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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 2025, 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 3.5 out of 5 stars in 2025.
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 $24.00. 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 $3700.00 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 has an enhanced alternative drug benefit. The plan has a deductible of $255.00. In the initial coverage phase, after you meet your deductible, you will pay a $0 copay for Standard Generic drugs at a Standard Pharmacy. For Preferred Brand drugs, you will pay a $100.00 copay. For Non-Preferred drugs, you will pay 30% coinsurance. Once your total drug costs reach $2000.00, you enter the next coverage phase.
Additional Benefits
The AARP Medicare Advantage from UHC TX-4P (HMO-POS) plan offers a variety of benefits, including inpatient hospital stays with a $295 copay per admission and outpatient services with copays ranging from $0 to $295. The plan also includes coverage for primary care, preventive, hearing, vision, and dental services, with some services having no copay, and others requiring a copay or coinsurance. This plan provides additional benefits like ambulance services with a $275 copay, emergency services with a $140 copay, and home health services with no copay. The plan also covers medical equipment, diagnostic services, and skilled nursing facility stays, along with other services like OTC items and meal benefits, all with varying costs.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization and a doctor referral. For Inpatient Hospital-Acute, you'll pay a $295 copay per admission or stay, and for additional days (91-999), there is no copay. Inpatient Hospital Psychiatric also has a $295 copay per admission or stay. 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 include coverage for Outpatient Hospital Services with a copay between $0 and $295, Observation Services with a $295 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a copay between $0 and $25 for individual sessions, and a $15 copay for group sessions. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC TX-4P (HMO-POS) plan, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC TX-4P (HMO-POS) plan. Ground and Air Ambulance services have a copay of $275, and there is 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 by the AARP Medicare Advantage from UHC TX-4P (HMO-POS) plan. Emergency Services has a $140 copay and no coinsurance, while Urgently Needed Services have a copay between $0 and $65 with no coinsurance. Worldwide Emergency Services includes Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, all with no copay and no coinsurance.
Primary Care See details
The AARP Medicare Advantage from UHC TX-4P (HMO-POS) plan covers Primary Care services including Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a copay between $0 and $15, Physician Specialist Services with a copay between $0 and $15, and Mental Health Specialty Services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. The plan also covers Podiatry Services with a $15 copay, Other Health Care Professional services with a copay between $0 and $15, Psychiatric Services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, Physical Therapy and Speech-Language Pathology Services with a copay between $0 and $15, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
The AARP Medicare Advantage from UHC TX-4P (HMO-POS) plan covers preventive services, including an annual physical exam with no copay. This plan also covers additional preventive services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit, all with no copay. Other services such as health education, in-home safety assessments, and counseling services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year. Prescription hearing aids are covered, with a copay between $199 and $1249, twice per year. OTC hearing aids are covered with a copay between $99 and $829. Fitting/evaluation for hearing aids, and prescription hearing aids for inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include eye exams and eyewear coverage. Eye exams have no copay, and routine eye exams are covered annually. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, all with no copay, but eyeglass lenses are limited to 1 pair every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, including Medicare dental services with 20% coinsurance, and other dental services with a maximum plan benefit of $4,000 per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay, but the number of visits allowed varies by service. Restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay. Prosthodontics (removable and fixed) are covered with 0% - 50% coinsurance. Implant services and orthodontics are not covered.
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 between 0% to 20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have between 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered with prior authorization and a doctor's referral, with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices, and Medical Supplies with 20% coinsurance. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a copay of $20, and Lab Services have no copay. Diagnostic Radiological Services have a maximum copay of $160, and Therapeutic Radiological Services have a 20% coinsurance. Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC TX-4P (HMO-POS) plan with no copay and no coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage from UHC TX-4P (HMO-POS), but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC TX-4P (HMO-POS) plan, but require prior authorization and a doctor's referral. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items with no copay, and Meal Benefits with no copay and prior authorization required; however, acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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