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AARP Medicare Advantage from UHC VA-0012 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC VA-0012 (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 VA-0012 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Virginia. 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 VA-0012 (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 VA-0012 (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 VA-0012 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $36.00. 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 $355.00 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 $5400.00 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 VA-0012 (HMO-POS) plan features an annual prescription drug deductible of $355. For Tier 1 preferred generic drugs, members pay no copay for standard pharmacy fills and mail order deliveries. Tier 2 generic drugs cost a $12 copay for a 1-month supply at standard pharmacies, but you can save with no copay on 3-month supplies ordered through preferred mail order. For brand-name and specialty medications, costs are structured as coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 17% coinsurance for standard pharmacy and mail-order fills. Tier 4 non-preferred drugs have a 39% coinsurance, while Tier 5 specialty drugs carry a 29% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC VA-0012 (HMO-POS) plan offers comprehensive medical coverage featuring no copays for primary care visits, telehealth, preventive services, and home health care. For inpatient hospital stays, members pay a daily copay of $295 for the first six days and no copay for days seven through 90, with no coinsurance. Specialist visits and outpatient services are also affordable, featuring copays ranging from no copay up to $30 and $295 respectively, with no coinsurance required. This plan also covers routine hearing, vision, and dental exams with no copays, including up to $3,500 in preventive dental care. Emergency room visits require a $130 copay, which is waived if you are admitted, and urgent care copays range from no copay up to $50. Durable medical equipment and dialysis services are covered with a 20% coinsurance, while other specialized benefits like hearing aids and eyewear are partially covered with specific copay limits.
Inpatient Hospital See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $295 daily copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional acute days are covered at no copay, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $295, daily observation services have a $295 copay, and outpatient substance abuse sessions carry a copay of $0 to $25.
Partial Hospitalization See details
Partial hospitalization is covered under the AARP Medicare Advantage from UHC VA-0012 (HMO-POS) plan with a $55.00 copay and no coinsurance. Prior authorization is required to access these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) covers ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. Some transportation services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage from UHC VA-0012 (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 copays or coinsurance.
Primary Care See details
Primary Care benefits under AARP Medicare Advantage from UHC VA-0012 (HMO-POS) feature no copay and no coinsurance for primary care and telehealth visits, while specialist visits cost a $0 to $30 copay with no coinsurance. Mental health, therapy, and podiatry services are also covered with no coinsurance and copays ranging from $0 to $30, though chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) covers preventive services, including annual physical exams, kidney disease education, and fitness benefits, with no copay and no coinsurance. However, additional preventive benefits are only partially covered, as services such as health education, personal emergency response systems, in-home support, and medical nutrition therapy are not covered.
Hearing Services See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) partially covers hearing services with no deductible, though prior authorization is required for exams and prescription aids. Routine hearing exams have no copay and no coinsurance, while covered OTC and prescription hearing aids have no coinsurance and copays ranging from $199.00 to $1,249.00. Hearing aid fitting and evaluations, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) partially covers vision services, offering routine eye exams with no copay and no coinsurance, while other eye exam services are not covered. Eyewear is also partially covered with no coinsurance and copays ranging from no copay to $153 up to a $300 limit every two years, though upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC VA-0012 (HMO-POS), excluding implant services and orthodontics. Preventive care has no copay and no coinsurance up to a $3,500 annual maximum, while Medicare-covered dental services have no copay and a 20% coinsurance, and covered comprehensive services require no copay and a 50% coinsurance.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Covered Medicare Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%, while chemotherapy, radiation, and other Part B drugs feature no copay and coinsurance from no coinsurance to 20%.
Dialysis Services See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) covers Dialysis Services 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 VA-0012 (HMO-POS), including durable medical equipment, prosthetics, and medical supplies which require no copay and 20% coinsurance. Diabetic supplies are covered with no copay, and diabetic shoes or inserts have a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC VA-0012 (HMO-POS), with prior authorization required for all services. Lab services and diagnostic radiology have no copay and no coinsurance, while diagnostic tests require a $50 copay, outpatient X-rays require a $30 copay with coinsurance, and therapeutic radiology requires a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC VA-0012 (HMO-POS) with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) covers Cardiac Rehabilitation Services with no copay or coinsurance and prior authorization required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by AARP Medicare Advantage from UHC VA-0012 (HMO-POS) 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, and additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) partially covers other services, offering over-the-counter items and meal benefits for chronic illnesses with no copay and no coinsurance. Prior authorization is required for the meal benefit, and acupuncture is not covered under this plan.
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