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AARP Medicare Advantage from UHC WI-0011 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC WI-0011 (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 WI-0011 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC WI-0011 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Wisconsin. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC WI-0011 (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 WI-0011 (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 WI-0011 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $59.00. 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 $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 WI-0011 (HMO-POS) plan features an annual prescription drug deductible of $440. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies or through mail-order services. Tier 2 generic drugs require a $10 copay for a 1-month standard pharmacy supply, though you can receive a 3-month supply with no copay when using preferred mail order. Higher-tier medications under this plan are subject to coinsurance rather than flat copayments. Tier 3 preferred brand drugs require a 17% coinsurance for standard pharmacy and mail-order fills. Tier 4 non-preferred drugs carry a 42% coinsurance, while Tier 5 specialty drugs require a 28% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC WI-0011 (HMO-POS) plan offers robust medical coverage with no copay for primary care visits, routine preventive services, and home health care. Specialist visits are highly affordable with copays ranging from no copay up to $45, while inpatient hospital stays require a $445 copay for days 1 through 5. Emergency room visits carry a $150 copay, which is waived if you are admitted to the hospital within 24 hours. Members also enjoy valuable supplemental benefits, including routine dental, vision, and hearing exams with no copay, alongside a $300 eyewear allowance. While many services feature no coinsurance, durable medical equipment and dialysis services require a 20% coinsurance. Additionally, the plan covers over-the-counter items and chronic illness meals with no copay or coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC WI-0011 (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $445 copay for days 1 to 5 and no copay for days 6 to 90. While unlimited additional acute days are covered at no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services under the AARP Medicare Advantage from UHC WI-0011 (HMO-POS) plan are covered with no coinsurance, although prior authorization is required for most services. Patients will pay no copay for ambulatory surgical center and blood services, a $0 to $445 copay for outpatient hospital and observation services, and a $0 to $25 copay for outpatient substance abuse sessions.
Partial Hospitalization See details
AARP Medicare Advantage from UHC WI-0011 (HMO-POS) covers partial hospitalization with a $55.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC WI-0011 (HMO-POS) covers emergency ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services for AARP Medicare Advantage from UHC WI-0011 (HMO-POS) are covered with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature no copay to a $65 copay 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 are provided by AARP Medicare Advantage from UHC WI-0011 (HMO-POS) with no copay and no coinsurance for primary care visits, telehealth, and opioid treatment. Other services feature no coinsurance, including specialist visits with a $0 to $45 copay, physical and occupational therapy with a $35 copay, and podiatry with a $45 copay. Some chiropractic services are covered, but routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage from UHC WI-0011 (HMO-POS) with no copay and no coinsurance for covered services like annual physical exams, kidney disease education, fitness benefits, and glaucoma screenings. Several supplemental benefits are not covered under this plan, including health education, personal emergency response systems, weight management programs, nutritional/dietary benefits, and in-home support services.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC WI-0011 (HMO-POS), offering one annual routine hearing exam with no copay or coinsurance, though fitting and evaluation exams are not covered. Up to two prescription or over-the-counter hearing aids are covered per year with no coinsurance and copays ranging from $199.00 to $1,249.00, though 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 from UHC WI-0011 (HMO-POS), offering routine eye exams with no copay or coinsurance, and eyewear coverage up to $300 every two years with no coinsurance and copays ranging from $0 to $153. Other eye exam services, upgrades, and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC WI-0011 (HMO-POS), excluding implant services and orthodontics. Preventive and diagnostic services feature no copay and no coinsurance up to a $3,000 annual maximum, while Medicare-covered dental services have no copay and 20% coinsurance, and covered comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC WI-0011 (HMO-POS) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other Part B drugs feature no copay and no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC WI-0011 (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Medical Equipment covered by AARP Medicare Advantage from UHC WI-0011 (HMO-POS) includes durable medical equipment, prosthetics, and medical supplies, all of which feature no copay and a 20% coinsurance. Diabetic supplies are also covered with no copay, while diabetic therapeutic shoes and inserts carry a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC WI-0011 (HMO-POS) covers diagnostic and radiological services with no copay or coinsurance for lab services, and a $50 copay with no coinsurance for diagnostic tests. Diagnostic radiology services have copays starting at $0, outpatient X-rays require a $30 copay along with coinsurance, and therapeutic radiology services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC WI-0011 (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered with no copay and no coinsurance under the AARP Medicare Advantage from UHC WI-0011 (HMO-POS) plan, though prior authorization is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by AARP Medicare Advantage from UHC WI-0011 (HMO-POS) 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 standard Medicare benefit are not covered.
Other Services See details
AARP Medicare Advantage from UHC WI-0011 (HMO-POS) partially covers other services, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit, and prior authorization is required for the meal benefit.
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