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AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Essentials from UHC KY-1 (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 Essentials from UHC KY-1 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Kentucky. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage Essentials from UHC KY-1 (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 Essentials from UHC KY-1 (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 Essentials from UHC KY-1 (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 Essentials from UHC KY-1 (HMO-POS) plan features an annual drug deductible of $520. For Tier 1 preferred generic drugs, members pay no copay for standard pharmacy fills or mail order options. Tier 2 generic medications require a $10 copay for a 1-month standard pharmacy supply, though a 3-month supply has no copay when filled through preferred mail order. Brand-name and specialty medications under this plan are subject to coinsurance rather than flat copayments. Tier 3 preferred brand drugs require a 15% coinsurance, while Tier 4 non-preferred drugs carry a 41% coinsurance. Specialty drugs in Tier 5 require a 27% coinsurance for a 1-month supply across both standard pharmacies and mail order services.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) offers comprehensive medical coverage with no copay for primary care visits, annual physicals, and routine home health services. For hospital stays, there is no coinsurance, but members pay a daily copay of $455 for the first six days of acute inpatient care and a $130 copay for emergency room visits. Outpatient surgical services and diagnostic lab tests are also highly accessible, featuring no copay and no coinsurance. Specialist visits require a copay ranging from $0 to $45, while routine vision, hearing, and preventive dental exams are available with no copay or coinsurance. Prescription hearing aids, eyewear, and diabetic supplies are covered, though durable medical equipment and dialysis services require a 20% coinsurance. Additionally, the plan provides coverage for over-the-counter items and home infusion services with no copay.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $455 daily copay for days 1 to 6 of acute stays (with no copay for days 7 and beyond) and a $455 daily copay for days 1 to 5 of psychiatric stays (with no copay for days 6 to 90). This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services covered by AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) require prior authorization and feature no coinsurance. Outpatient hospital copays range from no copay to $455 (including $455 daily for observation services), while ambulatory surgical center and blood services have no copay and no coinsurance. Outpatient substance abuse services also feature no coinsurance, with copays ranging from no copay to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) covers ground and air ambulance services with a $275 copay and no coinsurance, with prior authorization required. Transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) 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 of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) provides primary care and telehealth visits with no copay and no coinsurance, while specialist visits range from a $0 to $45 copay with no coinsurance. Physical, occupational, and speech therapies cost a $45 copay with no coinsurance, but routine and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS), featuring no copay and no coinsurance for covered options like annual physicals, fitness benefits, and home safety devices. Excluded sub-services that are not covered include 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/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services are partially covered under AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS), which offers one routine hearing exam annually with no copay or coinsurance, but excludes fitting and evaluation exams. Up to two prescription or OTC hearing aids are covered per year with no coinsurance and copays ranging from $199 to $1,249 for prescription and $199 to $829 for OTC devices, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) provides partially covered vision services with no deductibles or coinsurance, including one routine annual eye exam with no copay. Eyewear is covered up to a $300 combined maximum every two years with no copay for contact lenses or frames and a $0 to $153 copay for lenses, though upgrades, combined eyeglasses, and other eye exams are not covered.
Dental Services See details
AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) partially covers dental services, offering Medicare-covered dental care with no copay and a 20% coinsurance. Routine preventive services like exams, cleanings, fluoride, and X-rays are covered with no copay and no coinsurance. However, comprehensive treatments such as restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance, while covered Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) covers medical equipment, including durable medical equipment, prosthetics, and medical supplies, with no copay and 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require 20% coinsurance, with prior authorization required for most equipment.
Diagnostic and Radiological Services See details
AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) covers diagnostic and radiological services, with prior authorization required for all services. Diagnostic lab services and diagnostic radiological services have no copay and no coinsurance, while diagnostic tests require a $50 copay and no coinsurance, outpatient x-rays require a $30 copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) technically covers Cardiac Rehabilitation Services with no copay and no coinsurance, subject to prior authorization. However, this benefit is not covered in practice because standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation sub-services are all not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS) covers Skilled Nursing Facility (SNF) services 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, no prior three-day inpatient hospital stay is needed, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by AARP Medicare Advantage Essentials from UHC KY-1 (HMO-POS), offering over-the-counter (OTC) items and a chronic illness meal benefit with no copay and no coinsurance. Acupuncture is not covered under this plan, and the meal benefit requires prior authorization.
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