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AARP Medicare Advantage from UHC WA-0009 (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-0009 (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-0009 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC WA-0009 (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 from UHC WA-0009 (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-0009 (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-0009 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $28.00. 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 $4200.00 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-0009 (HMO-POS) plan has an annual prescription drug deductible of $355. For Tier 1 preferred generic and Tier 2 generic drugs, members pay no copay for one-month or three-month supplies at standard pharmacies and through standard mail order. This ensures that essential, everyday generic medications remain highly accessible and affordable. For brand-name and specialty prescriptions, costs are determined by coinsurance percentages. Tier 3 preferred brand drugs require a 21% coinsurance, Tier 4 non-preferred drugs require 42% coinsurance, and Tier 5 specialty drugs carry a 29% coinsurance. These coinsurance rates apply to standard pharmacy fills and standard mail-order services where applicable.
Additional Benefits
The AARP Medicare Advantage from UHC WA-0009 (HMO-POS) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, telehealth, home health services, and annual preventive exams. Inpatient hospital stays require a $350 daily copay for the first five days and no copay for days six through 90, while emergency room visits carry a $150 copay that is waived upon admission. Many outpatient services, diagnostic lab tests, and diabetic supplies are also covered with no copay, helping members manage their routine health needs affordably. For supplemental care, members enjoy no copay for routine vision exams and preventive dental cleanings, though comprehensive dental services are not covered under this plan. Hearing aids require copays starting at $199, while durable medical equipment and dialysis services generally require a 20% coinsurance with no copay. Skilled nursing facility stays are also covered with no copay for the first 20 days, followed by a $218 daily copay up to day 100.
Inpatient Hospital See details
AARP Medicare Advantage from UHC WA-0009 (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $350 daily copay for days 1-5 and no copay for days 6-90. While acute stays include unlimited additional days at no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC WA-0009 (HMO-POS) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copays. Outpatient hospital and observation services have copays ranging from $0 to $350, while outpatient substance abuse individual and group sessions have copays from $0 to $25.
Partial Hospitalization See details
Partial hospitalization is covered under the AARP Medicare Advantage from UHC WA-0009 (HMO-POS) plan with a $55.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by AARP Medicare Advantage from UHC WA-0009 (HMO-POS), offering ground and air ambulance services for a $275 copay and no coinsurance. Although transportation services are technically covered, transport to plan-approved or health-related locations is not covered in practice.
Emergency Services See details
AARP Medicare Advantage from UHC WA-0009 (HMO-POS) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay of up to $65 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care and specialist services are covered by AARP Medicare Advantage from UHC WA-0009 (HMO-POS), featuring no copay and no coinsurance for primary care and telehealth. Other benefits like therapy, mental health, and specialist visits require copays ranging from $0 to $35 with no coinsurance, while chiropractic services are partially covered with a $10 copay for routine care and no coverage for other chiropractic services.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage from UHC WA-0009 (HMO-POS) with no copay and no coinsurance, including annual physical exams, kidney disease education, diabetes training, and fitness benefits. This benefit is partially covered, as several additional services such as health education, medical nutrition therapy, and in-home safety assessments are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC WA-0009 (HMO-POS), featuring one annual routine hearing exam with no copay and no coinsurance, while fitting and evaluation exams are not covered. Up to two prescription hearing aids per year are covered with a $199 to $1,249 copay and no coinsurance, and up to two OTC hearing aids are available with a $199 to $829 copay and no coinsurance. However, inner ear, outer ear, and over-the-ear prescription hearing aid types are excluded from coverage.
Vision Services See details
Vision Services through AARP Medicare Advantage from UHC WA-0009 (HMO-POS) are partially covered with no coinsurance, offering one annual routine eye exam and eyeglass frames with no copay, plus eyeglass lenses with a $0 to $153 copay up to a $300 combined limit every two years. Contact lenses are also covered with no copay, while other eye exams, upgrades, and combined eyeglasses packages are not covered.
Dental Services See details
Dental services are partially covered under the AARP Medicare Advantage from UHC WA-0009 (HMO-POS) plan, offering preventive care like cleanings, exams, and x-rays with no copay and no coinsurance. Medicare-covered dental services are available with no copay and a 20% coinsurance, but comprehensive services including restorative treatments, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC WA-0009 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs require between no coinsurance and 20% coinsurance, while Part B insulin is covered with a $35 copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC WA-0009 (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
AARP Medicare Advantage from UHC WA-0009 (HMO-POS) covers durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts with no copay and 20% coinsurance. Diabetic supplies are covered with no copay and no coinsurance from specified manufacturers, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under AARP Medicare Advantage from UHC WA-0009 (HMO-POS) with prior authorization required. Members pay no copay and no coinsurance for lab services, a $50 copay with no coinsurance for diagnostic procedures, copays starting at $0 with no coinsurance for diagnostic radiology, a $30 copay for X-rays, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home health services are covered under the AARP Medicare Advantage from UHC WA-0009 (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC WA-0009 (HMO-POS) offers coverage for some cardiac rehabilitation services with no copay and no coinsurance, though prior authorization is required. However, specific sub-services including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC WA-0009 (HMO-POS) covers skilled nursing facility services with no coinsurance and no prior three-day hospital stay required. You will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with prior authorization required and no coverage for days beyond the Medicare-covered limit.
Other Services See details
AARP Medicare Advantage from UHC WA-0009 (HMO-POS) covers acupuncture with a $10.00 copay and no coinsurance for up to 12 treatments per year. Over-the-counter items and chronic illness meal benefits are also covered with no copay and no coinsurance, though the meal benefit requires prior authorization.
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