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AARP Medicare Advantage from UHC WA-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 WA-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 WA-0005 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC WA-0005 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Washington. 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 WA-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 WA-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 WA-0005 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $38.00. 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 $355.00 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 $5900.00 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 WA-0005 (HMO-POS) plan features an annual drug deductible of $355. For Tier 1 preferred generic and Tier 2 generic medications, members pay no copay for one-month and three-month supplies at standard pharmacies and standard mail order. This provides an affordable option for individuals relying primarily on generic prescription drugs. For brand-name and specialty medications, costs are based on coinsurance percentages rather than flat copays. Tier 3 preferred brand drugs require a 20% coinsurance, Tier 4 non-preferred drugs require a 42% coinsurance, and Tier 5 specialty drugs have a 29% coinsurance through standard pharmacies and mail order. These cost-sharing details help you accurately project your yearly out-of-pocket prescription costs.
Additional Benefits
The AARP Medicare Advantage from UHC WA-0005 (HMO-POS) plan offers affordable coverage with many essential services requiring no copay and no coinsurance. Members pay no copay for primary care doctor visits, annual physicals, routine eye and hearing exams, and home health care. Specialist visits and diagnostic lab services are also highly accessible, featuring low to no copays and no coinsurance. For emergency services and hospital stays, the plan utilizes predictable copays rather than coinsurance, such as a one hundred thirty dollar copay for emergency room visits and a four hundred ninety-five dollar daily copay for the first few days of an inpatient stay. Other medical needs, including dialysis and durable medical equipment, require a twenty percent coinsurance with no copay.
Inpatient Hospital See details
AARP Medicare Advantage from UHC WA-0005 (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $495 copay for days 1-5 of an acute stay or days 1-4 of a psychiatric stay, and no copay for subsequent covered days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC WA-0005 (HMO-POS) with no coinsurance, though prior authorization is required. Patients will pay no copay for ambulatory surgical center and outpatient blood services, while outpatient hospital copays range from $0 to $495, observation services cost $495 per day, and outpatient substance abuse sessions require a copay of $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC WA-0005 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC WA-0005 (HMO-POS) covers ground and air ambulance services with a $290 copay and no coinsurance, subject to prior authorization. For transportation services, 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 WA-0005 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $50 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 WA-0005 (HMO-POS) offers primary care physician services, telehealth, and opioid treatment with no copay and no coinsurance. Specialist visits, physical and occupational therapy, and mental health services require copays ranging from $0 to $40 and no coinsurance, while chiropractic care is partially covered because other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage from UHC WA-0005 (HMO-POS) with no copay and no coinsurance for covered services like annual physicals, fitness benefits, kidney education, and routine screenings. However, several sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC WA-0005 (HMO-POS), featuring one annual routine hearing exam with no copay and no coinsurance, though 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, excluding inner ear, outer ear, and over-the-ear models, while up to two OTC hearing aids are covered with a $199 to $829 copay and no coinsurance.
Vision Services See details
AARP Medicare Advantage from UHC WA-0005 (HMO-POS) offers partially covered vision services with no deductibles, including one annual routine eye exam with no copay and no coinsurance. Covered eyewear includes contact lenses and frames with no copay, and lenses with a $0 to $153 copay, up to a $300 limit every two years with no coinsurance, though other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services are partially covered by the AARP Medicare Advantage from UHC WA-0005 (HMO-POS) plan, which features no copay and no coinsurance for preventive care like cleanings, exams, and x-rays, and no copay with a 20% coinsurance for Medicare-covered dental services. Comprehensive dental treatments, including restorative, endodontics, periodontics, prosthodontics, implants, orthodontics, and oral surgery, are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC WA-0005 (HMO-POS) with no copay and require prior authorization. Under this benefit, Part B insulin drugs have a $35 copay and coinsurance ranging from no coinsurance to 20%, while chemotherapy and other Part B drugs carry no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC WA-0005 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC WA-0005 (HMO-POS), featuring no copay and a 20% coinsurance for durable medical equipment (DME), prosthetics, and medical supplies. Covered diabetic supplies also feature no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC WA-0005 (HMO-POS) with no coinsurance, though prior authorization is required. Under this plan, there is no copay for lab services and diagnostic radiology, while diagnostic procedures and tests cost $25, outpatient X-rays cost $30, and therapeutic radiology services require a minimum copay of $80.
Home Health Services See details
Home health services are covered by AARP Medicare Advantage from UHC WA-0005 (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC WA-0005 (HMO-POS) covers Cardiac Rehabilitation Services with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered in practice.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC WA-0005 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. You will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC WA-0005 (HMO-POS) partially covers other services, featuring acupuncture for a $10.00 copay and no coinsurance up to 12 treatments yearly, and a meal benefit for chronic illness with no copay, no coinsurance, and prior authorization required. Over-the-counter (OTC) items are not covered under this plan.
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