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AARP Medicare Advantage from UHC SC-0005 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC SC-0005 (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 SC-0005 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC SC-0005 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of South Carolina. 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 SC-0005 (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 SC-0005 (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 SC-0005 (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 $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 SC-0005 (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, you will pay a $12 copay for preferred generic drugs at a standard pharmacy. For preferred brand drugs, the copay is $100.00, while non-preferred drugs have a 29% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC SC-0005 (HMO-POS) plan offers a range of benefits with varying costs. For hospital stays, you'll pay a copay of $325 for the first six days, with no copay for the remainder. Outpatient services have copays ranging from $0 to $325 depending on the service, while primary care visits and many preventive services have no copay. The plan also covers emergency services with a $125 copay and provides coverage for hearing, vision, and dental services, often with no copay or a small copay. Additional benefits include ambulance services, home health services, and coverage for diagnostic services. Some services, such as prescription hearing aids, have copays, and some services such as dental, vision, and medical equipment have coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $325 copay for days 1-6, and no copay for days 7-90; for Additional Days, there is no copay. For Inpatient Hospital Psychiatric, you will pay a $325 copay for days 1-6, and no copay for days 7-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a copay between $0 and $325, observation services have a $325 copay, ambulatory surgical center services and outpatient blood services have no copay, individual outpatient substance abuse sessions have a copay between $0 and $25, and group outpatient substance abuse sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the AARP Medicare Advantage from UHC SC-0005 (HMO-POS) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC SC-0005 (HMO-POS) plan. Medicare-covered ground and air ambulance services have a $275 copay, and there is no coinsurance; however, 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 from UHC SC-0005 (HMO-POS) plan. Emergency Services have a $125 copay and no coinsurance, Urgently Needed Services have a copay between $0 and $55 and no coinsurance, and Worldwide Emergency Services has a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, with no coinsurance.
Primary Care See details
The AARP Medicare Advantage from UHC SC-0005 (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a copay between $0 and $25, and physician specialist services with a copay between $0 and $35. Mental health specialty services for individual sessions have a copay between $0 and $25, and group sessions have a $15 copay. The plan also covers podiatry services with a $35 copay, other health care professionals with a copay between $0 and $35, psychiatric services for individual sessions with a copay between $0 and $25, and group sessions with a $15 copay. Physical therapy and speech-language pathology services have a copay between $0 and $25, and additional telehealth benefits have no copay. Finally, Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services are covered, including an annual physical exam with no copay. Other preventive services, including Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, are covered with no copay. Some services are not covered, including Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, and Telemonitoring Services.
Hearing Services See details
Hearing exams are covered with no copay, while routine hearing exams are limited to one visit per year. Prescription hearing aids are covered with a copay between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, and has a combined maximum plan benefit of $300 every two years; however, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare Dental Services with 20% coinsurance, and other services like oral exams, dental x-rays, cleaning, fluoride treatments, and other preventative dental services with no copay. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable, fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services includes coverage for Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, as well as Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC SC-0005 (HMO-POS) plan, but require prior authorization. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services and all radiological services. Diagnostic Procedures/Tests have a $50 copay, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $160, Therapeutic Radiological Services have 20% coinsurance, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC SC-0005 (HMO-POS) plan with no copay and no coinsurance; however, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, there is no copay, and for days 21-100, there is a $203 copay per day. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items and a Meal Benefit. 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. Over-the-Counter (OTC) Items have no copay, and the Meal Benefit also has no copay.
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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.
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