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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 2025, 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 2025.
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. Additionally, this plan comes with a Part B Premium reduction of $9.00. You must continue to pay paying your reduced 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 $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:
Sign up for AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) plan has a $255 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 preferred generic drugs at a standard pharmacy, there is no copay, and for standard generic drugs, the copay is $47.00. The copay for preferred brand drugs is $100.00, and non-preferred drugs have 30% coinsurance.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) plan offers a range of benefits with varying costs. This plan covers inpatient hospital stays with a copay, as well as outpatient services with copays. It also includes coverage for primary care, preventive services, hearing, vision, and dental, with many services having no copay. The plan also covers ambulance services, emergency services, and home health services. Additionally, it provides coverage for skilled nursing facilities, diagnostic and radiological services, and medical equipment with copays or coinsurance. Certain services such as hearing exams, eye exams, and some dental services have no copay.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, there is a $390 copay for days 1-5, and no copay for days 6-90, and for Inpatient Hospital Psychiatric, there is a $390 copay for days 1-5, and no copay for days 6-90. Additional Days for Inpatient Hospital-Acute are covered with no copay for days 91-999. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a copay between $0 and $390, observation services with a $390 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a $55 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) plan, with a $125 copay for both ground and air ambulance services and 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. For Emergency Services, there is a $90 copay and no coinsurance; for Urgently Needed Services, the copay is between $0 and $30, and there is no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services are covered with a $20 copay, but Routine Chiropractic Care is not covered. Occupational Therapy Services are covered with a copay between $0 and $35. Physician Specialist Services are covered with a copay between $0 and $45. Mental Health Specialty Services have a copay, with individual sessions ranging from $0 to $25 and group sessions costing $15. Podiatry Services are covered with a $40 copay, with 6 visits per year for routine foot care. Other Health Care Professional services are covered with a copay between $0 and $45. Psychiatric Services have a copay, with individual sessions ranging from $0 to $25 and group sessions costing $15. Physical Therapy and Speech-Language Pathology Services are covered with a copay between $0 and $40. Additional Telehealth Benefits have no copay. Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services include Medicare-covered services with no copay, and additional preventive services. The plan covers an annual physical exam with no copay. Other services like Health Education, In-Home Safety Assessment, and Personal Emergency Response System (PERS) are not covered.
Hearing Services See details
Hearing services include coverage for hearing exams with no copay, routine hearing exams with no copay, and OTC hearing aids with a copay between $99 and $829. Prescription hearing aids are partially covered, with a copay between $199 and $1249, but the plan does not cover fitting/evaluation for hearing aids, or prescription hearing aids for inner ear, outer ear, or over the ear.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, all with no copay, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered by the AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) plan, with a 20% coinsurance for Medicare Dental Services and no copay for oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services. Orthodontic, restorative, adjunctive general, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) plan, with prior authorization required. Insulin has a $35 copay and a coinsurance between 0-20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) plan. You will pay a 20% coinsurance for these services, and prior authorization is required.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a $20 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $150, Therapeutic Radiological Services have a copay of at most $50, and Outpatient X-Ray Services have a $5 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Essentials from UHC WA-6 (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 specific services of 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 the copay will vary.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Essentials from UHC WA-6 (HMO-POS) plan. You will have no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
Other Services includes a meal benefit with no copay, but 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 are not covered.
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