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AARP Medicare Advantage Giveback from UHC TC-4 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Giveback from UHC TC-4 (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 Giveback from UHC TC-4 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Giveback from UHC TC-4 (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 and Virginia. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage Giveback from UHC TC-4 (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 Giveback from UHC TC-4 (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 Giveback from UHC TC-4 (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. Additionally, this plan comes with a Part B Premium reduction of $105.00. You must continue to pay paying your reduced 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 $495.00 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 $6300.00 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 Giveback from UHC TC-4 (HMO-POS) plan has a $495.00 deductible for prescription drugs. After the deductible is met, you will pay a copay for your prescriptions. For preferred generic drugs, the copay is $14.00, and for standard generic drugs, the copay is $47.00. For preferred brand drugs, the copay is $100.00. Non-preferred drugs have a 27% coinsurance. Once your total drug costs reach $2000.00, you will enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage Giveback from UHC TC-4 (HMO-POS) plan offers a range of benefits including inpatient hospital stays with a copay of $375 for days 1-5, and no copay for days 6-90. The plan also covers outpatient services with varying copays, emergency services, and offers no copays for primary care physician services, preventive services, and eye exams. This plan also provides coverage for hearing services, dental services, home infusion, and medical equipment with varying cost-sharing. Additionally, the plan includes skilled nursing facility stays, home health services, and dialysis services with some cost-sharing. However, certain services like cardiac rehabilitation, and additional days for some services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $375 for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay of $0-$375, observation services with a $375 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay of $0-$25 for individual sessions and a $15 copay for group sessions, and outpatient blood services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage Giveback from UHC TC-4 (HMO-POS) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the AARP Medicare Advantage Giveback from UHC TC-4 (HMO-POS) plan. Both ground and air ambulance services have a $270 copay, with no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the AARP Medicare Advantage Giveback from UHC TC-4 (HMO-POS) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The AARP Medicare Advantage Giveback from UHC TC-4 (HMO-POS) plan covers primary care physician services with no copay. Chiropractic services have a $20 copay, while occupational therapy services have a copay between $0 and $35. Physician specialist services and physical therapy/speech-language pathology services have copays that range from $0 to $45 and $0 to $40, respectively. Mental health and psychiatric individual sessions have a copay between $0 and $25, and group sessions have a $15 copay. Podiatry services and other healthcare professional services have varying copays, and additional telehealth benefits have no copay. Opioid treatment program services have no copay.
Preventive Services See details
Preventive services include no copay for an annual physical exam, as well as Medicare-covered preventive services. Additional preventive services are covered, including fitness benefits with no copay for memory fitness and activity trackers. Some preventive services like health education, in-home safety assessments, and others are not covered.
Hearing Services See details
Hearing services include routine hearing exams with no copay, and prescription hearing aids with a copay between $199 and $1249, and OTC hearing aids with a copay between $99 and $829. Fitting/evaluation for hearing aids, prescription hearing aids for the inner ear, outer ear, and 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 once per year, and other eye exams are covered. Contact lenses have no copay, and eyeglass lenses have a copay between $0 and $153. Eyeglass frames have no copay, but eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services, and no coinsurance for Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and the coinsurance is between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage Giveback from UHC TC-4 (HMO-POS) plan. This plan requires prior authorization and has a coinsurance of 20%.
Medical Equipment See details
Medical Equipment is covered, with a 20% coinsurance for Durable Medical Equipment, Prosthetic Devices, Medical Supplies, and Diabetic Therapeutic Shoes/Inserts. Diabetic Supplies have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a $25 copay, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $150, Therapeutic Radiological Services with 20% coinsurance, and Outpatient X-Ray Services with a $15 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Giveback from UHC TC-4 (HMO-POS) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the AARP Medicare Advantage Giveback from UHC TC-4 (HMO-POS) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the AARP Medicare Advantage Giveback from UHC TC-4 (HMO-POS) plan, with prior authorization required. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include a meal benefit with no copay, but acupuncture, over-the-counter items, 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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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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