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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 $35.00. 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 $4200.00 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, you will pay no copay for standard pharmacy fills and three-month mail orders. Tier 2 generic medications cost a $12 copay for a one-month standard pharmacy fill, but you can obtain a three-month supply with no copay through preferred mail order. Higher-tier medications are subject to coinsurance rates rather than flat copayments under this plan. Tier 3 preferred brand drugs require a 17% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs incur coinsurance rates of 39% and 29% respectively for a one-month supply. These details help you understand your potential out-of-pocket prescription costs when choosing this Medicare Advantage plan.
Additional Benefits
The AARP Medicare Advantage from UHC VA-0012 (HMO-POS) plan offers comprehensive medical coverage with no copays for primary care visits, preventive services, and routine home health care. For specialized care, members pay copays ranging from $0 to $35 for specialists, while inpatient hospital stays require a $345 daily copay for the first six days and no copay thereafter. Emergency care is available with a $150 copay, which is waived upon hospital admission, and urgent care visits feature copays between $0 and $65. This plan also includes robust dental, vision, and hearing benefits, featuring no copays for routine exams alongside a $300 biennial eyewear allowance and up to $3,000 in annual dental coverage. While many services feature no coinsurance, certain benefits like durable medical equipment, dialysis, and Part B drugs require a 20% coinsurance. Additionally, members can access select over-the-counter items and chronic illness meals with no copays, though hearing aids and prescription lenses do carry variable copayments.
Inpatient Hospital See details
Inpatient hospital care is partially covered by AARP Medicare Advantage from UHC VA-0012 (HMO-POS) with no coinsurance, requiring a $345 daily copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional acute care days are covered at no copay, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient Services under AARP Medicare Advantage from UHC VA-0012 (HMO-POS) are covered with no coinsurance, featuring copays ranging from $0 to $345 for outpatient hospital services and a $345 daily copay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services require no coinsurance and copays between $0 and $25 depending on the session type.
Partial Hospitalization See details
Partial hospitalization services are covered by AARP Medicare Advantage from UHC VA-0012 (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization is required for 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, though prior authorization is required. Transportation services are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $65 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
Primary care services under AARP Medicare Advantage from UHC VA-0012 (HMO-POS) feature no copay and no coinsurance for primary care visits, telehealth, and opioid treatment. Specialist visits range from a $0 to $35 copay, physical, occupational, and speech therapies require a $30 copay, and mental health services have copays up to $25, all with no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage from UHC VA-0012 (HMO-POS) with no copay and no coinsurance for annual physicals, kidney disease education, fitness benefits, and select screenings. However, these benefits are only partially covered, as services such as health education, medical nutrition therapy, and in-home support are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC VA-0012 (HMO-POS), which includes one routine hearing exam per year with no copay and no coinsurance, but does not cover fitting or evaluation services. Up to two prescription hearing aids (with a $199.00 to $1,249.00 copay) and two OTC hearing aids (with a $199.00 to $829.00 copay) are covered annually with no coinsurance, though inner ear, outer ear, and over-the-ear prescription aids are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC VA-0012 (HMO-POS) with no coinsurance, offering one routine eye exam annually with no copay and a $300 eyewear allowance every two years. Covered eyewear includes contact lenses and frames with no copay, and lenses with a $0 to $153 copay, while other eye exams, 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) up to a $3,000 annual maximum, excluding implant services and orthodontics. Covered preventive services feature no copay and no coinsurance, while Medicare-covered dental services have no copay and a 20% coinsurance, and comprehensive services carry 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, though prior authorization is required. Covered Medicare Part B drugs, such as chemotherapy, radiation, and insulin, require a coinsurance ranging from no coinsurance up to 20%, with insulin also having a $35 copay.
Dialysis Services See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) covers medical equipment, offering durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Under this plan, diagnostic tests have a $50 copay, outpatient X-rays have a $25 copay, therapeutic radiology has a $60 copay, and there is no copay for lab services or select diagnostic radiology services.
Home Health Services See details
The AARP Medicare Advantage from UHC VA-0012 (HMO-POS) plan covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage from UHC VA-0012 (HMO-POS) with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC VA-0012 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering 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 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 (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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