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AARP Medicare Advantage Essentials from UHC IN-11 (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 IN-11 (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 IN-11 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Indiana. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage Essentials from UHC IN-11 (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 IN-11 (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 IN-11 (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 Essentials from UHC IN-11 (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 you use. For example, you will pay a $12 copay for preferred generic drugs at a standard pharmacy. For preferred brand drugs, you will pay a $100 copay, regardless of the pharmacy. Once your total yearly drug costs reach $2000, you will enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay of $370 for days 1-5, with no copay for days 6-90. Outpatient services have copays ranging from $0 to $370, and emergency services have a $125 copay. This plan includes coverage for primary care with no copay, and preventive services also have no copay. Hearing exams are covered with no copay, and prescription hearing aids have copays ranging from $199 to $1249. Vision services include routine eye exams with no copay, and eyewear is covered with a combined maximum of $300 every two years. Dental services, home health services, and many other services also have no copay.
Inpatient Hospital See details
Inpatient Hospital coverage includes a $370 copay for days 1-5 and no copay for days 6-90 for acute care and psychiatric services. Additional days for inpatient hospital acute care have no copay, while non-Medicare-covered stays and upgrades for inpatient hospital acute care, and additional days and non-Medicare-covered stays for inpatient hospital psychiatric are not covered.
Outpatient Services See details
Outpatient Services include outpatient hospital services with a copay ranging from $0 to $370, observation services with a $370 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay ranging from $0 to $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) plan. Ground and Air Ambulance Services have a copay of $290, with no coinsurance, while other Transportation Services are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services are covered with a $20 copay, but routine care is not covered. Occupational Therapy Services are covered with a copay between $0 and $30. Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are also covered with varying copays.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional services like glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, all with no copay. Other services like Health Education, In-Home Safety Assessment, and more are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year. Prescription hearing aids and OTC hearing aids are covered, with copays ranging from $199 to $1249 and $99 to $829, respectively. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
The AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) plan covers vision services, including routine eye exams with no copay, and eyewear with a combined maximum of $300 every two years. Contact lenses, eyeglass lenses, and eyeglass frames are covered with no copay, but eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services have no copay. Medicare Dental Services have a 20% coinsurance. Orthodontic, restorative, and other dental services 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, as well as 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, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetic Devices, Medical Supplies, and Diabetic Therapeutic Shoes/Inserts with a 20% coinsurance; Diabetic Supplies have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) plan. Diagnostic Procedures/Tests have a $50 copay, and Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $165, Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Essentials from UHC IN-11 (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 by the AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) plan, but the specific services listed, including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) plan, but require prior authorization. You will have no copay for days 1-20, and a $203 copay per day for days 21-100. Additional days beyond Medicare-covered, and non-Medicare-covered stays are not covered.
Other Services See details
The AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) plan covers Over-the-Counter (OTC) Items and Meal Benefits. OTC items have no copay, and meal benefits also have no copay, but require prior authorization. Other services like acupuncture, Dual Eligible SNPs, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and others are not covered.
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