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AARP Medicare Advantage Essentials from UHC IN-12 (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-12 (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-12 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC IN-12 (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-12 (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-12 (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-12 (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 $440.00 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:
Sign up for AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) plan features an annual prescription drug deductible of $440. Under this plan, you will benefit from no copay for Tier 1 preferred generic and Tier 2 generic medications when filled through standard pharmacies or standard mail order. This coverage structure helps keep your everyday prescription costs predictable and highly affordable. For brand-name and specialty prescriptions, the plan utilizes coinsurance percentages rather than flat copayments. Tier 3 preferred brand drugs require a 22% coinsurance, while Tier 4 non-preferred drugs carry a 44% coinsurance. Tier 5 specialty medications are subject to a 28% coinsurance for a 1-month supply through standard retail pharmacies and mail-order services.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) plan offers comprehensive medical coverage with no copay for primary care visits, telehealth, and routine preventive services. For inpatient hospital stays, members pay a $400 daily copay for the first four days and no copay for days five through 90, while emergency room visits carry a $150 copay. Outpatient services and diagnostic lab tests are highly accessible, requiring no coinsurance and low-to-no copays. This plan also features key supplemental benefits, including no copay for annual routine vision and hearing exams, alongside preventive dental care with no copay or coinsurance. While durable medical equipment and dialysis services require a 20% coinsurance, home health services are covered with no copay. Members also benefit from cost-effective coverage for hearing aids and eyewear, though comprehensive dental and transportation services are not covered.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $400 daily copayment for days 1-4 and no copayment for days 5-90. Unlimited additional acute stay days are covered at no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
The AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) plan covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services, and a $0 to $400 copay for outpatient hospital and observation services. Outpatient substance abuse services also feature no coinsurance, with copays ranging from $0 to $25 for individual sessions and a $15 copay for group sessions.
Partial Hospitalization See details
Partial hospitalization is covered by the AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) plan with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) covers ground and air ambulance services with a $150 copay and no coinsurance, though prior authorization is required. Transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay ranging from $0 to $65 with no coinsurance, while worldwide emergency, urgent, and transportation services are fully covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) covers primary care and telehealth visits with no copay and no coinsurance. Specialist visits range from a $0 to $40 copay, physical and occupational therapies require a $10 copay, and podiatry has a $35 copay, all with no coinsurance, while chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) provides partially covered preventive services with no copay and no coinsurance for covered options like annual physical exams, fitness benefits, kidney disease education, and glaucoma screenings. However, several additional preventive services are not covered, including health education, in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, and weight management programs.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS), offering one annual routine hearing exam with no copay or coinsurance, though fitting and evaluation exams are not covered. The plan covers up to two prescription hearing aids (copays of $199 to $1,249) and two OTC hearing aids (copays of $199 to $829) per year with no coinsurance, while 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-12 (HMO-POS) with no coinsurance, featuring no copay for one routine eye exam per year, no copay for contact lenses or frames, and a $0 to $153 copay for lenses. A $300 combined maximum benefit applies to eyewear every two years, though other eye exams, upgrades, and bundled eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) offers partially covered dental services, with no copay and no coinsurance for preventive care like oral exams, cleanings, fluoride, and x-rays. Medicare-covered dental services require a 20% coinsurance and no copay, while comprehensive treatments—including restorative, endodontics, periodontics, prosthodontics, implants, and oral surgery—are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) with no copay and no coinsurance, though prior authorization and step therapy apply. Covered Medicare Part B chemotherapy and other infusion drugs have no copay and require between no coinsurance and 20% coinsurance, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required to receive this coverage.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) covers medical equipment, including durable medical equipment (DME), prosthetics, and medical supplies, with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts carry a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) with no coinsurance, though prior authorization is required. Members pay no copay for lab services and diagnostic radiology, a $5 copay for diagnostic tests and outpatient x-rays, and a minimum $30 copay for therapeutic radiology.
Home Health Services See details
AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) covers home health services with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) with no copay and no coinsurance, subject to prior authorization. Although some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance and requires prior authorization, but does not require a prior three-day hospital stay. There is no copay for days 1 through 20, a daily copay of $218 applies 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 IN-12 (HMO-POS) partially covers other services, offering 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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