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AARP Medicare Advantage from UHC OH-0003 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC OH-0003 (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 OH-0003 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC OH-0003 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Ohio and Kentucky. 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 OH-0003 (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 OH-0003 (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 OH-0003 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $33.00. 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 $4100.00 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 OH-0003 (HMO-POS) plan has a $340 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy. In the initial coverage phase, you may pay $10 or $47 copay for generic drugs, and $100 copay or 29% coinsurance for brand name and non-preferred drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC OH-0003 (HMO-POS) plan offers comprehensive coverage with a variety of benefits. This plan includes coverage for inpatient and outpatient hospital services with varying copays. It also covers a range of services such as primary care, preventive services with no copay for many services, and vision and dental services. Additional benefits include coverage for ambulance services, emergency services, and hearing services. The plan also offers benefits for home health services, skilled nursing facilities, and other services such as over-the-counter items and meal benefits. The copays and coinsurance amounts vary depending on the specific service.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $300 copay for days 1-4, and no copay for days 5-90, while additional days have no copay; for Inpatient Hospital Psychiatric, you will pay a $300 copay for days 1-4, and no copay for days 5-90. 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 hospital services have a copay between $0 and $300, while observation services have a $300 copay. Ambulatory Surgical Center (ASC) Services and outpatient blood services have no copay. Individual sessions for outpatient substance abuse have a copay between $0 and $25, and group sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the plan and requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the AARP Medicare Advantage from UHC OH-0003 (HMO-POS) plan, with prior authorization required for all ambulance services. Ground and Air Ambulance Services have a $275 copay, and Transportation Services to any health-related location are not covered. There is no coinsurance for these services.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the AARP Medicare Advantage from UHC OH-0003 (HMO-POS) plan. Emergency Services have a $140 copay and no coinsurance, while Urgently Needed Services have a copay between $0 and $65 with no coinsurance. Worldwide Emergency Services includes Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, all of which have no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC OH-0003 (HMO-POS) covers primary care physician services with no copay, chiropractic services with a $20 copay (prior authorization required), and occupational therapy services with a copay between $0 and $20 (prior authorization required). This plan also covers physician specialist services with a copay between $0 and $25 (prior authorization required), mental health specialty services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions (prior authorization required), and podiatry services and other health care professional services with a $25 copay (prior authorization required). Additionally, this plan offers physical therapy and speech-language pathology services with a copay between $0 and $20 (prior authorization required), additional telehealth benefits with no copay, and opioid treatment program services with no copay (prior authorization required).
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, annual physical exams, and additional preventive services, with no copay for the annual physical exam, Fitness Benefit, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. However, Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, but fitting/evaluation for hearing aids are not covered. Prescription hearing aids have a copay between $199 and $1249, while OTC hearing aids have a copay between $99 and $829.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear is covered with no copay, including contact lenses, eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $300 every two years; however, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
AARP Medicare Advantage from UHC OH-0003 (HMO-POS) covers Medicare Dental Services with 20% coinsurance and other dental services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Oral and Maxillofacial Surgery are covered with no copay. Implant Services and Orthodontics 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.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC OH-0003 (HMO-POS) plan and require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the AARP Medicare Advantage from UHC OH-0003 (HMO-POS) plan. Diagnostic Procedures/Tests have a $50 copay, while Lab Services have no copay. Diagnostic Radiological Services have a maximum copay of $200, and Therapeutic Radiological Services have a 20% coinsurance. 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 OH-0003 (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 the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required.
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, and for days 21-100, the copay is $203.
Other Services See details
Other services include coverage for over-the-counter items and meal benefits. Over-the-counter items have no copay, and 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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