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AARP Medicare Advantage from UHC NY-0005 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NY-0005 (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 from UHC NY-0005 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC NY-0005 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in New York City Metro Area. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC NY-0005 (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 from UHC NY-0005 (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 from UHC NY-0005 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $82.00. 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 $9250.00 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 from UHC NY-0005 (HMO-POS) plan features an annual drug deductible of $520. Under this plan, Tier 1 preferred generic drugs are highly affordable, requiring no copay for 1-month or 3-month fills at standard pharmacies and through mail order. Tier 2 generic drugs have a $12 copay for a 1-month supply at standard pharmacies, though you can save with no copay for a 3-month supply using preferred mail order. For higher-tier medications, costs shift to coinsurance. Tier 3 preferred brand drugs require a 16% coinsurance for both 1-month and 3-month supplies. Tier 4 non-preferred drugs carry a 33% coinsurance for a 1-month supply, while Tier 5 specialty drugs require a 27% coinsurance.
Additional Benefits
The AARP Medicare Advantage from UHC NY-0005 (HMO-POS) plan offers comprehensive coverage for essential medical services with predictable out-of-pocket costs. Beneficiaries enjoy no copay for primary care visits, preventive services, and home health care, while specialist visits require a copay of up to $55. For major medical needs, inpatient hospital stays require a daily copay of $485 for the first few days with no coinsurance, and emergency room visits carry a $115 copay. Routine vision and preventive dental services are covered with no copay, though comprehensive dental is not covered and Medicare-covered dental requires a 20% coinsurance. Routine hearing exams also feature no copay, while prescription hearing aids require copays ranging from $199 to $1,249. Durable medical equipment and dialysis services require a 20% coinsurance with no copay, helping you manage your healthcare expenses.
Inpatient Hospital See details
AARP Medicare Advantage from UHC NY-0005 (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $485 daily copay for days 1 to 5 of acute stays (no copay for days 6 and beyond) and days 1 to 4 of psychiatric stays (no copay for days 5 to 90). This benefit is partially covered, as prior authorization is required, and upgrades or non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC NY-0005 (HMO-POS) with no coinsurance for all services. Patients pay no copay for ambulatory surgical center and blood services, a copay of $0 to $485 for outpatient hospital and daily observation services, and a copay of $0 to $25 for outpatient substance abuse services.
Partial Hospitalization See details
Partial hospitalization is covered by the AARP Medicare Advantage from UHC NY-0005 (HMO-POS) plan with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC NY-0005 (HMO-POS) covers ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. For transportation, some services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC NY-0005 (HMO-POS) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay ranging from $0 to $40 with no coinsurance, and worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC NY-0005 (HMO-POS) covers primary care, telehealth, and opioid treatment services with no copay and no coinsurance, while specialist visits require a $0 to $55 copay and no coinsurance. Other benefits like physical, occupational, mental health, and podiatry services have copays ranging from $0 to $55 with no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage from UHC NY-0005 (HMO-POS) with no copay and no coinsurance for covered benefits like annual physical exams, kidney disease education, and a fitness benefit. However, the plan only partially covers additional preventive services, excluding options such as health education, weight management programs, and personal emergency response systems.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC NY-0005 (HMO-POS), offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams as well as inner, outer, and over-the-ear prescription hearing aids are not covered. Covered prescription hearing aids have a copay ranging from $199.00 to $1,249.00, and OTC hearing aids have a copay of $199.00 to $829.00 (limit of 2 per year for each), with no coinsurance required for either.
Vision Services See details
AARP Medicare Advantage from UHC NY-0005 (HMO-POS) offers partially covered vision services with no deductibles, featuring no copay and no coinsurance for annual routine eye exams, contact lenses, and eyeglass frames. Eyeglass lenses are covered with a $0 to $153 copay and no coinsurance up to a $300 combined limit every two years, while other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC NY-0005 (HMO-POS) partially covers dental services, offering Medicare-covered dental with no copay and a 20% coinsurance, and preventive services like cleanings and exams with no copay and no coinsurance. Comprehensive dental services, including restorative work, endodontics, periodontics, prosthodontics, implants, and oral surgery, are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC NY-0005 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B drugs associated with these services, including insulin and chemotherapy, carry a 0% to 20% coinsurance, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC NY-0005 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
AARP Medicare Advantage from UHC NY-0005 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for most equipment.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC NY-0005 (HMO-POS) covers diagnostic and radiological services, with prior authorization required. There is no copay or coinsurance for lab services and diagnostic radiology, while diagnostic tests require a $45 copay, outpatient X-rays require a $30 copay, and therapeutic radiology requires 20% coinsurance.
Home Health Services See details
Home health services are covered by AARP Medicare Advantage from UHC NY-0005 (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are not covered by AARP Medicare Advantage from UHC NY-0005 (HMO-POS), as all individual sub-services, including pulmonary, intensive cardiac, and SET for PAD rehabilitation, are excluded from coverage.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC NY-0005 (HMO-POS) partially covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. Patients pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though any additional days beyond the 100-day limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC NY-0005 (HMO-POS) partially covers other services, offering a meal benefit for chronic illness with no copay and no coinsurance, subject to prior authorization. Acupuncture and Over-the-Counter (OTC) items are not covered.
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