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AARP Medicare Advantage from UHC TX-0013 (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-0013 (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-0013 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC TX-0013 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in El Paso County. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC TX-0013 (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-0013 (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-0013 (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 $4200.00 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-0013 (HMO-POS) plan features an annual drug deductible of $355. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs when using standard pharmacies or standard mail order services for either 1-month or 3-month supplies. For higher-tier medications, cost-sharing is based on coinsurance rather than set copays, including a 16% coinsurance for Tier 3 preferred brand drugs. Tier 4 non-preferred drugs require a 38% coinsurance, and Tier 5 specialty drugs carry a 29% coinsurance for a 1-month supply at standard pharmacies or standard mail order.
Additional Benefits
The AARP Medicare Advantage from UHC TX-0013 (HMO-POS) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, telehealth, and preventive services. For inpatient hospital stays, members pay no coinsurance and a daily copay of $245 for the first six days, followed by no copay for days seven through 90. Outpatient hospital services feature no coinsurance and copays ranging from $0 to $245, while emergency room visits require a $150 copay that is waived upon admission. This plan also includes valuable supplemental benefits such as routine dental, vision, and hearing exams with no copays or coinsurance. Dental services feature a $3,000 annual maximum with comprehensive care requiring 50% coinsurance, while eyewear is covered up to $200 every two years. Additionally, members can access up to 12 free one-way transportation trips to plan-approved locations and receive over-the-counter items with no copay or coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC TX-0013 (HMO-POS) partially covers inpatient hospital services with no coinsurance and a copay of $245 per day for days 1 through 6, with no copay for days 7 through 90. Upgrades, non-Medicare-covered stays, and additional inpatient psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC TX-0013 (HMO-POS) with no coinsurance, featuring a copay of $0 to $245 for outpatient hospital services and $0 to $25 for substance abuse sessions. Ambulatory surgical center and outpatient blood services are available with no copay, though prior authorization and referrals are required for most services.
Partial Hospitalization See details
AARP Medicare Advantage from UHC TX-0013 (HMO-POS) covers partial hospitalization services with no copay and no coinsurance. Prior authorization and a referral are required to receive this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by AARP Medicare Advantage from UHC TX-0013 (HMO-POS), featuring a $275 copay and no coinsurance for both ground and air ambulance services. Transportation services are partially covered, offering no copay and no coinsurance for up to 12 one-way trips per year to plan-approved locations, while trips to any health-related location are not covered.
Emergency Services See details
Emergency services under the AARP Medicare Advantage from UHC TX-0013 (HMO-POS) plan are covered with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a copay ranging from $0 to $65 and no coinsurance, while worldwide emergency, urgent, and transportation services are available with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC TX-0013 (HMO-POS) covers primary care and telehealth visits with no copay and no coinsurance, while specialist visits require a $0 to $30 copay and no coinsurance. Physical, occupational, and speech therapies have a $25 copay and no coinsurance, and though some chiropractic services are covered with a $20 copay and no coinsurance, routine and other chiropractic services are not.
Preventive Services See details
AARP Medicare Advantage from UHC TX-0013 (HMO-POS) provides preventive services with no copay and no coinsurance, covering annual physical exams, kidney disease education, and select fitness and safety benefits. However, additional preventive services are only partially covered, as the plan does not cover health education, in-home safety assessments, nutritional counseling, and personal emergency response systems.
Hearing Services See details
AARP Medicare Advantage from UHC TX-0013 (HMO-POS) provides partially covered hearing services with no coinsurance. Routine hearing exams are covered once annually with no copay, but fitting and evaluation services are not covered. Up to two prescription hearing aids (with copays of $199.00 to $1,249.00) and two OTC hearing aids (with copays of $199.00 to $829.00) are covered per year, though inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC TX-0013 (HMO-POS) with no deductible, no coinsurance, and no copay for annual routine eye exams, though other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered. Covered eyewear has no coinsurance and includes contacts and frames with no copay, plus lenses with a $0 to $153 copay, up to a $200 combined maximum every two years.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC TX-0013 (HMO-POS) with a $3,000 annual maximum, though implant services and orthodontics are not covered. Covered preventive services feature no copay and no coinsurance, medicare dental services have no copay and 20% coinsurance, and comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC TX-0013 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs, such as chemotherapy and insulin, carry no coinsurance to 20% coinsurance, with insulin additionally requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC TX-0013 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization and a referral are required to access these services.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC TX-0013 (HMO-POS) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC TX-0013 (HMO-POS) with prior authorization and referrals required. Diagnostic tests require a $50 copay with no coinsurance, lab and diagnostic radiological services have no copay, outpatient X-rays require a $30 copay and coinsurance, and therapeutic radiological services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC TX-0013 (HMO-POS) with no copay and no coinsurance. Prior authorization and a referral are required to receive this benefit.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC TX-0013 (HMO-POS) does not cover cardiac rehabilitation services, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by AARP Medicare Advantage from UHC TX-0013 (HMO-POS) with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization and referrals are required for this benefit, which does not require a prior three-day hospital stay for admission.
Other Services See details
AARP Medicare Advantage from UHC TX-0013 (HMO-POS) partially covers other services, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and the meal benefit requires prior authorization.
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