AARP Medicare Advantage (HMO-POS)
AARP Medicare Advantage (HMO-POS) is a plan offered by AARP through UnitedHealthcare. It includes Medicare Part D prescription drug coverage plus other benefits not included with Original Medicare.
- Written by Terry Turner
Senior Financial Writer and Financial Wellness Facilitator
Terry Turner has more than 35 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).Read More
- Edited ByLamia Chowdhury
Lamia Chowdhury is a financial content editor for RetireGuide and has over three years of marketing experience in the finance industry. She has written copy for both digital and print pieces ranging from blogs, radio scripts and search ads to billboards, brochures, mailers and more.Read More
- Published: September 9, 2022
- Updated: January 17, 2023
- 12 min read time
- This page features 5 Cited Research Articles
- Edited By
AARP Medicare Advantage (HMO-POS) CMS Star Ratings
AARP Medicare Advantage (HMO-POS) is a highly rated Medicare Advantage plan that includes prescription drug coverage. It is offered through AARP and UnitedHealthcare and is among the highest rated plans available based on the CMS Star Rating system.
The CMS Star Rating is based in part on various surveys, complaints and other beneficiary feedback conducted by or shared with the U.S. Centers for Medicare & Medicaid Services. One star is poor while five stars represents excellent.
The plan is an HMO-POS, which stands for a health maintenance organization with a point-of-service option. This means it provides a network of doctors, hospitals and other health care providers you can choose from to receive services.
As part of your coverage, you will have to select a primary care doctor from within the provided network. But you can use other providers from outside the plan’s network. Your Medicare deductibles and other out-of-pocket costs will vary depending on whether you use in-network or out-of network health care.
AARP Medicare Advantage (HMO-POS) Health Plan Rating
The AARP Medicare Advantage (HMO-POS) health plan has a five-star rating from Medicare.
The plan received five-star ratings on 19 out of 33 criteria Medicare uses to rate plans.
- Annual medication review
- Breast cancer screening
- Colorectal cancer screening
- Coordination of members’ health care services
- Diabetes-related control of blood sugar
- Diabetes-related eye exams
- Diabetes-related kidney testing
- Fairness in appeals of plan decisions (based on an independent reviewer)
- Health plan customer service
- Low number of complaints about the plan
- Low number of members switching from the plan
- Member rating of health plan
- Members’ experience with the plan
- Members rating of health care quality
- Pain management and yearly pain screening
- Screenings, tests and vaccines
- Timely decisions about appeals
- TTY and foreign language interpreters for members calling the plan
The plan’s lowest ratings was three-stars on four categories.
- Fall reduction
- Improvement — if any — in the plan’s performance
- Improving bladder control
- Rheumatoid arthritis management
AARP Medicare Advantage (HMO-POS) Drug Plan Rating
The AARP Medicare Advantage (HMO-POS) has a five-star rating for its Medicare Part D prescription drug coverage.
It received five-star ratings on nine of the 16 categories.
- Drug plan customer service
- Improvements — if any — to the plan’s performance
- Low number of member complaints
- Low number of member complaints and changes in the plan’s performance
- Low number of members switching from the plan
- Making sure members are taking the most effective cholesterol control medications
- Member experience with the plan
- Member rating of the drug plan
- TTY and foreign language interpreters for calls to the plan
Costs and Coverage
The AARP Medicare Advantage (HMO-POS) is a no-premium Medicare Advantage plan. Even though it charges no monthly premium, you are still responsible for the monthly Medicare Part B premium — $164.90 in 2023.
It includes prescription and over-the-counter drug coverage along with dental and vision services and a fitness program. Members also have access to the UnitedHealthcare Medicare National Network.
|Health Plan Deductible||N/A|
|Drug Plan Deductible||$0|
|Tier 1 Prescription Drugs||$3 copay|
|Health Plan Premiums||$0|
|Drug Plan Premium||$0|
|Maximum Out-of-Pocket (in-network)||$3,900|
|Catastrophic coverage limit||$7,050|
Health Care Services and Durable Medical Equipment (DME) Coverage
The AARP Medicare Advantage (HMO-POS) benefits for health care services and durable medical equipment covers everything that Original Medicare covers. It also provides additional services, though exact out-of-pockets may vary.
