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AARP Medicare Advantage from UHC TX-4P (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC TX-4P (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 TX-4P (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC TX-4P (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Houston Metro Area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC TX-4P (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 TX-4P (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 TX-4P (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $34.00. 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 $3900.00 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 TX-4P (HMO-POS) plan features an annual drug deductible of $355. For Tier 1 preferred generic and Tier 2 generic drugs, members enjoy no copay for 1-month and 3-month supplies at standard pharmacies, as well as no copay for 3-month supplies through standard mail order. This structure helps keep common prescriptions highly affordable. For higher-tier medications, costs are based on coinsurance rather than set copays. Tier 3 preferred brand drugs require a 21% coinsurance for 1-month and 3-month supplies, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 42% and 29% coinsurance respectively for a 1-month supply. These percentage-based costs apply to both standard retail pharmacies and standard mail-order services.
Additional Benefits
The AARP Medicare Advantage from UHC TX-4P (HMO-POS) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. For specialized medical needs, the plan features a $395 copay per stay for inpatient hospital care, specialist copays up to $25, and emergency services for a $150 copay. Outpatient services, diagnostic lab tests, and home infusion services are also highly affordable, often requiring no copay and no coinsurance. This plan also provides strong dental, vision, and hearing benefits, including preventive dental care with no copay and a $300 eyewear allowance every two years. Members benefit from routine hearing exams with no copay, as well as no copay for over-the-counter items and chronic illness meals. Additionally, skilled nursing facility stays require no copay for the first 20 days, helping you keep your out-of-pocket healthcare costs predictable.
Inpatient Hospital See details
AARP Medicare Advantage from UHC TX-4P (HMO-POS) covers inpatient hospital services with a $395 copay per stay and no coinsurance for acute and psychiatric care, including unlimited additional acute days with no copay. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC TX-4P (HMO-POS) covers outpatient services with no coinsurance, though prior authorization and referrals are required for most care. Covered services feature a $0 to $395 copay for outpatient hospital and observation services, a $0 to $25 copay for outpatient substance abuse sessions, and no copay for ambulatory surgical center and blood services.
Partial Hospitalization See details
AARP Medicare Advantage from UHC TX-4P (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 from UHC TX-4P (HMO-POS) covers ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required. While some transportation services are covered, transportation to plan-approved health-related locations and any other health-related locations is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC TX-4P (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 require a copay ranging from $0 to $65 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay or coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC TX-4P (HMO-POS) provides primary care and telehealth visits with no copay and no coinsurance, while specialist visits range from a $0 to $25 copay with no coinsurance. Physical, occupational, and speech therapies require a $20 copay, podiatry and mental health services have copays up to $25 with no coinsurance, and chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC TX-4P (HMO-POS) offers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. However, these benefits are only partially covered, as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC TX-4P (HMO-POS), offering one annual routine hearing exam with no copay and no coinsurance, though hearing aid fittings and evaluations are not covered. Up to two prescription or OTC hearing aids are covered per year with no coinsurance and copays ranging from $199.00 to $1,249.00, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
AARP Medicare Advantage from UHC TX-4P (HMO-POS) features partially covered vision services with no deductible and no coinsurance, including no copay for one routine eye exam per year and a $300 combined eyewear allowance every two years. Under this benefit, contact lenses and eyeglass frames have no copay, and eyeglass lenses have a $0 to $153 copay, though other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC TX-4P (HMO-POS) up to a $4,000 annual limit, offering preventive care with no copay and no coinsurance, and comprehensive care with no copay and 50% coinsurance. Medicare-covered dental services require no copay and 20% coinsurance, while implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC TX-4P (HMO-POS) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by AARP Medicare Advantage from UHC TX-4P (HMO-POS) with no copay and a 20% coinsurance. Prior authorization and a referral are required for these services.
Medical Equipment See details
AARP Medicare Advantage from UHC TX-4P (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 require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC TX-4P (HMO-POS) covers diagnostic services with no coinsurance, offering lab services with no copay and diagnostic procedures with a $50 copay. Radiological services are also covered, featuring outpatient X-rays for a $30 copay, diagnostic radiology with no copay, and therapeutic radiology with 20% coinsurance, all requiring prior authorization.
Home Health Services See details
AARP Medicare Advantage from UHC TX-4P (HMO-POS) covers home health services with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage from UHC TX-4P (HMO-POS) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all excluded. Because these services are not covered, there is no copay or coinsurance benefit available.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC TX-4P (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, though prior authorization and a referral are required. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC TX-4P (HMO-POS) partially covers other services, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for the meal benefit, and acupuncture is not covered.
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