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AARP Medicare Advantage from UHC WI-0002 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC WI-0002 (PPO). 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 WI-0002 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC WI-0002 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Wisconsin. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC WI-0002 (PPO) 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 WI-0002 (PPO).
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 WI-0002 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $55.00. 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 $495.00 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 combined Maximum Out-Of-Pocket cost of $6700.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $6700.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 WI-0002 (PPO) plan has a $495 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy you use. In the initial coverage phase, you may pay a $14 copay for standard generic drugs, a $47 copay for standard generic drugs, or a $100 copay for preferred brand drugs. Non-preferred drugs have a 27% coinsurance. After 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 WI-0002 (PPO) plan offers a wide range of benefits, including inpatient hospital stays with a copay of $375 for the first five days and no copay thereafter. The plan also covers outpatient services with varying copays, emergency services with a $125 copay, and primary care visits with no copay. Other key benefits include preventive services with no copay, hearing exams and vision exams with no copay, and dental services with no copay for preventive care. This plan also covers ambulance services with a $290 copay, and skilled nursing facility stays with no copay for the first 20 days. Diagnostic and radiological services have copays depending on the service, and home health services have no copay. The plan provides additional benefits such as a meal benefit with no copay.
Inpatient Hospital See details
Inpatient hospital services are covered, with a copay of $375 for days 1-5 and no copay for days 6-90 for acute inpatient hospital stays, and a copay of $375 for days 1-4 and no copay for days 5-90 for psychiatric stays. Additional days for inpatient hospital-acute have no copay, while non-Medicare-covered stays and upgrades for inpatient hospital-acute are not covered, and additional days and non-Medicare-covered stays for psychiatric are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services with a copay between $0 and $375, observation services with a $375 copay, ambulatory surgical center services with no copay, individual outpatient substance abuse sessions with a copay between $0 and $5, group outpatient substance abuse sessions with no copay, and outpatient blood services with no copay. Prior authorization is required for all of these services.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC WI-0002 (PPO) 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 WI-0002 (PPO) plan. Medicare-covered ground and air ambulance services have a copay of $290.00, and there is no coinsurance. 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 under the AARP Medicare Advantage from UHC WI-0002 (PPO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The AARP Medicare Advantage from UHC WI-0002 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, and occupational therapy services with a $0-$40 copay. The plan also covers physician specialist services with a $0-$50 copay, mental health specialty services with a $0-$5 copay for individual sessions and no copay for group sessions, and podiatry services with a $45 copay. The plan also covers other health care professionals with a $0-$50 copay, psychiatric services with a $0-$5 copay for individual sessions and no copay for group sessions, physical therapy and speech-language pathology services with a $0-$45 copay, additional telehealth benefits with no copay, and opioid treatment program services with no copay.
Preventive Services See details
Preventive services include no copay for Medicare-covered services, annual physical exams, and Fitness Benefits, while other preventive services have a copay. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, while routine hearing exams are covered with no copay for one visit per year. Prescription hearing aids are covered with a copay between $199 and $1249 for two visits per year, and OTC hearing aids have a copay between $99 and $829 per year. 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 with no copay, and eyewear benefits, including contact lenses, eyeglass lenses, and eyeglass frames with no copay, but eyeglasses (lenses and frames) and upgrades are not covered. Contact lenses, eyeglass lenses, and eyeglass frames have a combined maximum benefit of $300 every two years.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with 20% coinsurance, and other dental services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services have no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered with prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%; 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 WI-0002 (PPO) plan and require prior authorization. You are responsible for 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Prosthetic Devices have a 20% coinsurance, while Medical Supplies also have a 20% coinsurance. Diabetic Supplies have no copay and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services and radiological services. Diagnostic Procedures/Tests have a $45 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $150, and Therapeutic Radiological Services have up to 20% coinsurance. Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC WI-0002 (PPO) 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 covered, but the plan does not cover Cardiac Rehabilitation Services, 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 by AARP Medicare Advantage from UHC WI-0002 (PPO), with a $0 copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services for AARP Medicare Advantage from UHC WI-0002 (PPO) include a Meal Benefit with no copay, while acupuncture, over-the-counter items, 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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