A non-government entity
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 2025, 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 out of 5 stars in 2025.
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. Additionally, this plan comes with a Part B Premium reduction of $20.00. You must continue to pay paying your reduced 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 $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:
Sign up for AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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 comprehensive coverage, including inpatient and outpatient hospital services, with varying copays depending on the specific service. Primary care, preventive, hearing, vision, and dental services are also covered, often with no copay, though some services have copays or coinsurance. The plan also provides coverage for ambulance, emergency, and home health services, and covers medical equipment with coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, the copay is $445 for days 1-6, and no copay for days 7-90, and the copay is $0 for days 91-999. For Inpatient Hospital Psychiatric, the copay is $445 for days 1-5, and no copay for days 6-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $445, observation services have a $445 copay, ambulatory surgical center services have no copay, individual outpatient substance abuse sessions have a copay between $0 and $5, group outpatient substance abuse sessions have no copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan. Ground and Air Ambulance Services have a $290 copay, with no coinsurance, while 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 by the AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan. Emergency Services have a $125 copay, Urgently Needed Services have a copay between $0 and $55, and Worldwide Emergency Services has a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $0-$45 copay, physician specialist services with a $0-$45 copay, and mental health specialty services, with $0-$5 copay for individual sessions and no copay for group sessions. The plan also covers podiatry services with a $45 copay, other health care professional services with a $0-$45 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. Routine chiropractic care is not covered.
Preventive Services See details
Preventive services are covered, including an annual physical exam with no copay. Additional preventive services, kidney disease education services, and other preventive services are also covered, but the copay details are listed in the plan documents.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and OTC hearing aids. Routine hearing exams have no copay, and are limited to one per year. Prescription hearing aids have a copay between $199 and $1249, with a limit of two per year, while OTC hearing aids have a copay between $99 and $829, with a limit of two per year.
Vision Services See details
The AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan covers vision services, including routine eye exams and eyewear. Routine eye exams and eyewear have no copay, while eyeglass lenses have a copay of $0-$153; however, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services, which require prior authorization. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan and require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME) with a 20% coinsurance and no copay, Prosthetics/Medical Supplies with a 20% coinsurance and no copay, and Diabetic Equipment. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services with a $50 copay, lab services with no copay, and diagnostic radiological services with a copay up to $250. Therapeutic radiological services have a coinsurance of at least 20%, and outpatient X-ray services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
The AARP Medicare Advantage Patriot No Rx WI-MA01 (PPO) plan covers Over-the-Counter (OTC) items with no copay, and a meal benefit with no copay and prior authorization required. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved