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AARP Medicare Advantage Essentials from UHC UT-4 (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 UT-4 (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 UT-4 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Utah. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage Essentials from UHC UT-4 (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 UT-4 (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 UT-4 (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 $440.00 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 $5200.00 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 UT-4 (HMO-POS) plan features an annual drug deductible of $440. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic drugs are available with a $10 copay for a 1-month supply at standard pharmacies, or no copay for a 3-month supply when using preferred mail order. For higher-tier medications, costs are based on coinsurance instead of flat copays. Tier 3 preferred brand drugs require a 16% coinsurance, while Tier 4 non-preferred drugs carry a 40% coinsurance for a 1-month supply. Specialty Tier 5 medications are covered with a 28% coinsurance for a 1-month supply across standard pharmacies and mail order options.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) plan offers comprehensive coverage with no copay or coinsurance for primary care visits, preventive services, annual physicals, and routine hearing and vision exams. Members also benefit from no copay on home health services, cardiac rehabilitation, and lab tests, making routine wellness highly affordable. For specialized care, specialist visits range from a $0 to $40 copay, while outpatient hospital services vary from a $0 to $425 copay depending on the care received. For major medical needs, inpatient hospital stays require a $425 daily copay for the first six days, after which there is no copay, while emergency room visits carry a $130 copay that is waived upon admission. Skilled nursing facility stays feature no copay for the first 20 days, and medical equipment, dialysis, and Medicare-covered dental services generally require a 20% coinsurance. This plan balances low-cost everyday wellness care with predictable cost-sharing for emergency, diagnostic, and inpatient services.
Inpatient Hospital See details
Inpatient Hospital benefits are partially covered by AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) with no coinsurance, though prior authorization is required. Acute hospital stays require a $425 daily copay for days 1-6 and no copay for days 7 and beyond, excluding upgrades and non-Medicare-covered stays. Psychiatric stays require a $425 daily copay for days 1-5 and no copay for days 6-90, while additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $425, while outpatient substance abuse sessions have a copay ranging from $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) with a $290 copay and no coinsurance for both ground and air transport, though prior authorization is required. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage Essentials from UHC UT-4 (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 require a copay of $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 through the AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) feature no copay and no coinsurance for primary care provider visits and telehealth services. Specialist visits range from a $0 to $40 copay, physical and occupational therapies require a $20 copay, and podiatry costs a $40 copay, all with no coinsurance. Additionally, some chiropractic services are covered with a $15 copay and no coinsurance, but routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) covers preventive services, including annual physical exams, kidney disease education, and fitness benefits, with no copay and no coinsurance. However, these additional preventive services are only partially covered, as options like health education, in-home safety assessments, and weight management programs are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS), offering one annual routine hearing exam with no copay and no coinsurance. Covered prescription hearing aids (up to two per year) require a copay of $199.00 to $1,249.00 with no coinsurance, and OTC hearing aids (up to two per year) require a copay of $199.00 to $829.00 with no coinsurance. Fitting and evaluation exams, along with inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Vision Services are partially covered by AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS), offering one routine eye exam per year with no copay or coinsurance, though other eye exam services are not covered. For eyewear, there is no coinsurance and a $150 maximum benefit every two years that covers contact lenses and frames with no copay, and lenses with a $0 to $153 copay, while upgrades and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered under the AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) plan, which features Medicare-covered dental services with no copay and a 20% coinsurance, alongside preventive services with no copay and no coinsurance. However, several services are not covered, including restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) with no copay and no coinsurance, though prior authorization is required. Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance up to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copays and a 20% coinsurance on most items. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) with prior authorization required. Diagnostic tests require a $50 copay with no coinsurance, lab services have no copay and no coinsurance, outpatient X-rays have a $30 copay, and therapeutic radiology has a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. Patients pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by AARP Medicare Advantage Essentials from UHC UT-4 (HMO-POS), which offers a meal benefit for chronic illnesses with no copay and no coinsurance, subject to prior authorization. Acupuncture, over-the-counter (OTC) items, and dual-eligible SNP services are not covered.
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