|BENEFIT||OUT-OF-POCKET COSTS (IN-NETWORK)|
|Ambulance services||$250 copay (applies to both ground and air ambulances)|
|Ambulatory surgical center||$0 - $100 copay|
|Diabetes monitoring supplies||$0 copay for covered brands|
|Diagnostic tests and procedures||$20 copay|
|Diagnostic radiology services (CT, MRI, X-rays)||$0 - $120 copay|
|Doctor visits (primary care)||$0 copay|
|Specialist visits||$20 copay (referral required and must be in-network)|
|Virtual medical visits||$0 copay|
|Durable medical equipment||20% coinsurance|
|Emergency room visits||$90 copay (worldwide coverage)|
|Urgent care visits||$40 copay (worldwide coverage)|
|Inpatient hospital care||Days 1 - 5: $195 per day $0 copay per day for unlimited days after that|
|Home health care||$0 copay|
You should consider out-of-pocket costs for the types of services you need when you compare Medicare Advantage plans.
Dental, Vision and Hearing Benefits
The AARP Medicare Advantage (HMO-POS) plan covers a wide range of services that Original Medicare does not cover. Most Medicare Advantage plans cover vision, dental or hearing services, but this plan includes additional services.
|BENEFIT||OUT-OF-POCKET COSTS IN-NETWORK||OUT-OF-POCKET COSTS OUT-OF-NETWORK|
|Annual routine physical||$0 copay||No coverage|
|Dental services (comprehensive and preventative)||Up to $1,000 limit on annual preventive and comprehensive dental services||Check with plan for out-of-network benefits|
|Eye exam||$0 copay One exam per year||No coverage|
|Eyewear||$0 copay up to $200 per year for frames or contact lenses. Standard lenses covered in full. Select home delivered eyewear available through UnitedHealthcare Vision||$0 copay up to $200 per year for frames or contact lenses. Standard lenses covered in full. Select home delivered eyewear available through UnitedHealthcare Vision|
|Fitness program (Renew Active)||Basic membership at a national network location included in enrollment||Basic membership at a national network location included in enrollment|
|Hearing aids||$375 - $1,425 copay for each hearing aid provided through UnitedHealthcare Hearing (up to two hearing aids per year)||$375 - $1,425 copay for each hearing aid provided through UnitedHealthcare Hearing (up to two hearing aids per year)|
|Hearing exam||$0 copay||No coverage|
|Over-the-counter (OTC) drugs and other OTC items||$40 credit per quarter on approved OTC products||$40 credit per quarter on approved OTC products|
|Routine foot care||$20 copay||No coverage|
Prescription Drug Costs and Coverage
The AARP Medicare Advantage (HMO-POS) formulary features six tiers of prescription drugs — including a second Tier 3 specifically for insulin drugs. It covers three copay options — a 30-day supply through a network pharmacy and 90-day supplies through the plans preferred mail order pharmacy or standard mail order.
|Tier||1 Month Standard Network Pharmacy||3 Month Preferred Mail Order Pharmacy*||3 Month Standard Mail Order Pharmacy|
|Tier 1 Preferred Generic||$3||$0||$0|
|Tier 2 Generic||$10||$0||$30|
|Tier 3 Preferred Brand Name||$45||$125||$135|
|Tier 3 Select Insulin Drugs||$35||$95||$105|
|Tier 4 Non- Preferred Drugs||$95||$275||$285|
|Tier 5 Specialty Drugs||33% of cost||N/A||N/A|
During your coverage gap, you will pay 25% of the cost (plus the dispensing fee) for both generic and brand name drugs until you reach the coverage gap: $7,050 of year-to-date out-of-pocket spending.
After you hit that limit, you will be responsible for a $3.95 copay for generics and a $9.85 copay for brand name drugs — or 5% of the cost, whichever is greater. The limit resets on Jan. 1 each year.
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5 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2022, September 27). 2023 Medicare Parts A and B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly
- U.S. Centers for Medicare & Medicaid Services. (2022, April 29). CY 2023 Medicare Advantage and Part D Final Rule (CMS-4192-F). Retrieved from https://www.cms.gov/newsroom/fact-sheets/cy-2023-medicare-advantage-and-part-d-final-rule-cms-4192-f
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Medicare Costs at a Glance. Retrieved from https://www.medicare.gov/your-medicare-costs/medicare-costs-at-a-glance
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Your Medicare Costs. Retrieved from https://www.medicare.gov/your-medicare-costs
- U.S. Centers for Medicare & Medicaid Services. (n.d.). 2022 Medicare Costs. Retrieved from https://www.medicare.gov/Pubs/pdf/11579-medicare-costs.pdf
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