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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 2025, 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 2025.
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 $340.00 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 $4500.00 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)
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Drug Coverage
The AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) plan has a $340 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, for a standard pharmacy, you'll pay a $12 copay for preferred generic drugs, a $47 copay for standard generic drugs, and a $100 copay for preferred brand drugs. Non-preferred drugs have a 29% coinsurance. After your total drug costs reach $2000, you pay nothing for Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a $325 copay for days 1-5, with no copay for days 6-90. Outpatient services, primary care, preventive services, hearing exams, eye exams, dental, and home health services all have no copay. The plan also covers ambulance services, emergency services, and other services with copays ranging from $0 to $165. You will pay coinsurance for dialysis services, medical equipment, and home infusion bundled services. The plan also offers coverage for skilled nursing facilities, and other services, with varying copays and coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits for AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) include coverage for acute and psychiatric inpatient hospital stays, with a copay of $325 for days 1-5 and no copay for days 6-90. Additional days for inpatient hospital-acute have 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, including all outpatient hospital services, are covered. You may have to pay a copay between $0 and $325 for outpatient hospital services, $325 for observation services, no copay for Ambulatory Surgical Center (ASC) services, and between $0 and $25 for individual outpatient substance abuse sessions and $15 for group outpatient substance abuse sessions; outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) plan. You will have a $55 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) plan. Ground and Air Ambulance Services have a $165 copay, with no coinsurance. 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 by the AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) plan covers primary care physician services with no copay, and chiropractic services with a $20 copay. Occupational Therapy Services are covered with a copay between $0 and $25. Physician Specialist Services are covered with a copay between $0 and $40. Mental Health Specialty Services are covered with copays between $0 and $25 for individual sessions and $15 for group sessions. Podiatry Services are covered with a $40 copay, and Other Health Care Professional services are covered with a copay between $0 and $40. Psychiatric Services are covered with copays between $0 and $25 for individual sessions and $15 for group sessions. Physical Therapy and Speech-Language Pathology Services are covered with a copay between $0 and $25. Additional Telehealth Benefits are covered with no copay, and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive services include coverage for annual physical exams with no copay, as well as other preventive services. Other preventive services include coverage for Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay. Additional preventive services, like Health Education, are not covered.
Hearing Services See details
Hearing exams are covered with no copay, while routine hearing exams are covered with no copay once per year. Prescription hearing aids are covered with a copay between $199 and $1249 per year, and OTC hearing aids are covered with a copay between $99 and $829 per year. However, fitting/evaluation for hearing aids, and prescription hearing aids for 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. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, all of which have no copay, though 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. Oral exams, dental x-rays, 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, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $25 copay, lab services with no copay, all radiological services, diagnostic radiological services with a copay up to $150, therapeutic radiological services with a minimum 20% coinsurance, and outpatient X-Ray services with a $15 copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Essentials from UHC OH-5 (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 covered, but not the sub-services of 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. Prior authorization is required, and a copay applies.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS) plan. There is no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and Meal Benefits. The plan offers OTC items with no copay, and Meal Benefits with no copay, though prior authorization is required. Acupuncture, 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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