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AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Essentials from UHC WA-6 (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 Essentials from UHC WA-6 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC WA-6 (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 Essentials from UHC WA-6 (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 Essentials from UHC WA-6 (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 Essentials from UHC WA-6 (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 $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 $6300.00 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 Essentials from UHC WA-6 (HMO-POS) plan features an annual prescription drug deductible of $355. For Tier 1 preferred generic and Tier 2 generic medications, members pay no copay for 1-month and 3-month supplies at standard pharmacies and through standard mail order. This makes managing everyday prescriptions highly affordable under this plan. For higher-tier medications, costs are based on coinsurance rather than flat copayments. Tier 3 preferred brand drugs require a 19% coinsurance, while Tier 4 non-preferred drugs carry a 42% coinsurance. Additionally, Tier 5 specialty drugs require a 29% coinsurance for a 1-month supply through standard pharmacies or standard mail order.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) plan offers comprehensive medical coverage with many essential services featuring no copay and no coinsurance. Members enjoy no copay for primary care visits, annual physicals, preventive screenings, and home health services, while specialist visits carry a copay of $0 to $50. For hospital care, inpatient stays require a $455 daily copay for days 1 through 5 and no copay for subsequent days, while emergency room visits have a $130 copay. Routine dental, vision, and hearing exams are covered with no copay, although comprehensive dental care is not covered and prescription hearing aids require a copay. Diagnostic lab work and diagnostic radiology are also available with no copay, whereas medical equipment and dialysis services require a 20% coinsurance. Skilled nursing facility care is covered with no copay for the first 20 days, transitioning to a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) covers inpatient hospital stays with no coinsurance, requiring a $455 daily copay for days 1 to 5 and no copay for days 6 to 90. This benefit is partially covered, as unlimited additional acute care days are covered with no copay, while additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) with no coinsurance across all services, though prior authorization is required. There is no copay for ambulatory surgical center and outpatient blood services, while outpatient hospital services carry a $0 to $455 copay, observation services have a $455 daily copay, and outpatient substance abuse sessions feature a copay of $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) covers partial hospitalization with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS), with ground and air ambulance services requiring a $290 copay and no coinsurance. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) with a $130 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature a copay ranging from no copay to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits under the AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) plan feature no copay and no coinsurance for primary care visits, telehealth, and opioid treatment. Other covered services require no coinsurance, with copays ranging from $0 to $50 for specialists, $35 for physical, occupational, and speech therapies, and $45 for podiatry, while for chiropractic services, some services are covered but routine care and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) with no copay and no coinsurance for covered services like annual physical exams, fitness benefits, kidney disease education, and select screenings. Sub-services that are not covered under this plan include health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, home modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) with no deductible and no coinsurance. Routine exams have no copay, while covered OTC and prescription hearing aids have copays ranging from $199.00 to $1,249.00; however, fitting and evaluation exams, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) with no coinsurance, offering routine eye exams and eyeglass frames with no copay, and eyeglass lenses with a $0 to $153 copay. Covered eyewear, including contact lenses with no copay, has a combined maximum benefit of $300 every two years, though other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS), offering preventive care like exams, cleanings, and x-rays with no copay and no coinsurance. Medicare-covered dental services require no copay and 20% coinsurance, but comprehensive services—including restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics—are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, insulin, and other drugs, have a coinsurance ranging from 0% to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) covers durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes with no copay and 20% coinsurance. Diabetic supplies are also covered with no copay, and prior authorization is required for these equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) with no coinsurance, although prior authorization is required. Members pay no copay for lab services and diagnostic radiology, while diagnostic tests require a $5 copay, outpatient X-rays require a $15 copay, and therapeutic radiology services require a $50 copay.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no copay and no coinsurance under the AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) plan, subject to prior authorization. While some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior 3-day hospital stay is not required for admission, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS), featuring a meal benefit for chronic illnesses with no copay and no coinsurance, though prior authorization is required. Other sub-services, including Acupuncture and Over-the-Counter (OTC) items, are not covered under this plan.
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