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AARP Medicare Advantage from UHC WI-0015 (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-0015 (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-0015 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC WI-0015 (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-0015 (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-0015 (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-0015 (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 $520.00 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 $6700.00 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-0015 (HMO-POS) drug plan features an annual prescription deductible of $520. Tier 1 preferred generic drugs have no copay for standard pharmacy fills and mail order deliveries. Tier 2 generic drugs cost a $14 copay for a 1-month standard pharmacy supply, but you can pay no copay for a 3-month supply using preferred mail order. Higher-tier medications under this plan require coinsurance instead of flat copays. Tier 3 preferred brand drugs carry a 15% coinsurance for both pharmacy fills and mail orders. Tier 4 non-preferred drugs require a 40% coinsurance, while Tier 5 specialty drugs have a 27% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC WI-0015 (HMO-POS) plan offers comprehensive medical coverage with no copay or coinsurance for primary care visits, preventive services, annual physicals, and home health care. Specialist visits feature copays ranging from $0 to $55, while emergency room visits require a $130 copay that is waived if you are admitted. For hospital stays, members pay a daily copay of $455 for the first few days of inpatient care and no copay for subsequent days. Routine vision and hearing exams, as well as preventive dental cleanings, are available with no copay, though comprehensive dental services are not covered. The plan also provides up to $300 for eyewear every two years and covers hearing aids with copays starting at $199. Durable medical equipment, dialysis, and Part B drugs generally require a 20% coinsurance, while diabetic supplies are covered with no copay.
Inpatient Hospital See details
AARP Medicare Advantage from UHC WI-0015 (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $455 copay for days 1 through 6 of acute stays (with no copay for days 7 and beyond) and a $455 copay for days 1 through 5 of psychiatric stays (with no copay for days 6 through 90). Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC WI-0015 (HMO-POS) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services require a copay of $0 to $455, including a $455 daily copay for observation services, while outpatient substance abuse services feature no coinsurance and copays ranging from $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC WI-0015 (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-0015 (HMO-POS) covers ground and air ambulance services with a $290 copay and no coinsurance, though prior authorization is required. Routine transportation services to health-related locations are not covered by this plan.
Emergency Services See details
AARP Medicare Advantage from UHC WI-0015 (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 feature a copay ranging from $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Primary care benefits under the AARP Medicare Advantage from UHC WI-0015 (HMO-POS) plan are covered with no copay and no coinsurance for primary care visits, telehealth, and opioid treatment. Other services also feature no coinsurance, with copays ranging from $0 to $55 for specialists, $25 for occupational therapy, $30 for physical and speech therapy, $45 for podiatry, and up to $25 for mental health and psychiatric sessions, while chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC WI-0015 (HMO-POS) partially covers preventive services with no copay and no coinsurance for covered benefits like annual physical exams, kidney disease education, and fitness benefits. However, several supplemental services, including health education, weight management programs, and in-home safety assessments, are not covered.
Hearing Services See details
AARP Medicare Advantage from UHC WI-0015 (HMO-POS) partially covers hearing services, offering one routine hearing exam per year with no copay and no coinsurance, though fitting and evaluation services are not covered. The plan also covers up to two prescription hearing aids per year with copays from $199.00 to $1,249.00 and two OTC hearing aids with copays from $199.00 to $829.00, both with no coinsurance, but 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-0015 (HMO-POS), offering one routine eye exam per year with no copay and no coinsurance, while other eye exams are not covered. Eyewear is covered up to a $300 combined limit every two years with no coinsurance, featuring contact lenses and eyeglass frames with no copay, and eyeglass lenses with a $0 to $153 copay, though upgrades and combined eyeglasses are not covered.
Dental Services See details
AARP Medicare Advantage from UHC WI-0015 (HMO-POS) dental services are partially covered, offering preventive care like exams and cleanings with no copay and no coinsurance, and Medicare-covered dental with no copay and 20% coinsurance. Comprehensive dental services, including restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC WI-0015 (HMO-POS) covers home infusion bundled services with no copay, although prior authorization is required. Covered Part B drugs, including chemotherapy and radiation, require 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 by AARP Medicare Advantage from UHC WI-0015 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC WI-0015 (HMO-POS), featuring no copay and 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are available with no copay, and diabetic therapeutic shoes or inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the AARP Medicare Advantage from UHC WI-0015 (HMO-POS) plan, with prior authorization required. Diagnostic tests require a $50 copay and lab services have no copay, both with no coinsurance, while radiological services involve a $30 copay for X-rays, copays starting at $0 for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage from UHC WI-0015 (HMO-POS) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Under the AARP Medicare Advantage from UHC WI-0015 (HMO-POS) plan, some services are covered for cardiac rehabilitation with no copay, no coinsurance, and prior authorization required. However, 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
Skilled Nursing Facility (SNF) care is partially covered by AARP Medicare Advantage from UHC WI-0015 (HMO-POS) with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and while a 3-day prior hospital stay is not needed, additional days beyond the standard 100-day Medicare benefit period are not covered.
Other Services See details
Other services are partially covered by the AARP Medicare Advantage from UHC WI-0015 (HMO-POS) plan, which features a meal benefit for chronic illnesses with no copay and no coinsurance, requiring prior authorization. Acupuncture and over-the-counter (OTC) items are not covered.
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