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AARP Medicare Advantage from UHC TX-0015 (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-0015 (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-0015 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC TX-0015 (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-0015 (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-0015 (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-0015 (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 $4100.00 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-0015 (HMO-POS) plan has a $340 deductible for prescription drugs. In the initial coverage phase, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy. For example, you pay a $12 copay for preferred generic drugs at a standard pharmacy. For preferred brand drugs, you will pay a $100 copay. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC TX-0015 (HMO-POS) plan offers a range of benefits with varying costs. This plan includes no copay for primary care visits, preventive services, eye exams, and eyewear. The plan also covers inpatient hospital stays with a $375 copay per admission, outpatient services with copays ranging from $0 to $375, and emergency services with a $140 copay, waived if admitted to the hospital within 24 hours. Additional benefits include coverage for hearing services, dental services, and home health services with no copay. The plan also covers ambulance services with a $290 copay, partial hospitalization with a $55 copay, and diagnostic and radiological services with copays ranging from $0 to $200. Other services like skilled nursing facilities, medical equipment, and dialysis services are covered with varying copays or coinsurance, and may require prior authorization.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization and a doctor's referral. For Inpatient Hospital-Acute, there is a $375 copay per admission or stay, with additional days (91-999) having no copay, while Non-Medicare-covered Stay and Upgrades are not covered. Inpatient Hospital Psychiatric has a $375 copay per admission or stay, and Additional Days and Non-Medicare-covered Stay are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $375, and Observation Services have a $375 copay per day. Ambulatory Surgical Center Services and Outpatient Blood Services have no copay, while Individual Sessions for Outpatient Substance Abuse have a copay between $0 and $25, and Group Sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC TX-0015 (HMO-POS) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the AARP Medicare Advantage from UHC TX-0015 (HMO-POS) plan. Both ground and air ambulance services have a copay of $290, with no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency services are covered, with a $140 copay; however, the copay is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay between $0 and $65, and worldwide emergency services are covered with no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Under the AARP Medicare Advantage from UHC TX-0015 (HMO-POS) plan, primary care physician services have no copay, chiropractic services have a $20 copay, occupational therapy services have a copay between $0 and $25, and physician specialist services have a copay between $0 and $25. Mental health specialty services, podiatry services, other health care professional, psychiatric services, physical therapy, and speech-language pathology services all have copays. Additional telehealth benefits have no copay, and opioid treatment program services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, annual physical exams, kidney disease education services, and other preventive services. The plan offers no copay for annual physical exams, and the other services have no copay.
Hearing Services See details
Hearing services include routine hearing exams with no copay, and prescription hearing aids with a copay between $199 and $1249. 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, with a combined maximum plan benefit of $200 every two years; contact lenses, eyeglass lenses, and eyeglass frames are covered, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, including oral exams, dental X-rays, prophylaxis (cleaning), fluoride treatment, and other preventive services with no copay. Medicare dental services are covered with 20% coinsurance and require prior authorization. Orthodontic, restorative, and other dental services 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 coinsurance between 0% and 20%. Other Medicare Part B drugs, as well as Medicare Part B Chemotherapy/Radiation Drugs, have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment (DME) has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic devices have a 20% coinsurance, while Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay. Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for Diagnostic Procedures/Tests with a copay of $40, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $200, Therapeutic Radiological Services with a coinsurance of 20% or more, and Outpatient X-Ray Services with a copay of $25.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC TX-0015 (HMO-POS) 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 specific services of Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD are not covered. Prior authorization and a doctor's referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under this 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, and non-Medicare-covered stays are not covered.
Other Services See details
Other Services includes Over-the-Counter (OTC) Items and Meal Benefits, but not 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. Over-the-Counter (OTC) Items have no copay. Meal Benefits also have no copay and require prior authorization.
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