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AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx WI-MA01 (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 Patriot No Rx WI-MA01 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx WI-MA01 (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 Patriot No Rx WI-MA01 (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage Patriot No Rx WI-MA01 (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 Patriot No Rx WI-MA01 (PPO), 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan offers robust coverage with no copay and no coinsurance for primary care visits, routine preventive services, and home health care. For inpatient hospital stays, members pay a $540 daily copay for the first four days and no copay for days five through 90, while specialist visits require a copay ranging from no copay to $55. Emergency room visits carry a $130 copay, which is waived upon hospital admission, and urgent care ranges from no copay to a $50 copay. Routine hearing and vision exams are covered with no copay, and the plan includes a $150 eyewear allowance every two years alongside hearing aid copays starting at $199. Although routine dental care is not covered, Medicare-covered dental services, dialysis, and durable medical equipment are covered with no copay and a 20% coinsurance. Additionally, diagnostic lab tests and home infusion services are available with no copay.
Inpatient Hospital See details
AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $540 daily copay for days 1 through 4 and no copay for days 5 through 90. Prior authorization is required, and while unlimited additional acute care days are covered at no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $540, observation services have a $540 daily copay, and outpatient substance abuse sessions range from no copay to a $25 copay.
Partial Hospitalization See details
Partial hospitalization is covered by AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) covers ground and air ambulance services with a $290 copay and no coinsurance, subject to prior authorization. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay of $0 to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits range from a $0 to $55 copay with no coinsurance. Physical, occupational, and speech therapies require a $50 to $55 copay with no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by the AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan with no copay and no coinsurance for covered services like annual physical exams, kidney disease education, select screenings, and a fitness benefit. However, several supplemental services are not covered under this plan, including health education, in-home safety assessments, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
Hearing services are partially covered by the AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO), which offers one routine annual hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids carry a copay of $199.00 to $1,249.00 and OTC hearing aids have a copay of $199.00 to $829.00 with no coinsurance for either, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) provides partially covered vision services with no coinsurance, featuring no copay for yearly routine eye exams, contact lenses, and frames, and a copay of $0 to $153 for eyeglass lenses. A combined $150 eyewear allowance is available every two years, though other eye exam services, combined eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) partially covers dental services, offering Medicare-covered dental care with no copay and a 20% coinsurance. Routine, preventive, and comprehensive dental services—including cleanings, exams, x-rays, fluoride, restorative treatments, and orthodontics—are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under the AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) covers durable medical equipment, 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 benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) covers diagnostic and radiological services, offering lab services with no copay and diagnostic tests with a $50 copay, both with no coinsurance. Diagnostic radiological services feature no copay, while outpatient X-rays require a $30 copay with coinsurance, and therapeutic radiology incurs a 20% coinsurance, with prior authorization required for most services.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) require prior authorization and feature no copay and no coinsurance. While some services are covered, specific sub-services—including standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation—are not covered.
Skilled Nursing Facility (SNF) See details
The AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan covers Skilled Nursing Facility (SNF) services with no coinsurance and does not require a prior three-day hospital stay, though prior authorization is required. There is no copay for days 1 through 20 and a daily copay of $218 for days 21 through 100, while additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) partially covers other services, providing a meal benefit for chronic illnesses with no copay and no coinsurance, although prior authorization is required. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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