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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 2026, 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 3.5 out of 5 stars in 2026.
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 $95.00. 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 $600.00 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 $10100.00 (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 $10100.00 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 features an annual drug deductible of $600. Tier 1 preferred generic drugs have no copay for 1-month and 3-month fills at standard pharmacies, as well as for 3-month mail orders. Tier 2 generic drugs carry a $14 copay for a 1-month supply at standard pharmacies, though members can secure a 3-month supply with no copay through preferred mail order. For higher-tier medications, costs transition from flat copays to coinsurance percentages. Tier 3 preferred brand drugs require a 20% coinsurance, while Tier 4 non-preferred drugs carry a 27% coinsurance for a 1-month supply. Specialty medications in Tier 5 have a 26% coinsurance for a 1-month supply across standard pharmacies and mail-order options.
Additional Benefits
The AARP Medicare Advantage from UHC WI-0002 (PPO) plan offers comprehensive coverage with no copay for primary care provider visits, preventive services, and routine eye and hearing exams. For inpatient hospital stays, members pay a $455 copay for the first six days of an acute stay with no coinsurance, while outpatient hospital services range from no copay up to a $455 copay. Emergency room visits require a $130 copay, which is waived if you are admitted, and urgent care costs range from no copay to $50. Preventive dental cleanings and exams are covered with no copay, while Medicare-covered dental services require a 20% coinsurance. Diagnostic lab services, home health, and home infusion services are available with no copay, whereas dialysis and durable medical equipment require a 20% coinsurance. The plan also covers up to two prescription hearing aids per year with copays starting at $199 and skilled nursing facility stays with no copay for the first 20 days.
Inpatient Hospital See details
AARP Medicare Advantage from UHC WI-0002 (PPO) covers inpatient hospital services with no coinsurance, requiring a $455 copay for days 1-6 of an acute stay (no copay for days 7-999) and a $455 copay for days 1-5 of a psychiatric stay (no copay for days 6-90). This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC WI-0002 (PPO) with no coinsurance, featuring a copay of $0 to $455 for outpatient hospital services and a $455 daily copay for observation services. Ambulatory surgical center and outpatient blood services are offered with no copay and no coinsurance, while outpatient substance abuse services require no coinsurance and a copay of $15 for group sessions or $0 to $25 for individual sessions.
Partial Hospitalization See details
Partial hospitalization services are covered under the AARP Medicare Advantage from UHC WI-0002 (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC WI-0002 (PPO) covers ground and air ambulance services with a $290 copay and no coinsurance, with prior authorization required. Transportation services to health-related or plan-approved locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC WI-0002 (PPO) 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 of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary Care benefits under AARP Medicare Advantage from UHC WI-0002 (PPO) feature no copay and no coinsurance for primary care provider visits, telehealth, and opioid treatment. Other covered services like specialists, mental health, podiatry, and physical therapy require copays ranging from $0 to $55 with no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive Services are covered by AARP Medicare Advantage from UHC WI-0002 (PPO) with no copay and no coinsurance for annual physical exams, kidney disease education, and select screenings. However, the benefit is partially covered, as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, home modifications, and counseling are not covered.
Hearing Services See details
AARP Medicare Advantage from UHC WI-0002 (PPO) provides partially covered hearing services with no coinsurance and no deductible, offering one routine hearing exam annually with no copay. While fitting and evaluation exams, as well as inner ear, outer ear, and over-the-ear prescription hearing aids are not covered, the plan covers up to two prescription hearing aids (copays from $199.00 to $1,249.00) and two OTC hearing aids (copays from $199.00 to $829.00) per year.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC WI-0002 (PPO) with no deductibles and no coinsurance. Routine eye exams (one per year), contact lenses, and eyeglass frames (one pair every two years) have no copay, while eyeglass lenses have a $0 to $153 copay under a $300 combined eyewear limit every two years; however, other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC WI-0002 (PPO) partially covers dental services, offering Medicare-covered dental with no copay and 20% coinsurance, and preventive care like cleanings, exams, and x-rays with no copay and no coinsurance. However, restorative, endodontic, periodontic, prosthodontic, orthodontic, implant, and oral surgery services are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC WI-0002 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
AARP Medicare Advantage from UHC WI-0002 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC WI-0002 (PPO) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay, and prior authorization is required for these equipment benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC WI-0002 (PPO) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic tests have a $50 copay and no coinsurance, lab services and diagnostic radiology have no copay and no coinsurance, while outpatient X-rays have a $30 copay and therapeutic radiology requires 20% coinsurance.
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, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are partially covered under AARP Medicare Advantage from UHC WI-0002 (PPO) with no coinsurance, but please note that cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC WI-0002 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance and requires prior authorization, but does not require a prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 copay for days 21 through 100, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by AARP Medicare Advantage from UHC WI-0002 (PPO), which offers a meal benefit for chronic illnesses with no copay and no coinsurance, though prior authorization is required. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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