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AARP Medicare Advantage from UHC NY-0007 (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-0007 (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-0007 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC NY-0007 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in New York. 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-0007 (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-0007 (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-0007 (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 $8300.00 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-0007 (HMO-POS) plan features an annual drug deductible of $440. Tier 1 preferred generic drugs offer excellent savings with no copay for standard pharmacy fills and three-month mail orders. Tier 2 generic drugs carry an $8.00 copay for a one-month supply at standard pharmacies, but they feature no copay when ordered as a three-month supply through preferred mail order. For brand-name and specialty medications, costs are structured as coinsurance during the initial coverage phase. Tier 3 preferred brand drugs require an 18% coinsurance, while Tier 5 specialty drugs carry a 28% coinsurance for a one-month supply. Tier 4 non-preferred drugs have the highest cost-sharing tier with a 41% coinsurance across standard pharmacies and mail-order services.
Additional Benefits
The AARP Medicare Advantage from UHC NY-0007 (HMO-POS) plan offers comprehensive medical coverage with no copay for primary care, telehealth, and preventive services. Specialist visits range from no copay to a $35 copay, while emergency room visits require a $115 copay that is waived if you are admitted. Hospital stays and outpatient procedures are covered with no coinsurance, though inpatient admissions require a $455 daily copay for the first few days before transitioning to no copay. This plan also includes valuable everyday health benefits, featuring no copay for routine vision exams, a $300 biennial eyewear allowance, and up to $1,500 in preventive dental care with no copay. Routine hearing exams are also provided with no copay, while prescription hearing aids require copays starting at $199. For recovery and support, home health services feature no copay, skilled nursing facilities offer no copay for the first 20 days, and medical equipment is covered with a 20 percent coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC NY-0007 (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $455 daily copay for days 1-5 of acute stays and days 1-4 of psychiatric stays, followed by no copay for subsequent days. Additional days for psychiatric stays, upgrades, and non-Medicare-covered stays are not covered under this plan.
Outpatient Services See details
AARP Medicare Advantage from UHC NY-0007 (HMO-POS) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $455 copay and observation services with a $455 daily copay. Ambulatory surgical center and blood services have no copay and no coinsurance, while outpatient substance abuse sessions have no coinsurance and copays ranging from no copay to $25.
Partial Hospitalization See details
Partial hospitalization services are covered by AARP Medicare Advantage from UHC NY-0007 (HMO-POS) 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-0007 (HMO-POS) covers ground and air ambulance services with a $275 copay and no coinsurance, although prior authorization is required. Routine transportation services to health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC NY-0007 (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 no copay to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC NY-0007 (HMO-POS) features primary care and telehealth services with no copay and no coinsurance. Specialist visits range from a $0 to $35 copay, therapy services require a $30 copay, and podiatry costs a $35 copay, all with no coinsurance, though routine chiropractic care is not covered.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage from UHC NY-0007 (HMO-POS) with no copay and no coinsurance for covered services like annual physical exams, fitness benefits, and kidney disease education. However, several supplemental services are not covered, including health education, weight management programs, personal emergency response systems, and in-home support services.
Hearing Services See details
AARP Medicare Advantage from UHC NY-0007 (HMO-POS) partially covers hearing services, featuring one annual routine hearing exam with no copay and no coinsurance, although fitting and evaluation exams are not covered. Up to two prescription hearing aids per year are covered with a $199 to $1,249 copay and no coinsurance, and up to two OTC hearing aids are covered with a $199 to $829 copay and no coinsurance, but inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC NY-0007 (HMO-POS), featuring no coinsurance and no copay for annual routine eye exams and select eyewear, though other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered. The plan provides a $300 eyewear allowance every two years with no copay for contact lenses or frames, while eyeglass lenses require a copay of $0 to $153.
Dental Services See details
AARP Medicare Advantage from UHC NY-0007 (HMO-POS) offers partially covered dental services, featuring no copay and no coinsurance for preventive care up to a $1,500 annual limit. Medicare-covered dental services require no copay and 20% coinsurance, while covered comprehensive services require no copay and 50% coinsurance, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC NY-0007 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
AARP Medicare Advantage from UHC NY-0007 (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
AARP Medicare Advantage from UHC NY-0007 (HMO-POS) covers durable medical equipment, prosthetics, and diabetic supplies with no copay and a 20% coinsurance. Prior authorization is required for these services, and diabetic therapeutic shoes or inserts are also covered with a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC NY-0007 (HMO-POS) with prior authorization. Diagnostic tests require a $50 copay and no coinsurance, lab and diagnostic radiological services have no copay, and outpatient X-rays require a $30 copay, while therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
AARP Medicare Advantage from UHC NY-0007 (HMO-POS) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these benefits.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are provided by AARP Medicare Advantage from UHC NY-0007 (HMO-POS) with no coinsurance and require prior authorization. Although some services are covered, standard cardiac, intensive cardiac, pulmonary (with a $15 copay), and SET for PAD (with a $15 copay) services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC NY-0007 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 copay for days 21 through 100, though additional days beyond the Medicare-covered period are not covered.
Other Services See details
Other services covered by AARP Medicare Advantage from UHC NY-0007 (HMO-POS) include over-the-counter (OTC) items and a chronic illness meal benefit 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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