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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 2026, 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 2026.
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 $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 $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 OR-4 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan features an annual prescription drug deductible of $355. Tier 1 preferred generic drugs have no copay for standard retail pharmacies and three-month mail orders. Tier 2 generic medications require a $5 copay for a one-month standard supply, but have no copay for a three-month preferred mail order. For brand-name and specialty medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 20% coinsurance for standard retail and mail-order fills. Tier 4 non-preferred drugs carry a 40% coinsurance, while Tier 5 specialty drugs incur a 29% coinsurance for a one-month supply.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, preventive services, routine eye exams, and preventive dental care. Specialist visits, urgent care, and diagnostic lab services feature low to no copays, while emergency room visits require a $130 copay with no coinsurance. For inpatient hospital stays, you will pay no coinsurance and a $455 copay per day for the first five to six days, after which there is no copay. Skilled nursing facility care is covered with no copay for the first 20 days, and home health services require no copay and no coinsurance. Dialysis and durable medical equipment are covered with no copay and a 20% coinsurance, while diabetic supplies feature no copay. Additionally, the plan offers no copay for over-the-counter items and routine hearing exams, though prescription hearing aids require copays ranging from $199 to $1,249.
Inpatient Hospital See details
Inpatient hospital services under the AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) are partially covered with no coinsurance, requiring a $455 copay for days 1 to 6 of acute stays (no copay for days 7 and beyond) and a $455 copay for days 1 to 5 of psychiatric stays (no copay for days 6 to 90). Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered under this plan.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) with no coinsurance, featuring copays ranging from $0 to $455 for outpatient hospital services and $455 per day for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse services require no coinsurance and copays ranging from $0 to $25 per session.
Partial Hospitalization See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) covers ground and air ambulance services with a $290 copay and no coinsurance, subject to prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Primary care benefits for AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) feature no copay and no coinsurance for primary care visits, telehealth, and opioid treatment, though chiropractic services are not covered. Other covered services, such as specialists, therapy, podiatry, and mental health sessions, have copays ranging from $0 to $45 and no coinsurance.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) with no copay and no coinsurance for covered benefits like annual physical exams, fitness programs, and kidney disease education. However, multiple services are not covered under this plan, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS), offering one routine hearing exam per year with no copay and no coinsurance, while fitting and evaluation exams are not covered. Prescription hearing aids (up to two per year) have copays ranging from $199 to $1,249 with no coinsurance, and over-the-counter hearing aids (up to two per year) have copays from $199 to $829 with no coinsurance. Inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS), featuring no deductible, no coinsurance, and no copay for annual routine eye exams, contact lenses, and eyeglass frames. Covered eyeglass lenses have a copay ranging from $0 to $153 under a $250 eyewear limit every two years, but other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) dental services are partially covered, offering preventive care like cleanings, exams, and X-rays with no copay and no coinsurance. Medicare-covered dental services have no copay and a 20% coinsurance, but comprehensive treatments such as restorative, 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 OR-4 (HMO-POS) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS), which offers durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, and prior authorization is required for these medical equipment and supply benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) with no coinsurance, though prior authorization is required. There is no copay for lab services, a $30 copay for outpatient X-rays, a $50 copay for diagnostic tests, and copays starting at $0 for diagnostic radiology and $60 for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) covers some Cardiac Rehabilitation Services with no copay and no coinsurance, although prior authorization is required. However, key sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered under this plan.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) covers skilled nursing facility care with no coinsurance, requiring no prior three-day hospital stay. You will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though prior authorization is required and additional days beyond Medicare coverage are not covered.
Other Services See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) partially covers other services, offering over-the-counter (OTC) items and a meal benefit for chronic illnesses with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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