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AARP Medicare Advantage Essentials from UHC MO-4 (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 MO-4 (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 MO-4 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Missouri. 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 MO-4 (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 MO-4 (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 MO-4 (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 $3200.00 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 MO-4 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) plan features an annual prescription drug deductible of $440. For Tier 1 preferred generic drugs, members enjoy no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic drugs cost a $10 copay for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay by using preferred mail order. Higher-tier medications are covered via coinsurance rather than flat copays. Tier 3 preferred brand drugs require an 18% coinsurance for both 1-month and 3-month fills across standard pharmacies and mail-order services. Tier 4 non-preferred drugs carry a 40% coinsurance, while Tier 5 specialty tier drugs require a 28% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) plan offers comprehensive medical coverage with many essential services featuring no copayments or coinsurance. Members enjoy no copays for primary care visits, telehealth, annual physical exams, and home health services. For more intensive care, inpatient hospital stays require a daily copay of $375 for the first five days followed by no copay, while emergency room visits carry a $150 copay that is waived if you are admitted. Routine vision and hearing exams are fully covered with no copay, alongside benefits for eyewear and hearing aids to help reduce out-of-pocket costs. Preventive dental services also feature no copay, while Medicare-covered dental care, dialysis, and durable medical equipment require a 20% coinsurance with no copay. Additionally, diagnostic lab tests and routine diagnostic radiology are covered with no copay, making this plan a highly accessible option for managing your health.
Inpatient Hospital See details
Inpatient hospital services are partially covered by AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) with no coinsurance, requiring a $375 daily copay for days 1-5 and no copay for days 6-90 for both acute and psychiatric stays. Unlimited additional acute care 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 MO-4 (HMO-POS) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $375 for outpatient hospital and observation services. Additionally, ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions carry copays between $0 and $25.
Partial Hospitalization See details
AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) with a $290 copay and no coinsurance for ground and air ambulance services, which require prior authorization. However, transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) with a $150 copay, which is waived if you are admitted to the hospital within 24 hours, and no coinsurance. 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
Primary Care benefits under the AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) plan feature no copay and no coinsurance for primary care physician visits, telehealth, and opioid treatment programs. Specialist visits, physical therapy, and mental health services range from no copay up to a $30 copay with no coinsurance, while chiropractic services are not covered in practice.
Preventive Services See details
Preventive Services are partially covered by AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) with no copays and no coinsurance for covered benefits like annual physical exams, fitness benefits, and diabetes self-management training. However, several additional supplemental services are not covered, including health education, in-home safety assessments, personal emergency response systems, and nutritional or dietary benefits.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS), offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Up to two prescription or OTC hearing aids are covered per year with no coinsurance and copays ranging from $199 to $1,249, though inner, outer, and over-the-ear prescription models are not covered.
Vision Services See details
Vision Services under AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) are partially covered, offering one annual routine eye exam with no copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no coinsurance up to a $300 limit every two years, featuring contact lenses and eyeglass frames with no copay and eyeglass lenses with a $0 to $153 copay, while upgrades and eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) partially covers dental services, offering Medicare-covered dental care with no copay and a 20% coinsurance. Preventive services such as oral exams, cleanings, fluoride, and X-rays are covered with no copay and no coinsurance, while 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 MO-4 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy and other drugs carry coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and coinsurance from no coinsurance to 20%.
Dialysis Services See details
AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical Equipment covered by AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) features no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts. 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 Essentials from UHC MO-4 (HMO-POS) with prior authorization required. Under this plan, lab services and diagnostic radiology have no copay and no coinsurance, diagnostic tests require a $50 copay and no coinsurance, outpatient X-rays require a $30 copay and coinsurance, and therapeutic radiology requires a 20% coinsurance and a copay.
Home Health Services See details
Home health services are covered by AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) plan. While the plan technically features no coinsurance, all specific sub-services, including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy, are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) with no coinsurance, requiring prior authorization and no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by the AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) plan, offering over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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