003 (HMO-POS), which includes a chronic illness meal benefit with no copay and no coinsurance, subject to prior authorization. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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