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AARP Medicare Advantage from UHC TN-0004 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC TN-0004 (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 TN-0004 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC TN-0004 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Tennessee. 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 TN-0004 (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 TN-0004 (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 TN-0004 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $39.00. 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 $3800.00 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 TN-0004 (HMO-POS) plan has an enhanced alternative drug benefit. The plan includes 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 preferred generic drugs, there is a $12 copay at standard pharmacies. Standard generic drugs have a $47 copay at standard pharmacies. Preferred brand drugs have a $100 copay, regardless of the pharmacy. Non-preferred drugs have a 29% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase.
Additional Benefits
The AARP Medicare Advantage from UHC TN-0004 (HMO-POS) plan offers comprehensive coverage with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services and many primary care visits have no copay. This plan includes coverage for ambulance services, emergency services, preventive services, hearing, vision, and dental services. Additionally, it covers home health, skilled nursing, and other services such as OTC items and meal benefits, all with varying copays or coinsurance, depending on the service.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered with a copay of $175 per day for days 1-5, and no copay for days 6-90. Additional days for inpatient hospital-acute have no copay. Non-Medicare-covered stays and upgrades for inpatient hospital-acute, as well as additional days and non-Medicare-covered stays for inpatient hospital psychiatric, are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $175, and observation services, with a copay of $175. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, while Individual Sessions for Outpatient Substance Abuse have a copay between $0 and $25 and Group Sessions have a copay of $15.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC TN-0004 (HMO-POS) plan, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered with a $185 copay for both ground and air ambulance services, and no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered, with a $140 copay, and no coinsurance. Urgently Needed Services have a copay between $0 and $45, and no coinsurance. Worldwide Emergency Services are covered, with no copay or coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Primary Care Physician Services have no copay, Chiropractic Services have a $20 copay, and Occupational Therapy Services have a copay between $0 and $20. Physician Specialist Services have a copay between $0 and $25, while Mental Health Specialty Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Podiatry Services have a $25 copay, Other Health Care Professional services have a copay between $0 and $25, and Psychiatric Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $20, Additional Telehealth Benefits have no copay, and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services are covered under this plan, including an annual physical exam with no copay. Additional preventive services may have a copay.
Hearing Services See details
Hearing exams are covered with no copay. Prescription hearing aids are covered with a copay between $199 and $1249, depending on the type of hearing aid. 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 eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered annually. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, all with no copay; however, eyeglass lenses are covered up to $153.00, and eyeglass frames are covered every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with 20% coinsurance for Medicare Dental Services. Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, Other Preventive Dental Services, and Oral and Maxillofacial Surgery have no copay. Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed) and Maxillofacial Prosthetics also have no copay. The plan does not cover Implant Services or Orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0-20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC TN-0004 (HMO-POS) plan, with a coinsurance of 20%. Prior authorization is required for this service.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, while 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, including diagnostic procedures and tests with a $20 copay, and lab services with no copay. Diagnostic radiological services have a copay of at most $105, and therapeutic radiological services have a coinsurance of at most 20%. Outpatient X-ray services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC TN-0004 (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but specific services including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage from UHC TN-0004 (HMO-POS) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100; additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The "Other Services" benefit for AARP Medicare Advantage from UHC TN-0004 (HMO-POS) covers Over-the-Counter (OTC) Items with no copay, and Meal Benefit with no copay and prior authorization required, but does not cover 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.
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