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AARP Medicare Advantage from UHC PA-0003 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC PA-0003 (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 from UHC PA-0003 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC PA-0003 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Pennsylvania. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC PA-0003 (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 from UHC PA-0003 (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 from UHC PA-0003 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $26.00. 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 $5900.00 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 from UHC PA-0003 (HMO-POS) plan has a $255.00 deductible. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs at a standard pharmacy, the copay is $8.00. Standard generic drugs at a standard pharmacy have a $47.00 copay. Preferred and standard brand drugs have a $100.00 copay. Non-preferred drugs have a 30% coinsurance.
Additional Benefits
The AARP Medicare Advantage from UHC PA-0003 (HMO-POS) plan offers a variety of benefits with differing cost-sharing. This plan covers inpatient hospital stays with a $395 copay per admission, outpatient services with varying copays, and emergency services with a $125 copay. Preventive services like annual physical exams have no copay, and primary care visits are also covered with no copay. The plan also includes coverage for hearing and vision services, along with dental services and durable medical equipment.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $395 per admission or stay. Additional days for Inpatient Hospital-Acute are covered with no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay of $0-$395, Observation Services with a $395 copay, Ambulatory Surgical Center (ASC) Services with no copay, Individual Sessions for Outpatient Substance Abuse with a copay of $0-$25, Group Sessions for Outpatient Substance Abuse with a $15 copay, and Outpatient Blood Services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC PA-0003 (HMO-POS) plan. This benefit requires prior authorization and has a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC PA-0003 (HMO-POS) plan. Both ground and air ambulance services have a copay of $275, with no coinsurance, while transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services are covered by the AARP Medicare Advantage from UHC PA-0003 (HMO-POS) plan, with a $125 copay, and no coinsurance. Urgently needed services have a copay between $0 and $55, and no coinsurance, while worldwide emergency services have a $0 copay for worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation.
Primary Care See details
AARP Medicare Advantage from UHC PA-0003 (HMO-POS) covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a copay between $0 and $30, and physician specialist services with a copay between $0 and $30. This plan also covers mental health specialty services, podiatry services (with a $30 copay), other health care professional services, psychiatric services, physical therapy and speech-language pathology services with a copay between $0 and $30, additional telehealth benefits with no copay, and opioid treatment program services with no copay. Routine chiropractic care is not covered.
Preventive Services See details
Preventive services are covered by the AARP Medicare Advantage from UHC PA-0003 (HMO-POS) plan, including an annual physical exam with no copay. Additional preventive services are covered, and some services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), and others are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are limited to one per year. Prescription hearing aids are partially covered, with a copay between $199 and $1249 for all types of hearing aids but not for inner, outer, or over-the-ear hearing aids. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision services include routine eye exams, eyewear, contact lenses, eyeglass lenses, and eyeglass frames. Eye exams and contact lenses have no copay, and eyeglass lenses have a copay between $0 and $153. Eyeglass frames have no copay. 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, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery have no copay. However, implants and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, all of which require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, and for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC PA-0003 (HMO-POS) plan, but require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered. Prosthetics/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 are covered, including Diagnostic Procedures/Tests with a $50 copay, Lab Services with no copay, and Diagnostic Radiological Services with a copay up to $200. Therapeutic Radiological Services have a 20% coinsurance, while Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC PA-0003 (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 not covered under the AARP Medicare Advantage from UHC PA-0003 (HMO-POS) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC PA-0003 (HMO-POS) plan, with a $0 copay for days 1-20 and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) items and a Meal Benefit. The plan has no copay for OTC items, and the Meal Benefit also has no copay. 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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