A non-government entity
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 2026, 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 2026.
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 $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 $5900.00 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 IN-11 (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) plan features an annual prescription drug deductible of $520. For Tier 1 preferred generic drugs, there is no copay for standard pharmacy fills or mail-order deliveries. Tier 2 generic drugs require a $12 copay for a one-month supply at standard pharmacies, but members can access these with no copay for a three-month supply via preferred mail order. For higher-tier prescription drugs, costs are structured as coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 16% coinsurance for both standard pharmacy and mail-order fills. Tier 4 non-preferred drugs carry a 35% coinsurance, and Tier 5 specialty drugs require a 27% coinsurance for a one-month supply.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, preventive screenings, annual physicals, and home health services. For hospital care, inpatient stays require a $455 daily copay for the first few days with no coinsurance, while outpatient services carry a copay ranging from $0 to $455 depending on the procedure. Emergency care is accessible with a $130 copay, which is waived upon admission, and urgent care visits cost between $0 and $50 with no coinsurance. Routine dental, vision, and hearing exams are available with no copay and no coinsurance, though comprehensive dental services and certain vision upgrades are not covered. Prescription and over-the-counter hearing aids are covered with copays starting at $199, and the plan provides a $300 eyewear allowance every two years with no coinsurance. Additionally, essential services like dialysis and durable medical equipment require no copay but carry a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital care is covered by AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) with no coinsurance, requiring a $455 daily copay for days 1 through 6 of acute stays (no copay for days 7 and beyond) and days 1 through 5 of psychiatric stays (no copay for days 6 through 90). This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) covers outpatient services with no coinsurance, though prior authorization is required for most services. Outpatient hospital services carry a copay of $0 to $455 (including a $455 daily copay for observation services), outpatient substance abuse sessions range from a $0 to $25 copay, and ambulatory surgical center and blood services have no copay.
Partial Hospitalization See details
AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) covers ground and air ambulance services with a $290 copay and no coinsurance, subject to prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature a copay ranging from $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
Primary care benefits through AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) feature no copay and no coinsurance for primary care provider visits and telehealth services, while chiropractic services are not covered. Specialist visits, therapy, and mental health services require no coinsurance, with copays ranging from $0 to $50 depending on the specific service.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) with no copay and no coinsurance for annual physicals, kidney disease education, and select screenings. Additional preventive benefits are partially covered, with a fitness benefit included, but services such as health education, nutritional therapy, and personal emergency response systems are not covered.
Hearing Services See details
AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) offers partially covered hearing services, including one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Up to two prescription hearing aids (copays ranging from $199.00 to $1,249.00) and OTC hearing aids (copays ranging from $199.00 to $829.00) are covered per year with no coinsurance, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS), featuring no coinsurance and no copay for annual routine eye exams, and no coinsurance with a $0 to $153 copay for eyewear up to a $300 limit every two years. Other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) provides partially covered dental services, featuring preventive care like exams, cleanings, and X-rays with no copay and no coinsurance, alongside Medicare-covered dental services for no copay and 20% coinsurance. Comprehensive treatments, including restorative work, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) with no copay, though prior authorization and step therapy may apply. Associated Medicare Part B chemotherapy and other drugs require no copay and a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) covers durable medical equipment, prosthetics, and diabetic supplies with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) plan with no coinsurance, though prior authorization is required. Lab services have no copay, outpatient X-rays carry a $5 copay, diagnostic procedures cost $20, and copays start at $0 for diagnostic radiology and $60 for therapeutic radiology.
Home Health Services See details
The AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) plan covers home health services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all not covered. While the overall benefit category technically lists no copay and no coinsurance, none of these specific services are covered in practice.
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) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage provided for additional days beyond the Medicare-covered limit.
Other Services See details
Other services are partially covered by AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS), which offers a meal benefit for chronic illnesses with no copay and no coinsurance, subject to prior authorization. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved