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AARP Medicare Advantage Essentials from UHC TX-14 (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 TX-14 (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 TX-14 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC TX-14 (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 2026.
It's important to know that AARP Medicare Advantage Essentials from UHC TX-14 (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 TX-14 (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 TX-14 (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 $3600.00 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 Essentials from UHC TX-14 (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 filled through standard mail order. This makes essential everyday medications highly affordable under this plan. For brand-name and specialty medications, cost-sharing is structured as a percentage of the drug cost. Tier 3 preferred brand drugs require a 19% coinsurance for both standard pharmacy and standard mail order fills. Tier 4 non-preferred drugs carry a 41% coinsurance, while Tier 5 specialty drugs require a 29% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) plan offers comprehensive medical coverage with no copay for primary care visits, telehealth, and preventive services. For inpatient hospital stays, members pay a $250 daily copay for days 1 through 5 and no copay for days 6 through 90, with no coinsurance required. Emergency room visits carry a $150 copay, which is waived if admitted within 24 hours, while urgent care visits range from no copay to a $65 copay. Specialist visits require a copay ranging from no copay to $25, while routine vision, hearing, and preventive dental care are available with no copay. Many specialized services, including home health care and cardiac rehabilitation, feature no copay and no coinsurance, though durable medical equipment and dialysis require a 20% coinsurance. Additionally, the plan covers over-the-counter items and up to 24 one-way transportation trips per year to plan-approved locations with no copay or coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $250 daily copay for days 1 through 5 and no copay for days 6 through 90. Unlimited additional days are covered for acute stays at no copay, though additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $250 copay for outpatient hospital services and a $250 daily copay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay, while outpatient substance abuse services have copays ranging from $0 to $25, with prior authorization and referrals required for most services.
Partial Hospitalization See details
AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) covers partial hospitalization with no copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS), featuring a $275 copay and no coinsurance for ground and air ambulance services. Transportation benefits are partially covered, providing up to 24 one-way trips per year to plan-approved locations with no copay or coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay of $0 to $65 and 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 TX-14 (HMO-POS) covers primary care and telehealth services with no copay and no coinsurance, while specialist, therapy, podiatry, and mental health services require a $0 to $25 copay and no coinsurance. Chiropractic services are not covered under this plan.
Preventive Services See details
Preventive Services are partially covered by the AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) plan with no copay and no coinsurance for covered services like annual physicals, fitness benefits, home safety devices, and kidney disease education. However, sub-services such as health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote technologies, and counseling are not covered.
Hearing Services See details
AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) partially covers hearing services, offering one annual routine hearing exam with no copay and no coinsurance, though hearing aid fittings and evaluations are not covered. Prescription hearing aids are covered with a $199.00 to $1,249.00 copay and no coinsurance, excluding inner ear, outer ear, and over-the-ear types, while up to two over-the-counter hearing aids are covered per year with a $199.00 to $829.00 copay and no coinsurance.
Vision Services See details
Vision Services are partially covered by AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) with no coinsurance or deductibles, offering annual routine eye exams with no copay and up to $150 every two years for eyewear. Covered eyewear includes contact lenses and frames with no copay, and lenses with a copay ranging from no copay to $153, while other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS), offering preventive and diagnostic care with no copay and no coinsurance up to a $1,250 yearly limit. Medicare-covered services require no copay and a 20% coinsurance, while covered comprehensive services have no copay and a 50% coinsurance, though implants and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, require no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic supplies, with no copay and a 20% coinsurance. Prior authorization is required for these covered benefits, which also include diabetic therapeutic shoes and inserts at a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS), featuring no coinsurance and a $50 copay for diagnostic tests, and no copay or coinsurance for lab services. Outpatient X-rays require a $30 copay and coinsurance, diagnostic radiology features no copay or coinsurance, and therapeutic radiology requires both a copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) plan with no copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) with no copay and no coinsurance, although prior authorization and referrals are required. However, in practice, sub-services including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 copay for days 21 to 100. Prior authorization and referrals are required, a prior three-day hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered under the AARP Medicare Advantage Essentials from UHC TX-14 (HMO-POS) plan, as acupuncture is not covered. Covered services include over-the-counter (OTC) items and a chronic illness meal benefit, both of which are offered with no copay and no coinsurance, though the meal benefit requires prior authorization.
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