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AARP Medicare Advantage from UHC TX-0011 (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-0011 (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-0011 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC TX-0011 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Texas. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC TX-0011 (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-0011 (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-0011 (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 $340.00 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-0011 (HMO-POS) plan has an "Enhanced Alternative" drug benefit. The plan has a $340 deductible. In the initial coverage phase, after the deductible is met, you will pay a $0 copay for standard generic drugs, and $47 for standard generic drugs. Preferred brand drugs have a $100 copay, and non-preferred drugs have a 29% coinsurance. After your total drug costs reach $2000, you will enter the catastrophic coverage phase where you will pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC TX-0011 (HMO-POS) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays. Emergency and urgent care services are covered, and primary care visits have no copay. The plan also includes preventive, hearing, vision, and dental services, with no copays for many of these services. This plan provides additional benefits like ambulance and transportation services, home health services, and skilled nursing facility care. You'll also have access to diagnostic and radiological services, as well as medical equipment. Some services, like hearing aids and prescription drugs, may have copays or coinsurance, so it's important to review the details of each benefit.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, but prior authorization and a doctor referral are required. For Inpatient Hospital-Acute, you pay a copay of $85 for days 1-5, and no copay for days 6-90, while additional days have no copay. Inpatient Hospital Psychiatric has the same cost-sharing as Inpatient Hospital-Acute. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with copays ranging from $0 to $85, and no coinsurance. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and no coinsurance. Outpatient substance abuse services are also covered, with individual sessions having copays from $0 to $25, and group sessions having a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with no copay. Prior authorization and a doctor referral are required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $275 copay. Transportation Services to a plan-approved health-related location are covered with no copay, up to 24 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by this plan. Emergency Services has a $140 copay, and Urgently Needed Services has a copay between $0 and $65; all of these services have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
The AARP Medicare Advantage from UHC TX-0011 (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $0-$10 copay, physician specialist services with a $0-$10 copay, and mental health specialty services with a $0-$25 copay for individual sessions and a $15 copay for group sessions. Additionally, physical therapy and speech-language pathology services are covered with a $0-$10 copay, and additional telehealth benefits have no copay. Opioid Treatment Program Services are covered with no copay, while podiatry services are not covered.
Preventive Services See details
Preventive services, including an annual physical exam, are covered with no copay. Additional preventive services, including fitness benefits, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and an EKG following a Welcome Visit, are covered with no copay. Other services, such as health education, in-home safety assessments, and personal emergency response systems, 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, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear has no copay, and contact lenses are covered, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services have 20% coinsurance for Medicare dental services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery have no copay. Prosthodontics removable and prosthodontics fixed have between 0% and 50% coinsurance. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC TX-0011 (HMO-POS) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 10% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 10% coinsurance, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services, diagnostic procedures/tests with a $50 copay, and lab services with no copay. Radiological services are covered, including diagnostic radiological services with a copay up to $175 and therapeutic radiological services with at least 20% coinsurance, as well as outpatient X-ray services with a $15 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC TX-0011 (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 covered, but the plan does not cover the specific sub-services of Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. A doctor referral and prior authorization are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC TX-0011 (HMO-POS). There is no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
Other Services includes Over-the-Counter (OTC) Items and Meal Benefit, with Acupuncture, Dual Eligible SNPs with Highly Integrated Services, 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 not covered. Over-the-Counter (OTC) Items have no copay, and Meal Benefit has no copay and requires prior authorization.
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