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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 2025, 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 2025.
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 $27.00. 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 $255.00 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 $5500.00 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 has a $255.00 deductible for prescription drugs. After the deductible is met, you will pay the following costs for your medications. For preferred generic drugs, you will have no copay at the standard pharmacy. For standard generic drugs, the copay is $47.00. For preferred and standard brand drugs, the copay is $100.00. For non-preferred drugs, you will pay 30% coinsurance. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC WA-0005 (HMO-POS) plan offers a variety of benefits with a focus on outpatient and preventative services. This plan includes no copay for primary care physician visits and many preventive services, as well as routine vision and hearing exams. Inpatient hospital stays have a copay, as do emergency services, while ambulance services have a $275 copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered with prior authorization. For acute care, there is a $475 copay for days 1-5, and no copay for days 6-90, with additional days 91-999 at no copay. Psychiatric care has a $475 copay for days 1-4, and no copay for days 5-90.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $475, observation services with a $475 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC WA-0005 (HMO-POS) plan. You will have a $55 copay for this benefit.
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 each have a $275 copay and no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services from AARP Medicare Advantage from UHC WA-0005 (HMO-POS) include a $125 copay for emergency services, no copay for urgently needed services with a copay between $0 and $55, and no copay for worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation. There is no coinsurance for any of these services.
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. Chiropractic Services, Podiatry Services, and Additional Telehealth Benefits require prior authorization. Primary Care Physician Services have no copay. Chiropractic Services have a $10 copay. Occupational Therapy Services have a copay of $0-$40. Physician Specialist Services have a $0-$40 copay. Mental Health Specialty Services have a copay of $0-$25 for individual sessions and $15 for group sessions. Podiatry Services have a $40 copay. Other Health Care Professional services have a $0-$40 copay. Psychiatric Services have a copay of $0-$25 for individual sessions and $15 for group sessions. Physical Therapy and Speech-Language Pathology Services have a $0-$40 copay. Additional Telehealth Benefits have no copay. Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive services include coverage for Medicare-covered services with no copay, annual physical exams with no copay, and additional preventive services, which include Medicare-covered Glaucoma Screening, Medicare-covered Diabetes Self-Management Training, Medicare-covered Barium Enemas, Medicare-covered Digital Rectal Exams, and Medicare-covered EKG following Welcome Visit with no copay. Other preventive services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered. Alternative therapies have a $10 copay. Fitness benefits have no copay. Kidney Disease Education Services have no copay.
Hearing Services See details
The AARP Medicare Advantage from UHC WA-0005 (HMO-POS) plan covers hearing exams with no copay, and covers routine hearing exams annually. Prescription hearing aids are covered with a copay between $199 and $1249, while OTC hearing aids have a copay between $99 and $829. Fitting/Evaluation for Hearing Aids, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
The AARP Medicare Advantage from UHC WA-0005 (HMO-POS) plan covers vision services, including routine eye exams and eyewear. Routine eye exams and contact lenses have no copay, while eyeglass lenses have a copay between $0 and $153. Eyeglass frames also have no copay, and a combined maximum of $200 is covered for all eyewear every two years.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with 20% coinsurance and Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services with no copay. 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 Medicare Part B Insulin Drugs. For Medicare Part B Insulin Drugs, you will pay a $35 copay, and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC WA-0005 (HMO-POS) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and no copay, and Prosthetic Devices, with 20% coinsurance and no copay. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 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 under the AARP Medicare Advantage from UHC WA-0005 (HMO-POS) plan. Diagnostic Procedures/Tests have a $25 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $250, Therapeutic Radiological Services have a copay of $80 or more, and Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC WA-0005 (HMO-POS) plan with no copay and no coinsurance; however, additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required for this benefit, and the copay information is available in the plan details.
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.
Other Services See details
Other Services includes acupuncture with a $10 copay per visit for up to 12 treatments per year, and meal benefits with no copay. 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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