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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 2025, 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 2025.
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 $43.00. 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 WI-0011 (HMO-POS) plan has a $340 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, you will pay a $10 copay for preferred generic drugs at a standard pharmacy, while standard generic drugs have a $47 copay at a standard pharmacy. Preferred brand drugs have a $100 copay, and non-preferred drugs have 29% coinsurance. Once your total drug costs reach $2000, you will enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC WI-0011 (HMO-POS) plan offers a wide range of benefits with varying cost-sharing. You can expect no copay for primary care visits, many outpatient services, and preventive services like annual physical exams. This plan also covers services like hearing exams, vision exams, and dental services with no copay for many services, and a 20% coinsurance for Medicare Dental Services. For inpatient hospital stays, you'll pay a $350 copay for the first 5 days, and no copay for the rest of the days. Emergency services have a $140 copay, and ambulance services have a $260 copay. The plan also covers home health services with no copay, and covers prescription hearing aids, with copays ranging from $199 to $1249.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric services, are covered. For acute inpatient hospital stays, you'll pay a $350 copay for days 1-5, and no copay for days 6-90, while additional days have no copay.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay of $0-$350, observation services with a $350 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a $0-$10 copay for individual sessions and a $5 copay for group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services, as offered by AARP Medicare Advantage from UHC WI-0011 (HMO-POS), covers both ground and air ambulance services, each with a $260 copay and no coinsurance. Transportation Services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $140 copay, while Urgently Needed Services have a copay between $0 and $65. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have no copay.
Primary Care See details
The AARP Medicare Advantage from UHC WI-0011 (HMO-POS) plan covers Primary Care Physician services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a copay between $0-$25, Physician Specialist Services with a copay between $0-$40, and Mental Health, Psychiatric, Podiatry, and Other Health Care Professional services with varying copays. This plan also covers Physical Therapy and Speech-Language Pathology Services with a copay between $0-$25, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
Preventive services include annual physical exams with no copay, and additional preventive services with copays for Fitness Benefit and Home and Bathroom Safety Devices and Modifications. Other services like Health Education, In-Home Safety Assessment, and others are not covered.
Hearing Services See details
Hearing exams are covered with no copay. Prescription hearing aids (all types) are covered with a copay between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/evaluation for hearing aids, 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 coverage for eye exams, routine eye exams, and eyewear. Eye exams and routine eye exams have no copay. Contact lenses and eyeglass frames have no copay, while eyeglass lenses have a copay between $0 and $153. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Other services include oral exams, dental x-rays, and other diagnostic and preventative services with no copay, and a maximum benefit of $2,500 per year. Prosthodontics, fixed and removable, have a coinsurance between 0% and 50%, while implant and orthodontic services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but prior authorization is required. For Medicare Part B insulin drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B chemotherapy/radiation drugs and other Medicare Part B drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC WI-0011 (HMO-POS) plan, but require prior authorization. The coinsurance for Dialysis Services is between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment, including Diabetic Supplies with no copay and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for Diagnostic Procedures/Tests with a $50 copay, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $220, Therapeutic Radiological Services with 20% coinsurance, and Outpatient X-Ray Services with a $25 copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered with no copay and no coinsurance, but Additional Hours of Care and Personal Care Services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services. Prior authorization is required, and the copay information is available separately.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC WI-0011 (HMO-POS) plan, with prior authorization required. There is no copay for days 1-20, and a $203 copay for days 21-100, while additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The AARP Medicare Advantage from UHC WI-0011 (HMO-POS) plan covers over-the-counter (OTC) items and meal benefits with no copay, but acupuncture and several other services are not covered. The plan offers OTC items with no copay, and meal benefits with no copay but require prior authorization.
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