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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 $16.00. 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 will pay a copay or coinsurance for your prescriptions. For example, you will pay no copay for preferred generic drugs at a standard pharmacy, and a $47 copay for standard generic drugs at a standard pharmacy. For preferred brand drugs, the copay is $100, regardless of the pharmacy. For non-preferred drugs, you pay 30% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan offers coverage for a wide range of services. You'll have a $400 copay for inpatient hospital stays for days 1-4, and no copay for days 5-90. Outpatient services, primary care, preventive services, and vision services are covered with varying copays, some of which have no copay. This plan also includes coverage for ambulance services with a $290 copay, and emergency services with a $125 copay. Hearing aids, dental services, and durable medical equipment are also covered, but may require coinsurance or have copays. Certain services like cardiac rehabilitation and additional home health care hours are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $400 for days 1-4 and no copay for days 5-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, Outpatient Substance Abuse Services, and Outpatient Blood Services, are covered. Outpatient Hospital Services have a copay between $0 and $400, Observation Services have a $400 copay, Ambulatory Surgical Center (ASC) Services have no copay, Individual Sessions for Outpatient Substance Abuse have a copay between $0 and $25, Group Sessions for Outpatient Substance Abuse have a $15 copay, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services, each with a $290 copay and no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan. Emergency Services have a $125 copay with no coinsurance, Urgently Needed Services have a copay between $0 and $55 with no coinsurance, and Worldwide Emergency Services have no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan covers primary care, chiropractic services, occupational therapy, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary Care Physician Services have no copay, Chiropractic Services have a $20 copay, and Occupational Therapy Services have a copay between $0 and $25. Physician Specialist Services have a copay between $0 and $35, Individual Sessions for Mental Health Specialty Services have a copay between $0 and $25, and Group Sessions for Mental Health Specialty Services have a $15 copay. Podiatry Services and Routine Foot Care have a $35 copay, Other Health Care Professional services have a copay between $0 and $35, Individual Sessions for Psychiatric Services have a copay between $0 and $25, and Group Sessions for Psychiatric Services have a $15 copay. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $25, Additional Telehealth Benefits have no copay, and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, and an annual physical exam with no copay. Additional preventive services, including fitness benefits, remote access technologies, and home and bathroom safety devices and modifications, are covered with no copay.
Hearing Services See details
Hearing exams are covered with no copay, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with a copay between $199 and $1249, depending on the type, while OTC hearing aids have a copay between $99 and $829.
Vision Services See details
Vision services include eye exams and eyewear coverage. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear has no copay, and includes coverage for contact lenses, eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $300 every two years; eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0-20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), is covered with 20% coinsurance, and Prosthetic Devices and Medical Supplies are covered with 20% coinsurance, while Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts 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 all diagnostic services and radiological services. Diagnostic Procedures/Tests have a $50 copay, and Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $225, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a $15 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. This includes Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan, with a prior authorization requirement. There is 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
The AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan covers Over-the-Counter (OTC) Items and Meal Benefits. OTC items have no copay, while the meal benefit also has no copay and requires prior authorization. Acupuncture, Dual Eligible SNPs, 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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