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AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx TX-MA01 (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 Patriot No Rx TX-MA01 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx TX-MA01 (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 Patriot No Rx TX-MA01 (HMO-POS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage Patriot No Rx TX-MA01 (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 Patriot No Rx TX-MA01 (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. Additionally, this plan comes with a Part B Premium reduction of $50.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6700.00 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
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) plan provides medical coverage featuring no copay and no coinsurance for primary care doctor visits, telehealth sessions, annual physical exams, and home health services. For inpatient hospital stays, members pay a $550 daily copay for the first five days and no copay for subsequent days, while emergency room visits carry a $130 copay that is waived if admitted within 24 hours. Specialist visits and therapy sessions feature copays ranging from $0 to $65, and outpatient hospital services carry a copay of $0 to $550. Routine vision exams and preventive dental care are covered with no copay and no coinsurance, though comprehensive dental services are excluded. For specialized medical needs, members pay a 20% coinsurance with no copay for dialysis services, durable medical equipment, and prosthetics. Skilled nursing facility care is also covered with no coinsurance, requiring no copay for the first 20 days and a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) covers inpatient hospital services with no coinsurance, though the benefit is partially covered as upgrades, non-Medicare-covered stays, and additional psychiatric days are excluded. Medicare-covered acute stays require a $550 daily copay for days 1 to 5 and no copay for days 6 and beyond, while psychiatric stays require a $550 daily copay for days 1 to 4 and no copay for days 5 to 90.
Outpatient Services See details
AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) covers outpatient services with no coinsurance, though prior authorizations and referrals are required for most services. Covered ambulatory surgical center and outpatient blood services have no copay, while outpatient hospital services carry a copay of $0 to $550 and outpatient substance abuse sessions require a copay of $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) covers partial hospitalization with no copay and no coinsurance. Prior authorization and a referral are required to access this covered benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) covers ground and air ambulance services with a $290 copay and no coinsurance, though prior authorization is required. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay ranging from $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits under the AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) plan feature no coinsurance for all covered services, including primary care physician visits and telehealth sessions with no copay. Specialist visits, therapy services, and mental health sessions have copays ranging from $0 to $65, while chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) with no copay and no coinsurance for annual physical exams, fitness benefits, kidney disease education, and other screenings. This benefit is partially covered because sub-services such 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, smoking cessation, disease management, telemonitoring, remote access, home safety modifications, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered under the AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) plan, featuring one annual routine hearing exam with no copay and no coinsurance, while fitting and evaluation exams are not covered. Up to two prescription hearing aids (copays of $199 to $1,249) and two OTC hearing aids (copays of $199 to $829) are covered annually with no coinsurance, although inner ear, outer ear, and over-the-ear prescription devices are not covered.
Vision Services See details
Vision services are partially covered by the AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) plan, featuring no deductible, no coinsurance, and no copay for annual routine eye exams, contact lenses, and frames. Covered eyeglass lenses require a copay of $0 to $153 under a $150 combined eyewear limit every two years, while other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered under the AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) plan, which features preventive care like exams, cleanings, and X-rays with no copay and no coinsurance, and Medicare-covered dental services with no copay and 20% coinsurance. Comprehensive services, including restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by the AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) plan with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a 0% (no coinsurance) to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% (no coinsurance) to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) covers dialysis services with no copay and a 20% coinsurance. Prior authorization and a referral are required for these covered services.
Medical Equipment See details
AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) covers medical equipment, including 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
Diagnostic and radiological services are covered by the AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) plan, requiring both prior authorization and referrals. Lab services and diagnostic radiological services feature no copays or coinsurance, while diagnostic tests require a $25 copay, outpatient X-rays carry a $30 copay, and therapeutic radiological services incur a minimum 20% coinsurance.
Home Health Services See details
AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) covers home health services with no copay and no coinsurance. Prior authorization and a referral are required to receive these covered services.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) covers some cardiac rehabilitation services with no copay and no coinsurance, though prior authorization and referrals are required. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by the AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization and referrals are required, and additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
Other Services are not covered under the AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) plan, which excludes coverage for acupuncture, over-the-counter (OTC) items, and meal benefits.
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