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AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Giveback from UHC TX-38 (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 Giveback from UHC TX-38 (HMO-POS) in 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) is a HMO-POS plan offered by Physicians Health Choice of Texas, LLC available for the 2026 plan year 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 Giveback from UHC TX-38 (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 Giveback from UHC TX-38 (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 Giveback from UHC TX-38 (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 $66.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
Health deductible: information not available.
This plan has a $203.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $7900.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $7900.00 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 Giveback from UHC TX-38 (HMO-POS) plan features an annual drug deductible of $203. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay for a 1-month or 3-month supply at standard pharmacies, and no copay for a 3-month supply through standard mail order. This coverage provides an affordable way to manage your everyday generic prescription needs. For higher-tier medications, your costs are determined by a percentage of the drug cost rather than a flat fee. Tier 3 preferred brand drugs require a 19% coinsurance for standard pharmacy and mail-order options. Tier 4 non-preferred drugs carry a 28% coinsurance, while Tier 5 specialty drugs have a 26% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) offers comprehensive healthcare coverage with predictable cost-sharing, featuring no copays or coinsurance for primary care visits, telehealth, home health services, and routine preventive care. For hospital stays, members pay a $485 daily copay for the first five days of acute inpatient care and no copay thereafter, while outpatient hospital visits range from no copay up to $485. Emergency care is accessible with a $115 copay, which is waived if you are admitted, and there is no copay or coinsurance for worldwide emergency coverage. Specialist visits require a copay of up to $55 with no coinsurance, while routine annual vision and hearing exams are available with no copay. Diagnostic lab services and preventive dental care, such as cleanings and exams, also require no copay or coinsurance, though Medicare-covered dental services and dialysis require a 20% coinsurance. Durable medical equipment and Part B drugs also carry a 20% coinsurance, while prescription hearing aids require copays ranging from $199 to $1,249.
Inpatient Hospital See details
The AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) covers inpatient hospital services with no coinsurance, though prior authorization and referrals are required. For acute stays, you will pay a $485 daily copay for days 1-5 and no copay for days 6 and beyond, while psychiatric stays require a $485 daily copay for days 1-4 and no copay for days 5-90. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital visits have a copay ranging from $0 to $485, observation services carry a $485 daily copay, and outpatient substance abuse sessions require a copay of $0 to $25.
Partial Hospitalization See details
Partial hospitalization is covered by the AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) plan with a $55.00 copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) covers ground and air ambulance services with a $285 copay and no coinsurance, subject to prior authorization. However, transportation services to plan-approved or any health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) covers primary care doctor visits and telehealth services with no copay and no coinsurance. Specialist visits ($0 to $55 copay), therapy services ($35 to $55 copay), mental health services (up to $25 copay), and podiatry ($45 copay) are covered with no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) with no copay and no coinsurance for covered services like annual physicals, kidney disease education, glaucoma screenings, and fitness benefits. Non-covered services under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access, home modifications, and counseling.
Hearing Services See details
Hearing Services under the AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) are partially covered with no coinsurance, offering one routine hearing exam annually with no copay, though hearing aid fittings and evaluations are not covered. Prescription hearing aids (excluding inner, outer, and over-the-ear types) require a copay of $199.00 to $1,249.00, while OTC hearing aids have a copay of $199.00 to $829.00, both allowing up to two devices per year with no coinsurance.
Vision Services See details
Vision services are partially covered by the AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS), featuring one routine eye exam per year with no copay and no coinsurance. Eyewear is also partially covered with no coinsurance up to a $150 maximum every two years, offering contact lenses and frames with no copay, and lenses with a $0 to $153 copay. Other eye exam services, upgrades, and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) provides partially covered dental services, featuring Medicare-covered dental care with no copay and a 20% coinsurance. Preventive and diagnostic benefits like exams, cleanings, fluoride, and x-rays are available with no copay and no coinsurance, but restorative, endodontic, periodontic, prosthodontic, orthodontic, implant, maxillofacial prosthetic, adjunctive general, and oral surgery services are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Related Medicare Part B drugs, such as chemotherapy, insulin, and other drugs, feature a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) 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 Giveback from UHC TX-38 (HMO-POS) covers 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
AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) covers diagnostic and radiological services, requiring prior authorization and referrals. Diagnostic tests have a $50 copay with no coinsurance, while lab services and diagnostic radiological services have no copay and no coinsurance. Outpatient X-rays require a $30 copay, and therapeutic radiological services have a 20% coinsurance.
Home Health Services See details
AARP Medicare Advantage Giveback from UHC TX-38 (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
Cardiac rehabilitation services are not covered under the AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS) with no coinsurance, requiring prior authorization and a referral. There is no copay for days 1 through 20, but a $218 daily copay applies for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by the AARP Medicare Advantage Giveback from UHC TX-38 (HMO-POS), which provides a meal benefit for chronic illness with no copay and no coinsurance, though prior authorization is required. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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