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AARP Medicare Advantage Essentials from UHC OR-4 (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 OR-4 (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 OR-4 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Oregon. 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 OR-4 (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 OR-4 (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 OR-4 (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 $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 $4500.00 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 OR-4 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan has a $255 deductible for prescription drugs. After the deductible, you'll pay different copays or coinsurance amounts depending on the drug tier and pharmacy you use. For example, you may pay a $0 copay for a standard generic drug, a $47 copay for a standard generic drug, or 30% coinsurance for a non-preferred drug. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs. If you qualify for the low-income subsidy, you may have a reduced premium for your prescription drugs.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan offers a range of benefits with varying cost-sharing arrangements. Hospital stays have a $400 copay for the first few days, while outpatient services can have copays ranging from $0 to $400. Emergency services have a $125 copay, and primary care visits are covered with no copay. The plan also includes coverage for preventive, hearing, vision, and dental services, with no copays for many services. Home health and home infusion services are covered with no copay, while diagnostic and radiological services, skilled nursing facilities, and medical equipment all have varying copays and coinsurance amounts. Additional benefits like over-the-counter items and meal benefits are covered with no copay, but some services, such as Cardiac Rehabilitation and additional hours of care, are not covered.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric, are covered. For acute care, you pay a $400 copay for days 1-4, and no copay for days 5-90, with additional days 91-999 having no copay; non-Medicare-covered stays and upgrades are not covered. Inpatient Hospital Psychiatric has a $400 copay for days 1-4, and no copay for days 5-90, with additional days and non-Medicare-covered stays not covered.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services with a copay between $0 and $400, observation services with a $400 copay, ambulatory surgical center services with no copay, individual outpatient substance abuse sessions with a copay between $0 and $25, group outpatient substance abuse sessions with a $15 copay, and outpatient blood services with no copay. Prior authorization is required for many of these services.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan. There is a $55 copay for this benefit, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan. Ground and air ambulance services have a $125 copay, with no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered, with a $125 copay and no coinsurance. Urgently Needed Services have a copay between $0 and $40, with no coinsurance. Worldwide Emergency Services include no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services have a $20 copay. Occupational Therapy Services have a copay between $0 and $35. Physician Specialist Services have a copay between $0 and $35. Mental Health Specialty Services and Psychiatric Services have a copay of $0 to $25 for individual sessions and a $15 copay for group sessions. Podiatry Services and Routine Foot Care have a $35 copay. Other Health Care Professional services have a copay between $0 and $35. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $35. Additional Telehealth Benefits have no copay. Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services include coverage for a yearly physical exam with no copay, and additional preventive services. Additional preventive services include Fitness Benefit, Remote Access Technologies, and Home and Bathroom Safety Devices and Modifications with no copay, while other services such as Health Education, Counseling Services, and others are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and prescription hearing aids are covered with a copay between $199 and $1249; however, fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision services include eye exams with no copay, routine eye exams with no copay, contact lenses with no copay, eyeglass lenses with a copay between $0.00 and $153.00, and eyeglass frames with no copay; however, eyeglasses (lenses and frames) and upgrades are not covered. The plan offers a combined maximum of $200.00 for eyewear every two years.
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 for these services and 20% coinsurance for Medicare Dental Services. Orthodontic services, restorative services, and other dental services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay with 0-20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics, Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, and radiological services, are covered by the AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan. Diagnostic procedures/tests have a $20 copay, lab services have no copay, diagnostic radiological services have a copay up to $150, therapeutic radiological services have a copay of $60, 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 OR-4 (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 OR-4 (HMO-POS) plan, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan, with prior authorization required. You will have no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for over-the-counter items and meal benefits; over-the-counter items have no copay, while meal benefits also have no copay and require prior authorization. Acupuncture, 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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