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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 $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:
Sign up for AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS)
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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. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic drugs cost a $12 copay for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay through preferred mail order. For brand-name and higher-tier medications, the plan utilizes coinsurance instead of flat copays. Tier 3 preferred brand drugs require 15% coinsurance, while Tier 4 non-preferred drugs carry a 43% coinsurance. Tier 5 specialty drugs have a 27% coinsurance for a 1-month supply across standard pharmacies and mail order options.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) plan offers comprehensive medical coverage, featuring no copay and no coinsurance for primary care visits, annual physicals, and home health services. For hospital stays, members pay a $295 daily copay for the first six days of inpatient care and no copay for days seven through 90. Emergency room visits require a $150 copay, while specialist visits range from no copay up to a $35 copay. Supplemental benefits include routine vision and hearing exams, as well as preventive dental care, all with no copays or coinsurance. Members also receive coverage for prescription hearing aids and eyewear with set copays, alongside a 20% coinsurance for dialysis and durable medical equipment. Additionally, the plan covers over-the-counter items and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $295 daily copay for days 1 through 6 and no copay for days 7 through 90 per stay. Unlimited additional acute care days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Outpatient hospital services require a copay ranging from $0 to $295, while outpatient substance abuse sessions carry a copay of up to $25.
Partial Hospitalization See details
Partial hospitalization services are covered under the AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) plan with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
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 per service and no coinsurance, though prior authorization is required. Transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) 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 and no coinsurance, while worldwide emergency, urgent, and transportation services are fully covered with no copays and no coinsurance.
Primary Care See details
Primary care benefits under the AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) plan feature no copay and no coinsurance for primary care doctor visits, telehealth, and opioid treatment. Specialist visits range from a $0 to $35 copay, therapy services require a $25 copay, and podiatry costs $35, all with no coinsurance, while chiropractic services are not covered. Mental health and psychiatric sessions have no coinsurance and copays ranging from $0 to $25.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) with no copay and no coinsurance for covered care such as annual physicals, kidney disease education, glaucoma screenings, fitness benefits, and home safety devices. However, several additional supplemental services are not covered under this plan, including health education, in-home safety assessments, personal emergency response systems, weight management programs, and nutritional or dietary benefits.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS), including one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids have no coinsurance and a copay of $199 to $1,249 for up to two devices per year, but inner ear, outer ear, and over the ear types are not covered. Up to two OTC hearing aids are also covered annually with no coinsurance and a copay of $199 to $829.
Vision Services See details
Vision Services are partially covered by AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS), which offers one routine eye exam annually with no copay, no coinsurance, and no deductible, though other eye exam services are not covered. Covered eyewear includes contact lenses and eyeglass frames with no copay, and eyeglass lenses with a $0 to $153 copay, up to a $300 combined maximum every two years with no coinsurance, while upgrades and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services are partially covered by AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS), offering preventive and diagnostic care with no copay and no coinsurance up to a $1,500 annual limit. Medicare-covered dental services require no copay and a 20% coinsurance, while covered comprehensive services have no copay and a 50% coinsurance; however, implant services and orthodontics 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 and no coinsurance, subject to prior authorization. Associated Medicare Part B chemotherapy, radiation, and other drugs require no copay and 0% to 20% coinsurance, while Part B insulin has a $35 copay, 0% to 20% coinsurance, and no deductible.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) 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, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS). Diagnostic services require no coinsurance, with a $50 copay for tests and no copay for lab services, while radiological services range from no copay for diagnostic radiology to a $25 copay for x-rays and 20% coinsurance for therapeutic 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) plan are technically covered with no copay and no coinsurance, meaning some services are covered, but prior authorization is required. However, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) covers Skilled Nursing Facility (SNF) services 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, though a prior three-day inpatient hospital stay is not necessary before admission.
Other Services See details
AARP Medicare Advantage Essentials from UHC OH-7 (HMO-POS) provides partial coverage for other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. However, acupuncture is not covered under this benefit, and prior authorization is required for the meal benefit.
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