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AARP Medicare Advantage from UHC WI-0014 (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-0014 (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-0014 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC WI-0014 (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-0014 (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-0014 (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-0014 (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 $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 $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:
Sign up for AARP Medicare Advantage from UHC WI-0014 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage from UHC WI-0014 (HMO-POS) plan has a $340 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, standard generic drugs have a $14 copay, and preferred brand drugs have a $100 copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered Part D drugs. However, you may still pay for excluded drugs covered under any enhanced benefit. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS).
Additional Benefits
The AARP Medicare Advantage from UHC WI-0014 (HMO-POS) plan offers a range of benefits with varying costs. Hospital stays have copays of $395, while outpatient services range from no copay to $395. Emergency services have a $125 copay, and ambulance services have a $275 copay. The plan provides no copay for primary care, preventive services, hearing exams, eye exams, and many dental services. Additionally, there is no copay for home health services and over-the-counter items. However, you may be responsible for coinsurance for some services like dialysis, medical equipment, and certain radiological services.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $395 copay for days 1-4, and no copay for days 5-90. For Inpatient Hospital Psychiatric, you will pay a $395 copay for days 1-3, and no copay for days 4-90. Additional days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $395, Observation Services with a $395 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a copay between $0 and $15 for individual sessions and a $10 copay for group sessions, and Outpatient Blood Services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. For this benefit, you will have a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC WI-0014 (HMO-POS) plan. Ground and air ambulance services have a $275 copay, and there is no coinsurance, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including urgently needed services and worldwide emergency services, are covered by the AARP Medicare Advantage from UHC WI-0014 (HMO-POS) plan. Emergency services have a $125 copay, while urgently needed services have a copay between $0 and $55; worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation all have no copay. There is no coinsurance for any of these services.
Primary Care See details
The AARP Medicare Advantage from UHC WI-0014 (HMO-POS) plan covers primary care physician services with no copay. Chiropractic services have a $20 copay, while occupational therapy services have a copay between $0 and $25. Physician specialist services have a copay between $0 and $40. Mental health specialty services, individual sessions for mental health specialty services, and psychiatric services have a copay between $0 and $15, and group sessions for these services have a $10 copay. Podiatry services and other health care professional services have a copay between $40 and $0, respectively. Physical therapy and speech-language pathology services have a copay between $0 and $25. Additional telehealth benefits have no copay, and opioid treatment program services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, as well as an annual physical exam with no copay. Additional preventive services, including Fitness Benefit and Home and Bathroom Safety Devices and Modifications, are covered with a $0 copay. Other services such as Health Education, and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with no copay. Prescription hearing aids are partially covered; Prescription Hearing Aids (all types) have a copay between $199 and $1249, while Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
The AARP Medicare Advantage from UHC WI-0014 (HMO-POS) plan covers vision services, including eye exams with no copay. Eyewear benefits are covered, including contact lenses, eyeglass lenses, and eyeglass frames with no copay, and a combined maximum of $300 every two years. However, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include a 20% coinsurance for Medicare Dental Services, with prior authorization required. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for Home Infusion bundled Services.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC WI-0014 (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, is covered. Durable medical equipment has a 20% coinsurance, while prosthetic devices and medical supplies have a 20% coinsurance and no copay. Diabetic supplies have no copay, and diabetic therapeutic shoes/inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a $50 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $170, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC WI-0014 (HMO-POS) plan with no copay and no coinsurance, but Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required, and the copay information is available below.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, but for days 21-100, the copay is $203. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for over-the-counter items and meal benefits. Over-the-counter items have no copay, while meal benefits also have no copay and require prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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