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AARP Medicare Advantage Essentials from UHC OH-7 (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-7 (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-7 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC OH-7 (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 2026.
It's important to know that AARP Medicare Advantage Essentials from UHC OH-7 (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-7 (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-7 (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.
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 $520.00 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 Essentials from UHC OH-7 (HMO-POS) plan features an annual drug deductible of $520. Under this plan, you will pay no copay for Tier 1 preferred generic drugs at standard pharmacies or through mail order. Tier 2 generic drugs cost a $12 copay for a one-month supply at standard pharmacies, but you can save with no copay on a three-month supply when using preferred mail order. For higher-tier medications, costs transition to coinsurance percentages instead of flat copays. Tier 3 preferred brand drugs require a 15% coinsurance for both one-month and three-month supplies. Non-preferred drugs in Tier 4 carry a 43% coinsurance, while Tier 5 specialty drugs require a 27% coinsurance for a one-month supply.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) plan offers comprehensive medical coverage with no copays or coinsurance for primary care visits, annual preventive exams, and home health services. For specialized care, specialist visits require a copay ranging from no copay to $40, while inpatient hospital stays carry a $395 daily copay for the first six days. Emergency care is accessible with a $130 copay, which is waived upon hospital admission, and urgent care services range from no copay up to a $50 copay. This plan also includes valuable supplemental benefits, featuring no copays for routine dental cleanings, annual eye exams, and yearly hearing tests. While comprehensive dental care is limited, the plan provides a $300 eyewear allowance every two years and covers up to two hearing aids annually with copays. Additionally, diagnostic lab work is covered with no copay, while durable medical equipment and dialysis services require a 20% coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) partially covers inpatient hospital services with no coinsurance, excluding upgrades, non-Medicare-covered stays, and additional psychiatric days. Covered acute stays require a $395 copay for days 1-6 (no copay for days 7 and beyond), while psychiatric stays require a $395 copay for days 1-5 (no copay for days 6-90).
Outpatient Services See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay ranging from no copay up to $395, while outpatient substance abuse sessions range from no copay to a $25 copay, with prior authorization required.
Partial Hospitalization See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this covered benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) covers ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) covers emergency services 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 ranging from $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) offers primary care, telehealth, and opioid treatment services with no copay and no coinsurance, while specialist visits require a $0 to $40 copay and no coinsurance. Physical, occupational, and speech therapies have a $20 copay with no coinsurance, whereas chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered under the AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) plan with no copay and no coinsurance for covered services like annual exams, kidney disease education, and fitness benefits. However, sub-services such as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote technologies, home safety modifications, and counseling are not covered.
Hearing Services See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) offers partially covered hearing services, featuring one annual routine hearing exam with no copay and no coinsurance. The plan covers up to two prescription hearing aids per year with a $199 to $1,249 copay and up to two OTC hearing aids with a $199 to $829 copay, both with no coinsurance, but fitting/evaluation exams and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS), featuring one routine eye exam annually with no copay and no coinsurance, though other exam services are not covered. Eyewear is covered with no coinsurance and a $300 limit every two years, providing contact lenses and frames with no copay and lenses with a $0 to $153 copay, while upgrades and bundled eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by the AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) plan. Medicare-covered dental services feature no copay and a 20% coinsurance, while preventive services such as cleanings, exams, and x-rays are available with no copay and no coinsurance. However, restorative, endodontic, periodontic, prosthodontic, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) with no copay, while associated Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance up to 20% coinsurance. Covered Part B insulin has a $35 copay and no coinsurance up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance and no copay. Prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) covers diagnostic and radiological services with no copay for lab services and diagnostic radiology, and a $50 copay with no coinsurance for diagnostic tests. Outpatient x-rays require a $30 copay, and therapeutic radiological services have a 20% coinsurance, with prior authorization required for most services.
Home Health Services See details
Home health services are covered by the AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) require prior authorization and feature no copay and no coinsurance, though only some services are covered. Specifically, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. Patients pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered under the AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) plan, which offers a limited-duration meal benefit for chronic illnesses with no copay and no coinsurance, subject to prior authorization. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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