AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) 2025 Plan Details for Benton County, Oregon Residents
AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) 2025 Plan Details for Benton County, Oregon Residents
When selecting a Medicare Advantage plan in Benton County for 2025, it's important to compare all your options. AARP Medicare Advantage Essentials from UHC OR-4 (HMO-POS) is among the plans you can review side-by-side with others, ensuring you find the coverage that suits your needs. You can easily enroll online or reach out to a licensed agent for personalized guidance.
As of May 31, 2025, plan enrollments topped 44,988 members, with 511 in Benton County, Oregon.
AARP Medicare Advantage Essentials from UHC OR-4 Overview
| Plan ID H3805-039-1 Overview | |
|---|---|
| Health Plan ID: | H3805-039-1 |
| Medicare Advantage Plan Type: | HMO-POS |
| Plan Year: | 2025 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $4,500.00 (In-Network) |
| Part B Give Back: | $0.00/mo |
| Part D Drug Plan Benefit: | Enhanced, $255.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Benton County, OR |
| Insured By: | UnitedHealthcare® |
Why Consider AARP Medicare Advantage Essentials from UHC OR-4 ?
This Medicare Advantage Prescription Drug (MAPD) HMO-POS plan combines complete coverage with flexible provider access. With a monthly premium of $0.00, AARP Medicare Advantage Essentials from UHC OR-4 includes Medicare Part A and Part B benefits, plus prescription drug coverage to manage ongoing medication needs. The annual Part D deductible is $255.00. You can visit providers both in and out of network — but you’ll generally save more when choosing in-network care.
Primary care visits have a $0 copay, specialist visits come with a $35 copay, urgent care services carry a $40 copay, and ambulance transportation is $125 copay. These costs apply toward the plan’s maximum out-of-pocket (MOOP) limit of $4,500.00 . After you reach that cap, all in-network services are covered in full through year’s end.
You’ll find this plan listed by CMS as H3805-039-1. A summary of cost sharing appears below. Still have questions? Check the FAQ section for more info.
| We're Here to Help You Enroll |
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Out-of-Pocket Expenses
AARP Medicare Advantage Essentials from UHC OR-4 includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H3805-039-1.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | $0 Copay |
| Specialist: | $35 Copay Prior Authorization Required |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $125 Copay |
| Urgent care: | $40 Copay |
| Ground ambulance: | $125 Copay |
| Inpatient hospital care: | $400.00 per day for days 1 through 4 $0.00 per day for days 5 and beyond |
| Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $203.00 per day for days 21 and beyond |
This section covers Medicare-approved foot care services, including exams and routine foot care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | $35 Copay Prior Authorization Required |
| Routine Foot Care: | $35 Copay Prior Authorization Required |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | $20 Copay Prior Authorization Required |
| Routine chiropractic: | Not Covered |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | $25 Copay |
| Outpatient group therapy: | $15 Copay |
| Inpatient psychiatric hospital care: | $400.00 per day for days 1 through 4 $0.00 per day for days 5 and beyond |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | $35 Copay Prior Authorization Required |
| Occupational therapy: | $35 Copay Prior Authorization Required |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | $0 Copay Prior Authorization Required |
| Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
| Prosthetics: | 20% Coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | $150 Copay Prior Authorization Required |
| Lab services: | $0 Copay Prior Authorization Required |
| Outpatient x-rays: | $5 Copay Prior Authorization Required |
| Diagnostic tests and procedures: | $20 Copay Prior Authorization Required |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | 20% Coinsurance |
| Other Part B drugs (Medicare-covered): | 20% Coinsurance |
This section details the dental services covered under your plan including, Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Medicare Covered Preventive Dental | 20% Coinsurance Prior Authorization Required |
| Oral exam | |
| Dental x-rays | |
| Cleaning | |
| Periodontics | |
| Endodontics | |
| Restorative Services |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | Covered Limits may apply |
| Hearing aids | Covered Limits may apply |
| Hearing exam | Not Covered |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam (in-network) | $0 Copay |
| Routine eye exam (in-network) | $0 Copay Prior Authorization Required, 1 Every year |
| Eyewear benefits | Eyeglasses: No Contact Lenses: Yes Eyeglass Lenses: Yes Eyeglass Frames: Yes Eyewear Upgrades: Yes |
Maximum eyewear benefit: | $200.00 Every two years |
Certain preventive services are covered 100% by AARP Medicare Advantage Essentials from UHC OR-4 as a Part B benefit.
Part D Prescription Drug Costs & Benefits
AARP Medicare Advantage Essentials from UHC OR-4 includes an enhanced benefit Medicare Part D plan (PDP), which offers greater coverage than basic plans. An enhanced benefit plan has a higher actuarial value, meaning it covers a larger percentage of your healthcare costs.
