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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 drug deductible of $355. Tier 1 preferred generic drugs have no copay for standard pharmacy fills or three-month mail orders. For Tier 2 generic drugs, you will pay a $5 copay for a one-month supply at standard pharmacies, or no copay for a three-month supply through preferred mail order. Tier 3 preferred brand drugs require a 20% coinsurance for both one-month and three-month supplies across standard pharmacies and mail order options. Non-preferred drugs in Tier 4 carry a 40% coinsurance for a one-month supply, while Tier 5 specialty drugs require a 29% coinsurance.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan offers robust medical coverage with no copay for primary care, telehealth, and annual preventive exams. For hospital care, inpatient stays require a $455 daily copay for the first five days and no copay for days six through 90, while emergency room visits carry a $130 copay that is waived if you are admitted. Outpatient services and specialist visits are also covered with no coinsurance, keeping your out-of-pocket costs highly manageable. Routine vision, hearing, and preventive dental services are covered with no copay, and members receive a $300 eyewear allowance every two years. Home health services and chronic illness meal benefits are also available with no copay or coinsurance. For specialized care, durable medical equipment, dialysis, and Medicare-covered dental services require a 20% coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $455 daily copay for days 1-5 and no copay for days 6-90. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) covers outpatient services with no coinsurance, though prior authorization is required for most treatments. There is no copay and no coinsurance for ambulatory surgical center and outpatient blood services, while outpatient hospital visits range from no copay to a $455 copay, and substance abuse therapy sessions range from no copay up to a $25 copay.
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 access 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 per service and no coinsurance, subject to prior authorization. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature 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 OR-4 (HMO-POS) offers primary care and telehealth visits with no copay and no coinsurance, while specialist and therapy services require copays up to $45 with no coinsurance. Mental health and psychiatric care are covered with copays up to $25 and no coinsurance, podiatry has a $45 copay with no coinsurance, and chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) offers partially covered preventive services with no copay and no coinsurance for annual physical exams, kidney disease education, select screenings, fitness benefits, and home safety devices. However, several supplemental benefits, such as health education, in-home safety assessments, personal emergency response systems, and nutritional therapy, are not covered.
Hearing Services See details
Hearing Services are partially covered by AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS), which offers routine hearing exams with no copay and no coinsurance, but does not cover hearing aid fitting and evaluations. Prescription and OTC hearing aids are covered with no coinsurance and copays ranging from $199.00 to $1,249.00 and $199.00 to $829.00 respectively, though inner ear, outer ear, and over the ear prescription models 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 and contact lenses. There is a $300 eyewear allowance every two years with no copay for frames and a $0 to $153 copay for lenses, though upgrades, other eye exams, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services are partially covered by AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS), offering preventive care such as exams, cleanings, and x-rays with no copay and no coinsurance. Medicare-covered dental services require a 20% coinsurance with no copay, while restorative, endodontic, periodontic, prosthodontic, oral surgery, and orthodontic services 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, although prior authorization and step therapy may be required. Medicare Part B drugs associated with these services, including chemotherapy and insulin, carry a coinsurance of no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts are covered with a 20% coinsurance.
Diagnostic and Radiological Services See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) covers diagnostic and radiological services with no coinsurance, although prior authorization is required. Members pay no copay for lab services and select diagnostic radiology, a $30 copay for outpatient X-rays, a $50 copay for diagnostic procedures and tests, and a $60 copay for therapeutic radiology services.
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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) plan with no copay, no coinsurance, and prior authorization required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) covers over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, though the meal benefit requires prior authorization. Acupuncture and other additional services are not covered under this benefit.
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