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AARP Medicare Advantage from UHC WI-0012 (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-0012 (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-0012 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC WI-0012 (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-0012 (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-0012 (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-0012 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $44.00. 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 $4900.00 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-0012 (HMO-POS) plan has an annual prescription drug deductible of $440. Under this plan, Tier 1 preferred generic drugs have no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic drugs cost a $12 copay for a 1-month supply at standard pharmacies, but you can save with no copay for a 3-month supply using preferred mail order. Brand-name and specialty medications are subject to coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 17% coinsurance, while Tier 4 non-preferred drugs require a 40% coinsurance for a 1-month supply. Tier 5 specialty drugs carry a 28% coinsurance for a 1-month supply at standard pharmacies and through mail order.
Additional Benefits
The AARP Medicare Advantage from UHC WI-0012 (HMO-POS) plan offers comprehensive coverage for core medical services with many benefits requiring no copayments or coinsurance. Routine primary care visits, telehealth, annual physicals, and home health services feature no copay, while specialist visits require a copay of up to $45. For hospital stays, there is no coinsurance, though inpatient admissions require a daily copay of $395 for the first several days and emergency room visits carry a $130 copay. This plan also includes valuable supplemental coverage for dental, vision, and hearing services, featuring no copay for routine exams and preventive dental care up to a $1,000 annual limit. Prescription hearing aids and eyewear are covered with specific copays and allowance limits, and there is no coinsurance for these routine services. Medical equipment, dialysis, and Medicare Part B drugs generally require a 20% coinsurance, while diabetic supplies are available with no copay.
Inpatient Hospital See details
AARP Medicare Advantage from UHC WI-0012 (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $395 daily copay for days 1 to 7 of acute stays (no copay for days 8 and beyond) and days 1 to 5 of psychiatric stays (no copay for days 6 to 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC WI-0012 (HMO-POS) with no coinsurance, featuring copays ranging from $0 to $395 for outpatient hospital and observation services. Ambulatory surgical center and outpatient blood services are available with no copay and no coinsurance, while outpatient substance abuse sessions have no coinsurance and copays ranging from $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC WI-0012 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC WI-0012 (HMO-POS) covers ground and air ambulance services with a $290 copay and no coinsurance, with prior authorization required. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services under the AARP Medicare Advantage from UHC WI-0012 (HMO-POS) are covered 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 $0 to $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care services under AARP Medicare Advantage from UHC WI-0012 (HMO-POS) feature no copay and no coinsurance for primary care and telehealth visits, while specialists and therapy services require copays up to $45 and no coinsurance. Chiropractic care is partially covered with a $15 copay and no coinsurance, though routine and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by AARP Medicare Advantage from UHC WI-0012 (HMO-POS) with no copay and no coinsurance for covered options like annual physicals, kidney disease education, glaucoma screenings, fitness benefits, and home safety devices. However, several additional preventive sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, in-home support, tobacco cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
AARP Medicare Advantage from UHC WI-0012 (HMO-POS) partially covers hearing services with no deductible and no coinsurance. Routine exams have no copay, while covered prescription and OTC hearing aids require copays ranging from $199.00 to $1,249.00. Fitting and evaluation exams, as well as 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-0012 (HMO-POS) with no coinsurance, offering one routine eye exam annually with no copay, while other eye exam services are not covered. Eyewear coverage includes a $200 limit every two years with no coinsurance, featuring no copay for contact lenses and frames, and no copay to a $153 copay for lenses, though upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC WI-0012 (HMO-POS), offering preventive and diagnostic care with no copay and no coinsurance up to a $1,000 yearly limit. Medicare-covered dental services have no copay and 20% coinsurance, while covered comprehensive services have no copay and 50% coinsurance, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC WI-0012 (HMO-POS) with no copay, requiring prior authorization and step therapy. Covered Medicare Part B drugs, including chemotherapy, have no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC WI-0012 (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage from UHC WI-0012 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are available with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for most medical equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC WI-0012 (HMO-POS) with prior authorization required. Lab services and diagnostic radiology feature no copay and no coinsurance, while diagnostic tests require a $50 copay with no coinsurance, outpatient X-rays require a $30 copay, and therapeutic radiology services carry a 20% coinsurance.
Home Health Services See details
Home health services are covered under the AARP Medicare Advantage from UHC WI-0012 (HMO-POS) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are not covered under the AARP Medicare Advantage from UHC WI-0012 (HMO-POS) plan, with cardiac, intensive cardiac, pulmonary, and supervised exercise therapy services all excluded from coverage despite the plan listing no coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC WI-0012 (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 is required, a prior three-day hospital stay is not required for admission, and additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
AARP Medicare Advantage from UHC WI-0012 (HMO-POS) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for the meal benefit, and acupuncture is not covered.
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