Part D Plan Premium
The Part D prescription drug plan premium is included in your overall Medicare Advantage plan cost. However, additional expenses or subsidies may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help. LIS, provided by Social Security, helps those with limited income and resources to lower or eliminate Part D costs. LIS benefits are not part of Medicare Advantage coverage.
| Basic Part D Premium: | $0.00 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | ${part_d_lips_amount} |
| Low-Income Premium Subsidy Paid by CMS: | $0.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program.
Prescription Drug Plan Deductible
This plan has a $255.00 annual Part D deductible. You'll pay this deductible at the pharmacy before UnitedHealthcare® starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, AARP Medicare Advantage Essentials from UHC OR-4 may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic* | $0.00 | $0.00 |
| Generic* | $0.00 | $0.00 |
| Preferred Brand | $47.00 | $0.00 |
| Non-Preferred Drug | $100.00 | $100.00 |
| Specialty Tier | 30.00% | 30.00% |
| *Deductible does not apply. | ||
Understanding CMS Star Ratings
Each year, the Centers for Medicare & Medicaid Services (CMS) assesses health plans (Part C) and drug plans (Part D) based on a 5-star rating system. These ratings provide an overview of the plan’s performance in areas such as preventive care, managing chronic conditions, and member experience.
Considering a plan’s star rating can be an important part of your decision-making process, as higher ratings often reflect stronger performance in key areas of healthcare and customer service.
| CMS Measure | Star Rating |
|---|---|
| 2025 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Am I Eligible for AARP Medicare Advantage Essentials from UHC OR-4 ?
To qualify for enrollment in AARP Medicare Advantage Essentials from UHC OR-4 , you must:
- Be entitled to Medicare Part A and enrolled in Medicare Part B.
- Live within the plan’s designated service area.
If you fulfill these criteria, you can enroll in AARP Medicare Advantage Essentials from UHC OR-4 and enjoy the extensive healthcare benefits it offers.
Enrollment Periods for AARP Medicare Advantage Essentials from UHC OR-4
Knowing when you can enroll in AARP Medicare Advantage Essentials from UHC OR-4 is essential. Here are the main enrollment periods:
- Initial Enrollment Period (IEP): Your IEP starts three months before your 65th birthday and ends three months after, giving you a seven-month window to enroll in Medicare.
- Annual Enrollment Period (AEP): The AEP, from October 15 to December 7, allows you to make changes to your Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): Running from January 1 to March 31, the MA OEP lets you switch plans or return to Original Medicare if you are currently enrolled in a Medicare Advantage plan.
- Special Enrollment Periods (SEPs): Life events such as moving or losing coverage may qualify you for a SEP, enabling you to enroll or make changes outside the usual periods.
If you're uncertain about the right time to enroll, Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) for guidance from a licensed insurance agent.
Steps to Enroll in AARP Medicare Advantage Essentials from UHC OR-4
Enrolling in AARP Medicare Advantage Essentials from UHC OR-4 is easy. Choose the option that works best for you:
- Online through MedicareEnrollment.com: Visit the enrollment page and complete your enrollment through their Secure Online Enrollment Form.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent can assist you with the enrollment process and provide answers to any questions.
- Through Medicare.gov: Go to Medicare.gov, log in or create an account, and follow the instructions to join AARP Medicare Advantage Essentials from UHC OR-4 through the official Medicare website.
- Directly with AARP Medicare Advantage Essentials from UHC OR-4 : You can also enroll directly with the plan. The necessary contact details are provided below in the "Contact" section.
Remember to enroll during the correct enrollment period to ensure your coverage starts on time.
Here are some of the most frequently asked questions people have about plan ID H3805-039-1:
How much does H3805-039-1 cost per month?
The 2025 premium is $0.00 each month, and you must continue to pay your Part B premium.
How high can my costs go in a worst-case year?
For 2025, the maximum you’d spend out-of-pocket in-network is $4,500.00 .
What’s the prescription-drug deductible for 2025?
You’ll pay the first $255.00 in drug costs before coinsurance kicks in.
How is this plan rated by Medicare?
For 2025, plan H3805-039-1 has a ★3.5 rating. The best rating is 5 stars.
Is AARP Medicare Advantage Essentials from UHC OR-4 popular?
As of last month, about 44,988 beneficiaries are enrolled.
Contact UnitedHealthcare®
| Website: | UnitedHealthcare® Plan Page |
|---|---|
| Providers: | UnitedHealthcare® Providers Page |
| Formulary: | UnitedHealthcare® Formulary Page |
| Pharmacy: | UnitedHealthcare® Pharmacy Page |
| New Member Health Plan Help: | (800)555-5757 |
| New Member Health Plan TTY: | 711 |
| New Member Part D Help: | (800)555-5757 |
| New Member Part D TTY Users: | 711 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- UnitedHealthcare®, http://AARPMedicarePlans.com, Last Accessed June 1, 2025
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You", Last Accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage", Last Accessed 25 May, 2025
- CMS.gov, Landscape Source Files, Last Accessed October 15, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed October 15, 2024
- CMS.gov, Plan Benefits Package, Last Accessed October 15, 2024
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County, Last Accessed June 6, 2025
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