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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 2025, 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 2025.
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 $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 $2900.00 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 MO-4 (HMO-POS) plan has a $340 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance for your prescriptions. For example, you will pay a $10 copay for preferred generic drugs at a standard pharmacy. For standard generic drugs, the copay is $47. For preferred brand drugs, the copay is $100, regardless of the pharmacy. For non-preferred drugs, you will pay 29% coinsurance. Once your total drug costs reach $2000, you will enter the catastrophic coverage phase where you pay nothing for your covered drugs.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) plan offers comprehensive coverage with a focus on outpatient and preventive services. Many services, including primary care visits, eye exams, and dental cleanings, have no copay. Additionally, the plan covers inpatient hospital stays with a copay, as well as ambulance, emergency, and skilled nursing facility services. This plan includes coverage for hearing and vision, with no copay for routine hearing exams and eye exams, and offers coverage for prescription hearing aids and eyewear. The plan also covers home health services, cardiac rehabilitation, and diagnostic services. However, some services, such as some dental, vision, and other services, may have coinsurance or are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $325 copay for days 1-5, and no copay for days 6-90, while additional days have no copay; Inpatient Hospital Psychiatric services have a $325 copay for days 1-5, and no copay for days 6-90. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient Hospital Services have a copay between $0 and $325, Observation Services have a $325 copay, Ambulatory Surgical Center Services have no copay, Outpatient Substance Abuse Individual Sessions have a copay between $0 and $25, Outpatient Substance Abuse Group Sessions have a $15 copay, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the plan, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) plan. Both ground and air ambulance services have a $275 copay and no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency services are covered, with a $140 copay. Urgently needed services have a copay between $0 and $65, and worldwide emergency services have no copay for emergency coverage, urgent coverage, or emergency transportation.
Primary Care See details
Primary Care Physician Services, Physician Specialist Services, and Additional Telehealth Benefits have no copay. Chiropractic Services have a $20 copay, while Occupational Therapy Services have a copay between $0 and $20. Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, and Opioid Treatment Program Services have varying copays, and Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $20. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services include no copay for the annual physical exam, along with no copay for Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. Fitness benefit, Remote Access Technologies, and Home and Bathroom Safety Devices and Modifications have copays. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, and Counseling Services are not covered.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and OTC hearing aids. Routine hearing exams have no copay, while fitting/evaluation for hearing aids is not covered. Prescription hearing aids have a copay between $199 and $1249, and OTC hearing aids have a copay between $99 and $829.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and eyewear has no copay. Contact lenses, eyeglass lenses, and eyeglass frames are covered, but eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with 20% coinsurance and other dental services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay, and some services have visit limits. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0-20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) plan, with a coinsurance between 20% and 20%. Prior authorization is required for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay. Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a $50 copay, lab services with no copay, and outpatient X-ray services with a $15 copay. Therapeutic Radiological Services have a 20% coinsurance, and Diagnostic Radiological Services have a copay of at most $100.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage Essentials from UHC MO-4 (HMO-POS) plan with no copay and no coinsurance, but Additional Hours of Care and Personal Care Services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. 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 MO-4 (HMO-POS) plan, with prior authorization required. 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
Other Services includes coverage for Over-the-Counter (OTC) Items and a Meal Benefit, with no copay for either benefit, and Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and additional services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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