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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 2026, 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 3.5 out of 5 stars in 2026.
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 $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 $6700.00 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 features an annual drug deductible of $440. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies and through mail-order services. Tier 2 generic drugs cost a $12 copay for a 1-month supply at standard pharmacies, while a 3-month supply has no copay when filled through preferred mail order. For brand-name and specialty medications, the plan transitions to coinsurance rates. Tier 3 preferred brand drugs require a 15% coinsurance for standard pharmacy and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 40% coinsurance and 28% coinsurance respectively for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC SC-0005 (HMO-POS) plan offers comprehensive medical coverage with no copay for primary care visits, telehealth, and routine preventive services. Specialist doctor visits require up to a $50 copay, while emergency room visits carry a $130 copay that is waived upon hospital admission. If you require an inpatient hospital stay, you will pay a $455 daily copay for the first few days, followed by no copay for the rest of your covered stay. This plan also provides essential everyday benefits, including no copay for annual routine vision and hearing exams, plus up to a $300 allowance for eyewear every two years. Preventive dental care and home health services are covered with no copay, while durable medical equipment and dialysis require a 20% coinsurance. Additionally, skilled nursing facility stays feature no copay for the first 20 days, followed by a $218 daily copay for days 21 to 100.
Inpatient Hospital See details
Inpatient hospital services are covered by AARP Medicare Advantage from UHC SC-0005 (HMO-POS) with no coinsurance, requiring a $455 daily copay for days 1 to 6 of acute stays and days 1 to 5 of psychiatric stays, followed by no copay for remaining covered days. Prior authorization is required, and certain services such as non-Medicare-covered stays, room upgrades, and additional psychiatric days beyond 90 days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC SC-0005 (HMO-POS) covers outpatient hospital services with no coinsurance and copays ranging from no copay to $455, which includes a $455 daily copay for observation services. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while outpatient substance abuse services have no coinsurance and copays ranging from no copay to $25 per session.
Partial Hospitalization See details
AARP Medicare Advantage from UHC SC-0005 (HMO-POS) covers partial hospitalization benefits with a $55.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services through AARP Medicare Advantage from UHC SC-0005 (HMO-POS) feature a $275 copay and no coinsurance for Medicare-covered ground and air ambulance services, which require prior authorization. Routine transportation services to plan-approved or any other health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage from UHC SC-0005 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay ranging from $0 to $50 with no coinsurance, while worldwide emergency, urgent care, and emergency transportation are covered with no copay and no coinsurance.
Primary Care See details
Primary Care benefits under the AARP Medicare Advantage from UHC SC-0005 (HMO-POS) feature primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $50 copay and no coinsurance. Therapy services have a $25 copay and no coinsurance, though routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage from UHC SC-0005 (HMO-POS) with no copays and no coinsurance for covered benefits like annual physical exams, kidney disease education, glaucoma screenings, and a fitness benefit. However, several supplemental services are not covered under this plan, including health education, nutritional training, weight management programs, and in-home support services.
Hearing Services See details
AARP Medicare Advantage from UHC SC-0005 (HMO-POS) offers partial coverage for hearing services with no deductible, featuring one routine hearing exam per year with no copay and no coinsurance, though fitting and evaluation exams are not covered. Up to two prescription or OTC hearing aids are covered annually with no coinsurance and copays ranging from $199 to $1,249, but inner ear, outer ear, and over-the-ear prescription hearing aids are excluded.
Vision Services See details
AARP Medicare Advantage from UHC SC-0005 (HMO-POS) offers partially covered vision services, which include one routine eye exam per year with no copay or coinsurance, while other eye exams are not covered. Eyewear is also partially covered with a $300 combined maximum every two years, featuring contact lenses, eyeglass lenses (with a $0 to $153 copay), and frames with no copay or coinsurance, though upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC SC-0005 (HMO-POS) partially covers dental services, offering Medicare-covered care with no copay and a 20% coinsurance, and preventive care with no copay and no coinsurance. However, restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC SC-0005 (HMO-POS) covers Home Infusion bundled Services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC SC-0005 (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
AARP Medicare Advantage from UHC SC-0005 (HMO-POS) covers durable medical equipment (DME), 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 medical equipment benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC SC-0005 (HMO-POS) covers diagnostic services with no coinsurance, offering lab services at no copay and diagnostic procedures or tests for a $55 copay. Radiological services are also covered, featuring no copay for diagnostic radiology, a $30 copay for outpatient X-rays, and a 20% coinsurance for therapeutic radiology.
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. Prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered with no copay and no coinsurance under the AARP Medicare Advantage from UHC SC-0005 (HMO-POS) plan, although prior authorization is required. While the plan states some services are covered, in practice, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by AARP Medicare Advantage from UHC SC-0005 (HMO-POS) with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required and no prior 3-day hospital stay is needed, but additional days beyond the standard Medicare-covered 100 days are not covered.
Other Services See details
AARP Medicare Advantage from UHC SC-0005 (HMO-POS) partially covers other services, providing a meal benefit for chronic illnesses with no copay and no coinsurance, subject to prior authorization. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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