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AARP Medicare Advantage Essentials from UHC WA-8 (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-8 (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-8 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Spokane County. 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-8 (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-8 (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-8 (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 $3.00. 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 $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 Essentials from UHC WA-8 (HMO-POS) plan has a $255 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier. For example, you'll pay no copay for preferred generic drugs at a standard pharmacy. For standard generic drugs, the copay is $47, while preferred brand drugs have a $100 copay. Non-preferred drugs have a 30% coinsurance. Once your out-of-pocket drug costs reach $2000, you will enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) plan offers a range of benefits with varying cost-sharing. This plan includes coverage for inpatient hospital stays, outpatient services, and emergency services, with copays ranging from $0 to $390 depending on the service. You'll also find coverage for preventive services, primary care, vision, hearing, and dental services, with many of these having no copay. In addition to the above, this plan provides coverage for home health services, skilled nursing facilities, and home infusion bundled services with specific copays or coinsurance amounts. The plan also covers medical equipment, diagnostic and radiological services, and ambulance services, with a few services requiring prior authorization. However, there are some services that are not covered, such as cardiac rehabilitation, and additional hours of care, so be sure to check the details of the plan.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered. For acute care, you'll pay a $390 copay for days 1-4, and no copay for days 5-90, with additional days covered with no copay; psychiatric care has the same cost-sharing structure.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay ranging from $0 to $390, and observation services with a $390 copay. Ambulatory Surgical Center (ASC) Services and outpatient blood services have no copay, and outpatient substance abuse services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered under the AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, 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 are covered under the AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) plan. Emergency services have a $90 copay, and urgently needed services have a copay between $0 and $30, while worldwide emergency services have a copay, depending on the service.
Primary Care See details
AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) covers primary care services with no copay, chiropractic services with a $10 copay, occupational therapy services with a copay between $0 and $20, and physician specialist services with a copay between $0 and $35. Mental health, podiatry, and other services have varying copays. Additional telehealth benefits are covered with no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services with no copay, and annual physical exams with no copay. Additional preventive services, including alternative therapies, have a $10 copay.
Hearing Services See details
Hearing exams are covered with no copay, but fitting/evaluation for hearing aids are not covered. Prescription hearing aids are covered with a copay between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision services include eye exams, eyewear, contact lenses, eyeglass lenses, and eyeglass frames. Eye exams and eyewear have no copay, contact lenses and eyeglass frames have no copay, and eyeglass lenses have a copay of $0-$153. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services, with no copay. Medicare Dental Services are covered with a 20% coinsurance, while 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 and require prior authorization, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, as well as Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) plan, but prior authorization is required. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered, with Durable Medical Equipment (DME) requiring 20% coinsurance and Prosthetic Devices also requiring 20% coinsurance. Medical Supplies and Diabetic Supplies have no copay, with a 20% coinsurance for Medical Supplies and Diabetic Therapeutic Shoes/Inserts also have 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for Diagnostic Procedures/Tests with a $25 copay, and Lab Services with no copay. Diagnostic Radiological Services have a maximum copay of $150, Therapeutic Radiological Services have a minimum copay of $80, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage Essentials from UHC WA-8 (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 not covered by the AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) plan. Specifically, 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 are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) plan. 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 coverage for acupuncture, with a $10 copay, and a meal benefit with no copay, but other services like over-the-counter items, and several other services, are not covered. Acupuncture is limited to 12 treatments per year.
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