A non-government entity
AARP Medicare Advantage Essentials from UHC OH-5 (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-5 (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-5 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Essentials from UHC OH-5 (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 2026.
It's important to know that AARP Medicare Advantage Essentials from UHC OH-5 (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-5 (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-5 (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 $440.00 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:
Sign up for AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) prescription drug coverage features an annual drug deductible of $440. Members benefit from no copay on Tier 1 preferred generic drugs for both 1-month and 3-month supplies at standard pharmacies and through mail order. Tier 2 generic drugs have a $12 copay for a 1-month supply at standard pharmacies, but members can receive a 3-month supply with no copay when using preferred mail order. Brand-name and specialty medications on higher tiers are subject to coinsurance during the initial coverage phase. Tier 3 preferred brand drugs require a 15% coinsurance for both standard pharmacy and mail order fills. Tier 4 non-preferred drugs carry a 43% coinsurance, while Tier 5 specialty drugs require a 28% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) offers comprehensive medical coverage with many services requiring no copay and no coinsurance, including primary care visits, annual physicals, and home health care. For hospital stays, members pay a $395 daily copay for the first few days of inpatient care with no coinsurance, while specialist visits feature copays ranging from no copay to $45. Emergency room visits carry a $130 copay, which is waived if you are admitted, and urgent care copays range from no copay to $50. Routine dental cleanings and annual vision exams are covered with no copay and no coinsurance, while prescription eyewear is supported by a $300 maximum benefit every two years. Hearing care includes routine exams with no copay, though prescription hearing aids require copays ranging from $199 to $1,249. Additionally, durable medical equipment, prosthetic devices, and dialysis services are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) with no coinsurance, requiring a $395 daily copay for days 1 to 6 of acute stays (no copay for days 7 and beyond) and a $395 daily copay for days 1 to 5 of psychiatric stays (no copay for days 6 to 90). Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) with no coinsurance, featuring copays of $0 to $395 for outpatient hospital care and $395 per day for observation services. Ambulatory surgical center and outpatient blood services have no copays and no coinsurance, while outpatient substance abuse services carry no coinsurance and copays between $0 and $25.
Partial Hospitalization See details
Partial hospitalization is covered by the AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) plan with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) covers Medicare-approved ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. Routine transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits have a $0 to $45 copay and no coinsurance. Physical, occupational, and speech therapy services require a $25 copay and no coinsurance, and chiropractic services are only partially covered with a $15 copay and no coinsurance as routine and other chiropractic care are not covered.
Preventive Services See details
Preventive Services are covered by AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) with no copay and no coinsurance for annual physicals, kidney disease education, fitness benefits, and select screenings. Additional preventive services are partially covered, but do not include health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, home modifications, or counseling.
Hearing Services See details
AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) provides partially covered hearing services with no deductible and no coinsurance. Routine hearing exams have no copay, but fitting evaluations, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered. Covered prescription hearing aids require a $199 to $1,249 copay, while OTC hearing aids have a $199 to $829 copay, with both limited to two devices per year.
Vision Services See details
Vision Services under the AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) are partially covered, featuring one annual routine eye exam with no copay, no coinsurance, and no deductible, though other eye exams are not covered. Covered eyewear includes contact lenses and frames with no copay, and lenses with a $0 to $153 copay, subject to a $300 maximum benefit every two years with no deductible or coinsurance, while upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS), offering preventive care like exams and cleanings with no copay and no coinsurance, and Medicare-covered dental services with no copay and a 20% coinsurance. Several major services are not covered under this plan, including restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) with no copay, although prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require a coinsurance ranging from no coinsurance up to 20%, while Part B insulin has a $35 copay and a coinsurance of up to 20%.
Dialysis Services See details
Dialysis services are covered under the AARP Medicare Advantage Essentials from UHC OH-5 (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-5 (HMO-POS) covers durable medical equipment, prosthetic devices, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are offered 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 under the AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) plan, with prior authorization required. Members pay a $50 copay with no coinsurance for diagnostic procedures, a $30 copay for outpatient X-rays, a 20% coinsurance for therapeutic radiology, and no copay or coinsurance for lab services and diagnostic radiological services.
Home Health Services See details
Home health services are covered under the AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, 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-5 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance and does not require a prior three-day hospital stay. You will 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
AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) partially covers other services, offering a meal benefit for chronic illnesses with no copay and no coinsurance, though prior authorization is required. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved