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AARP Medicare Advantage from UHC TX-46 (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-46 (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-46 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC TX-46 (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 from UHC TX-46 (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-46 (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-46 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $21.00. 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 $5500.00 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:
Sign up for AARP Medicare Advantage from UHC TX-46 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage from UHC TX-46 (HMO-POS) plan features an annual prescription drug deductible of $355. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic medications filled at standard pharmacies or through standard mail order. This ensures that many common, everyday prescriptions are available to members at no additional cost. For higher-tier prescriptions, costs are calculated as a percentage of the drug's price. You will pay a 21% coinsurance for Tier 3 preferred brand drugs, a 44% coinsurance for Tier 4 non-preferred drugs, and a 29% coinsurance for Tier 5 specialty drugs. These coinsurance rates apply to standard pharmacy fills as well as standard mail-order services.
Additional Benefits
The AARP Medicare Advantage from UHC TX-46 (HMO-POS) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. For hospital stays, inpatient care features a $295 daily copay for the first five days and no copay for days six through 90, while outpatient hospital services range from no copay up to a $295 copay. Specialist visits require a copay of up to $35 and emergency services carry a $130 copay, both with no coinsurance. This plan also includes key supplemental benefits, such as dental care with no copay for preventive services and 50% coinsurance for comprehensive care up to a $4,000 annual limit. Routine vision and hearing exams are covered with no copay, and members receive a $150 eyewear allowance every two years alongside coverage for prescription hearing aids. For specialized medical needs, durable medical equipment and dialysis services require a 20% coinsurance with no copay.
Inpatient Hospital See details
Inpatient hospital care is partially covered by AARP Medicare Advantage from UHC TX-46 (HMO-POS) with no coinsurance, though prior authorization and referrals are required. Medicare-covered acute and psychiatric stays incur a $295 copay per day for days 1 through 5 and no copay for days 6 through 90, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under AARP Medicare Advantage from UHC TX-46 (HMO-POS) are covered with no coinsurance, featuring a $0 to $295 copay for outpatient hospital services and a $295 daily copay for observation services. Ambulatory surgical center and outpatient blood services require no copay and no coinsurance, while outpatient substance abuse services have no coinsurance and copays ranging from $0 to $25 per session.
Partial Hospitalization See details
AARP Medicare Advantage from UHC TX-46 (HMO-POS) covers partial hospitalization services with no copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC TX-46 (HMO-POS) covers ground and air ambulance services with a $150 copay and no coinsurance, though prior authorization is required. For transportation benefits, some services are covered, but trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC TX-46 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay ranging from $0 to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care, telehealth, and opioid treatment services are covered by AARP Medicare Advantage from UHC TX-46 (HMO-POS) with no copay and no coinsurance, while specialists, mental health, and podiatry services require copays up to $35 with no coinsurance. Therapy services have a $20 copay and no coinsurance, and while some chiropractic services are covered with a $15 copay and no coinsurance, routine and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are covered by AARP Medicare Advantage from UHC TX-46 (HMO-POS) with no copay and no coinsurance for annual physicals, kidney disease education, and screenings. Additional preventive services are partially covered with no copay and no coinsurance for fitness benefits and home safety devices, while sub-services such as health education, weight management, personal emergency response systems, in-home support, and alternative therapies are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC TX-46 (HMO-POS) with no coinsurance, offering one annual routine hearing exam with no copay, while fitting and evaluation exams as well as inner ear, outer ear, and over the ear prescription hearing aids are not covered. Covered prescription hearing aids have a copay of $199.00 to $1,249.00 with no coinsurance for up to two devices per year, and up to two over-the-counter (OTC) hearing aids are covered with a copay of $199.00 to $829.00 and no coinsurance.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC TX-46 (HMO-POS), offering routine eye exams with no copay, no deductible, and no coinsurance. Covered eyewear features a $150 maximum benefit every two years with no coinsurance, no copay for frames and contact lenses, and a $0 to $153 copay for eyeglass lenses; however, other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC TX-46 (HMO-POS) provides partially covered dental services with an annual limit of $4,000, featuring no copay and no coinsurance for preventive care. Medicare-covered dental services require no copay and 20% coinsurance, while covered comprehensive services have no copay and 50% coinsurance, though orthodontics and implant services are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC TX-46 (HMO-POS) covers home infusion bundled services with no copay, although prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from 0% to 20%, while Medicare Part B insulin drugs are covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC TX-46 (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
Medical equipment benefits under AARP Medicare Advantage from UHC TX-46 (HMO-POS) cover durable medical equipment, prosthetics, medical supplies, and diabetic services. Covered equipment and supplies feature no copayment and a 20% coinsurance, with prior authorization required for most services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC TX-46 (HMO-POS) with no coinsurance, though prior authorization and referrals are required. Members will pay no copay for lab services and diagnostic radiological services, a $5 copay for diagnostic procedures/tests and outpatient X-rays, and a minimum $60 copay for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC TX-46 (HMO-POS) with no copay and no coinsurance, although prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC TX-46 (HMO-POS) does not cover Cardiac Rehabilitation Services, as all associated sub-services, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD), are not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC TX-46 (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 days beyond the standard 100-day benefit period are not covered.
Other Services See details
AARP Medicare Advantage from UHC TX-46 (HMO-POS) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required to receive the meal benefit.
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