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AARP Medicare Advantage from UHC NY-0028 (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-0028 (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-0028 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC NY-0028 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Kings, New York, and Queens counties. 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-0028 (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-0028 (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-0028 (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 $495.00 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 $8900.00 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-0028 (HMO-POS) plan has a $495.00 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, for a standard pharmacy, you will pay a $12 copay for tier 1 drugs, a $47 copay for tier 2 drugs, and a $100 copay for tier 3 drugs. Non-preferred drugs have a 27% coinsurance. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC NY-0028 (HMO-POS) plan offers comprehensive coverage with varying cost-sharing. This plan provides coverage for inpatient hospital stays, outpatient services, primary care, preventive services, hearing, vision, and dental services. Many services, like primary care visits, routine hearing and vision exams, and home health services, have no copay, while others, like inpatient hospital stays and specialist visits, have copays.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $395 for days 1-5 and no copay for days 6-90 for Inpatient Hospital-Acute. Additional days for Inpatient Hospital-Acute have no copay for days 91-999. Inpatient Hospital Psychiatric has a copay of $395 for days 1-4 and no copay for days 5-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $395, observation services have a $395 copay, ASC services have no copay, individual outpatient substance abuse sessions have a copay between $0 and $25, group outpatient substance abuse sessions have a $15 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered, 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 by the AARP Medicare Advantage from UHC NY-0028 (HMO-POS) plan. Ground and air ambulance services each have a $125 copay, with no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay, while Urgently Needed Services have a copay between $0 and $45; Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The AARP Medicare Advantage from UHC NY-0028 (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, and occupational therapy with a copay between $0 and $20. It also covers physician specialist services with a copay between $0 and $50, mental health specialty services and psychiatric services with varying copays, podiatry services with a $45 copay, and other health care professional services with a copay between $0 and $50. The plan also covers physical therapy and speech-language pathology services with a copay between $0 and $25, additional telehealth benefits with no copay, and opioid treatment program services with no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, while additional preventive services like health education, in-home safety assessments, and others are not covered. Kidney disease education services are covered with a $0 copay, and other preventive services, including glaucoma screenings and diabetes self-management training, have no copay.
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 partially covered, with a copay between $199 and $1249 for prescription hearing aids of all types, but inner ear, outer ear, and over-the-ear hearing aids are not covered. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision services include eye exams, eyewear, and contact lenses. Eye exams and routine eye exams have no copay, and eyewear has no copay. Contact lenses have no copay, while eyeglass lenses may have a copay between $0 and $153. Eyeglass frames have no copay. This plan does not cover eyeglasses (lenses and frames) or upgrades.
Dental Services See details
Dental Services are covered, with 20% coinsurance for Medicare Dental Services. Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Prosthodontics (fixed), and Oral and Maxillofacial Surgery are covered, but are optional, supplemental benefits. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC NY-0028 (HMO-POS) plan. There is a 20% coinsurance for this benefit, and prior authorization is required.
Medical Equipment See details
Medical Equipment is covered, including 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; Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by this plan. Diagnostic Procedures/Tests have a $25 copay, and Lab Services have no copay, while Diagnostic Radiological Services have a copay up to $150, and Therapeutic Radiological Services have 20% coinsurance.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC NY-0028 (HMO-POS) 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 under the AARP Medicare Advantage from UHC NY-0028 (HMO-POS) plan, but the specific sub-services listed are not covered. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include a meal benefit with no copay, but also include 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 which are not covered.
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