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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 2025, 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 2025.
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 $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 $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-0007 (HMO-POS) plan has a $340 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy used. For preferred generic drugs at a standard pharmacy, the copay is $8.00. Standard generic drugs have a $47.00 copay at a standard pharmacy. Preferred and standard brand drugs have a $100.00 copay. Non-preferred drugs have a 29% coinsurance. After your yearly out-of-pocket drug costs reach $2000, you will pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC NY-0007 (HMO-POS) plan offers a wide range of benefits, including coverage for inpatient and outpatient services, with varying copays for different services. Emergency services have a copay, and primary care, preventive, vision, and hearing services are covered. Dental services are covered with a coinsurance. Additional benefits include coverage for ambulance services, home infusion, and medical equipment, each with specific copays or coinsurance. The plan also covers diagnostic and radiological services, home health, cardiac rehabilitation, and skilled nursing facility services. The plan also offers over-the-counter (OTC) items and meal benefits with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $350 copay for days 1-5, and no copay for days 6-90; for additional days, there is no copay. For Inpatient Hospital Psychiatric services, you will pay a $350 copay for days 1-4, and no copay for days 5-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $350, Observation Services with a $350 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.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan with a $55 copay. Prior authorization is required for coverage.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground and Air Ambulance Services have a $270 copay, but 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-0007 (HMO-POS) plan, with a $110 copay for emergency services and a $0-$45 copay for urgently needed services. Worldwide emergency services, worldwide urgent coverage, and worldwide emergency transportation are covered with no copay.
Primary Care See details
Primary Care Physician services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered under the AARP Medicare Advantage from UHC NY-0007 (HMO-POS) plan. Chiropractic Services require prior authorization and have a $15 copay, while Routine Chiropractic Care is not covered. Occupational Therapy Services have a copay between $0 and $20, and Physician Specialist Services have a copay between $0 and $25. Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, and Psychiatric Services have varying copays depending on the specific services. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $20, and Additional Telehealth Benefits have no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay. Other preventive services such as health education, in-home safety assessments, and others are not covered.
Hearing Services See details
The AARP Medicare Advantage from UHC NY-0007 (HMO-POS) plan covers hearing exams with no copay, routine hearing exams with no copay, and OTC hearing aids with a copay between $99 and $829; however, fitting/evaluation for hearing aids, and Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered. Prescription Hearing Aids (all types) have a copay between $199 and $1249.
Vision Services See details
Vision services include eye exams with no copay, routine eye exams with no copay, contact lenses with no copay, eyeglass lenses with a copay between $0 and $153, and eyeglass frames with no copay. 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, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Maxillofacial Prosthetics, and Oral and Maxillofacial Surgery have no copay, while Prosthodontics, removable and Prosthodontics, fixed have a coinsurance between 0% and 50%. Implant Services 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 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 with prior authorization, and require a 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment, including Diabetic Supplies with no copay and Medicare-covered Diabetic Therapeutic Shoes or Inserts with 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a $20 copay, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $220, Therapeutic Radiological Services with a copay up to $30, and Outpatient X-Ray Services with a $5 copay. Prior authorization is required for all services.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC NY-0007 (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not the sub-services: 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, and there is a copay for the covered services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC NY-0007 (HMO-POS) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items with no copay, and Meal Benefits with no copay and requires prior authorization; however, acupuncture, 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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