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AARP Medicare Advantage Essentials from UHC OH-6 (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 OH-6 (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 OH-6 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC OH-6 (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. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage Essentials from UHC OH-6 (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 OH-6 (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 OH-6 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $29.00. 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 $255.00 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 $3900.00 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 OH-6 (HMO-POS) plan has a $255.00 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay a $5.00 copay for preferred generic drugs at a standard pharmacy, and a $47.00 copay for standard generic drugs at a standard pharmacy. For preferred brand drugs, the copay is $100.00, and for non-preferred drugs, you will pay 30% coinsurance. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC OH-6 (HMO-POS) plan offers coverage for a wide range of services. This plan includes inpatient hospital stays with a $275 copay for the first five days, and then no copay for the rest of the stay. Outpatient services, including primary care, have varying copays. The plan also covers emergency services, hearing, vision, and dental services. Emergency services have a $140 copay, while routine hearing and vision exams have no copay. Dental services have a 20% coinsurance. Additionally, the plan provides benefits like home health services with no copay, and covers skilled nursing facility stays with no copay for the first 20 days, and a $203 per day copay for days 21-100.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $275 copay for days 1-5, and no copay for days 6-90, and for Inpatient Hospital Psychiatric, you will pay a $275 copay for days 1-5, and no copay for days 6-90. Additional Days for Inpatient Hospital-Acute are covered with no copay for days 91-999, while Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services with a copay between $0 and $275, observation services with a $275 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay between $0 and $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 under this plan with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage Essentials from UHC OH-6 (HMO-POS) plan, with a $275 copay for both ground and air ambulance services. 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 Essentials from UHC OH-6 (HMO-POS) plan. Emergency Services have a $140 copay, Urgently Needed Services have a copay between $0 and $65, and Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
Primary Care services include no copay for Primary Care Physician Services, a $20 copay for Chiropractic Services, and a $0-$25 copay for Occupational Therapy Services, Physician Specialist Services, and Physical Therapy and Speech-Language Pathology Services. Mental Health Specialty Services, Psychiatric Services, and Opioid Treatment Program Services have a $0-$25 copay for individual sessions and a $15 copay for group sessions. Podiatry Services, Other Health Care Professional, and Additional Telehealth Benefits have a $0-$25 copay. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, and other services such as glaucoma screenings, diabetes self-management training, and barium enemas with no copay. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other services are not covered.
Hearing Services See details
Hearing exams are covered with no copay. Routine hearing exams are covered once per year with no copay, while fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered, with a copay between $199 and $1249, depending on the type, up to two times per year, but prescription hearing aids - inner ear, outer ear, and over the ear are not covered. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
The AARP Medicare Advantage Essentials from UHC OH-6 (HMO-POS) plan covers vision services, including routine eye exams and eyewear. Routine eye exams and contact lenses have no copay, while eyeglass lenses may have a copay between $0 and $153. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered and include a 20% coinsurance for Medicare 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.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the AARP Medicare Advantage Essentials from UHC OH-6 (HMO-POS) plan. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0-20%, while for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Essentials from UHC OH-6 (HMO-POS) plan. The coinsurance for dialysis services is 20%, with a minimum and maximum coinsurance of 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a $50 copay for diagnostic procedures/tests, and a $0 copay for lab services. Diagnostic Radiological Services have a copay of up to $100, while Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage Essentials from UHC OH-6 (HMO-POS) 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 not in practice. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Essentials from UHC OH-6 (HMO-POS) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203 per day.
Other Services See details
Other Services include Over-the-Counter (OTC) Items and Meal Benefit, both with no copay, but acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered. The OTC benefit includes Nicotine Replacement Therapy (NRT) and Naloxone.
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