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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 2025, 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 2025.
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 $59.00. 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 $420.00 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 $7900.00 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 has an enhanced alternative drug benefit. The plan has a $420 deductible. In the initial coverage phase, after the deductible is met, you will pay a copay for your prescriptions. For example, you'll pay a $12 copay for standard generic drugs. For preferred brand drugs, you'll pay a $100 copay. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC NY-0005 (HMO-POS) plan offers a range of benefits with varying cost-sharing. Many services, such as primary care visits, preventive services, hearing exams, vision exams, and home health services, are available with no copay. Hospital stays have a copay, and outpatient and specialist services have copays that vary. Other services like ambulance, emergency care, and dental services also have copays or coinsurance, so it's important to review the specific costs for the services you need. The plan also covers home infusion, medical equipment, and diagnostic services with varying cost-sharing.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, there is a $390 copay for days 1-5, and no copay for days 6-90, with no coinsurance; additional days 91-999 have no copay. Inpatient Hospital Psychiatric services have a $390 copay for days 1-4, and no copay for days 5-90, with no coinsurance. Non-Medicare-covered stays and upgrades for both services are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $390, Observation Services with a $390 copay, Ambulatory Surgical Center (ASC) Services with no copay, Individual Sessions for Outpatient Substance Abuse with a copay between $0 and $25, Group Sessions for Outpatient Substance Abuse with a $15 copay, and Outpatient Blood Services with no copay. All services require prior authorization.
Partial Hospitalization See details
Partial Hospitalization is covered under the AARP Medicare Advantage from UHC NY-0005 (HMO-POS) plan, but requires prior authorization. You will pay a $55 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC NY-0005 (HMO-POS) plan, with prior authorization required for all ambulance services. Ground and Air Ambulance Services have a $275 copay, and there is no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by the AARP Medicare Advantage from UHC NY-0005 (HMO-POS) plan, with a $110 copay for emergency services, and no coinsurance. Urgently Needed Services have a copay between $0 and $45 with no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are also covered, each with no copay and no coinsurance.
Primary Care See details
The AARP Medicare Advantage from UHC NY-0005 (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, and occupational therapy services with a copay between $0 and $25. Physician specialist services have a copay between $0 and $50, and mental health specialty services have a copay between $0 and $25 for individual sessions and $15 for group sessions. Podiatry services have a $45 copay, and other health care professionals have a copay between $0 and $50. Psychiatric services have a copay between $0 and $25 for individual sessions and $15 for group sessions. Physical therapy and speech-language pathology services have a copay between $0 and $40, and additional telehealth benefits have no copay. Opioid treatment program services have no copay.
Preventive Services See details
Preventive services are covered, including an annual physical exam with no copay, and additional services like Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following a Welcome Visit, all with no copay. However, Health Education, In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, and other services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year with no copay. Prescription hearing aids are covered with a copay between $199 and $1249, and over-the-counter hearing aids are covered with a copay between $99 and $829. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Vision Services include eye exams with no copay, and eyewear benefits. Eyewear includes contact lenses, eyeglass lenses and eyeglass frames with no copay, while eyeglass frames are limited to one every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. However, orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Insulin and other Medicare Part B drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and the coinsurance is between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC NY-0005 (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with varying cost sharing. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a $25 copay for diagnostic procedures and tests, and no copay for lab services. Radiological services include coverage for diagnostic and therapeutic radiological services, with a copay of up to $150 for diagnostic radiological services and a 20% coinsurance for therapeutic radiological services, as well as a $15 copay for outpatient X-ray services.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage from UHC NY-0005 (HMO-POS) plan with no copay and no coinsurance, however, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the AARP Medicare Advantage from UHC NY-0005 (HMO-POS) plan, but the plan does not cover any of the sub-services including Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC NY-0005 (HMO-POS) plan, with a $0 copay for days 1-20 and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services includes a meal benefit with no copay, but acupuncture, over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, 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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