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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 2026, 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 2026.
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.
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 $440.00 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:
Sign up for AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) plan has an annual prescription drug deductible of $440. Beneficiaries enjoy no copay for Tier 1 preferred generic and Tier 2 generic drugs for both 1-month and 3-month supplies through standard pharmacies and standard mail order. This ensures that essential everyday medications remain highly accessible and affordable. For brand-name and specialty prescriptions, costs are determined by coinsurance rates instead of flat copays. Tier 3 preferred brand drugs require a 19% coinsurance, Tier 4 non-preferred drugs have a 41% coinsurance, and Tier 5 specialty drugs carry a 28% coinsurance. These coinsurance percentages apply to standard pharmacy and standard mail-order fills.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) plan offers robust coverage with no copays for primary care visits, telehealth, and covered preventive services. For inpatient hospital stays, members pay a daily copay of $390 for the first five days and no copay for days six through 90, with no coinsurance required. Emergency room visits carry a $130 copay that is waived if admitted, while specialist visits require no copay or a copay up to $50. Routine vision and preventive dental services are covered with no copays, and the plan includes a $300 eyewear allowance every two years alongside covered annual hearing exams. Durable medical equipment, dialysis, and Medicare-covered dental services require a 20% coinsurance with no copays. Additionally, members pay no copays for diagnostic lab tests, home health services, and the first 20 days of skilled nursing facility care.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) covers inpatient hospital care with no coinsurance, requiring a $390 daily copay for days 1 through 5 and no copay for days 6 through 90. Unlimited additional acute care days are covered at no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered under the AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) plan with no coinsurance, though prior authorization is required for most treatments. Patients will pay no copay for ambulatory surgical center and blood services, while copays range from $0 to $390 for outpatient hospital services and $0 to $25 for outpatient substance abuse sessions.
Partial Hospitalization See details
AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) covers ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required. While some transportation services are covered, trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a copay ranging from $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 Essentials from UHC WA-8 (HMO-POS) offers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $50 copay and no coinsurance. Other professional benefits like therapy services have a $25 copay and no coinsurance, while chiropractic care is partially covered with a $10 copay for routine care and no coinsurance (other chiropractic services are not covered).
Preventive Services See details
AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) provides partially covered preventive services with no copay and no coinsurance for covered benefits such as annual physical exams, kidney disease education, and a fitness benefit. Non-covered sub-services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS), featuring one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids are covered up to two per year with a $199 to $1,249 copay and no coinsurance (excluding inner ear, outer ear, and over the ear types), while up to two OTC hearing aids are covered annually with a $199 to $829 copay and no coinsurance.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS), featuring one routine eye exam per year with no deductible, copay, or coinsurance. Up to $300 in eyewear is covered every two years with no deductible or coinsurance, including contact lenses and frames with no copay, and lenses with a copay of $0 to $153, while other eye exams, combined eyeglasses, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS), featuring Medicare-covered dental services with no copay and a 20% coinsurance, and preventive services like exams, cleanings, and X-rays with no copay and no coinsurance. Major dental treatments, including restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs feature no copay and ranging from no coinsurance to 20% coinsurance, while Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) covers durable medical equipment (DME), prosthetics, medical supplies, and diabetic therapeutic shoes with no copay and 20% coinsurance. Diabetic supplies are covered with no copay and no coinsurance, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Members pay no copay for lab services and diagnostic radiology, a $5 copay for diagnostic tests and outpatient X-rays, and a copay starting at $80 for therapeutic radiology services.
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, although prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) covers cardiac rehabilitation services with no copay and no coinsurance, though in practice only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage provided for additional days beyond the Medicare-covered limit.
Other Services See details
Other services under AARP Medicare Advantage Essentials from UHC WA-8 (HMO-POS) are partially covered, offering acupuncture for a $10.00 copay and no coinsurance up to 12 treatments per year, and chronic illness meal benefits with no copay and no coinsurance with prior authorization. Over-the-counter (OTC) items are not covered under this plan.
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