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AARP Medicare Advantage from UHC WI-6 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC WI-6 (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-6 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC WI-6 (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-6 (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-6 (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-6 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $50.00. 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-6 (PPO) prescription drug plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies, as well as for 3-month mail-order supplies. Tier 2 generic drugs cost a $14 copay for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay through preferred mail order. For higher-tier medications, costs shift to coinsurance. Tier 3 preferred brand drugs require a 15% coinsurance for both 1-month and 3-month supplies at standard pharmacies and through mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 38% and 26% coinsurance respectively for a 1-month supply across standard pharmacies and mail-order options.
Additional Benefits
The AARP Medicare Advantage from UHC WI-6 (PPO) plan offers robust coverage with no copay for primary care visits, annual physicals, and home health services. For specialist visits, copays range from $0 to $60, while inpatient hospital stays require a $550 daily copay for the first few days and no copay for additional days. Emergency care is available with a $130 copay, which is waived if you are admitted, and urgent care copays range from $0 to $50. Routine hearing and vision exams feature no copay, and the plan provides allowances for contact lenses, frames, and hearing aids with varying copays. Preventive dental cleanings and exams have no copay, though Medicare-covered dental services, dialysis, and durable medical equipment require a 20% coinsurance. Diagnostic lab services and cardiac rehabilitation are also covered with no copay, helping to keep your out-of-pocket costs predictable.
Inpatient Hospital See details
AARP Medicare Advantage from UHC WI-6 (PPO) covers inpatient hospital services with no coinsurance, requiring a $550 daily copay for days 1–5 of acute stays (with no copay for additional days) and a $550 daily copay for days 1–4 of psychiatric stays (with no copay for days 5–90). Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, and prior authorization is required.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC WI-6 (PPO) with no coinsurance, featuring a $0 to $550 copay for outpatient hospital and observation services, and no copay for ambulatory surgical center and blood services. Outpatient substance abuse services require a copay of $0 to $25 for individual sessions and $15 for group sessions, with prior authorization required for most outpatient services.
Partial Hospitalization See details
AARP Medicare Advantage from UHC WI-6 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC WI-6 (PPO) partially covers ambulance and transportation services, offering ground and air ambulance coverage with a $290 copay and no coinsurance, subject to prior authorization. Transportation services, including trips to plan-approved or any other health-related locations, are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC WI-6 (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 ranging from $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
AARP Medicare Advantage from UHC WI-6 (PPO) covers primary care and telehealth with no copay and no coinsurance, while specialists require a $0 to $60 copay and no coinsurance. Therapy, mental health, and podiatry services are covered with varying copays up to $45 and no coinsurance, though some chiropractic services are covered but routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage from UHC WI-6 (PPO), featuring no copay and no coinsurance for covered services such as annual physical exams, kidney disease education, and a fitness benefit. However, several additional preventive services are not covered, including 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, enhanced disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
Hearing services covered by the AARP Medicare Advantage from UHC WI-6 (PPO) plan include one annual routine hearing exam with no deductible, no copay, and no coinsurance, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are partially covered for up to two devices per year with no coinsurance and copays ranging from $199 to $1,249, but inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC WI-6 (PPO) with no coinsurance, featuring no copay for one routine eye exam per year and contact lenses. Eyeglass frames (no copay) and eyeglass lenses (copays from $0.00 to $153.00) are covered up to a combined $300 maximum every two years, while other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC WI-6 (PPO) partially covers dental services, offering Medicare-covered dental care with no copay and a 20% coinsurance, and preventive services like exams and cleanings with no copay and no coinsurance. Comprehensive dental services, including restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the AARP Medicare Advantage from UHC WI-6 (PPO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
The AARP Medicare Advantage from UHC WI-6 (PPO) plan covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage from UHC WI-6 (PPO) covers medical equipment, including durable medical equipment (DME), 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
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC WI-6 (PPO), featuring no copay and no coinsurance for lab services, and a $50 copay with no coinsurance for diagnostic procedures. Diagnostic radiological services have no copay, outpatient X-rays require a $30 copay and coinsurance, and therapeutic radiological services carry a 20% coinsurance and a copay.
Home Health Services See details
AARP Medicare Advantage from UHC WI-6 (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by AARP Medicare Advantage from UHC WI-6 (PPO) with no copay and no coinsurance, but require prior authorization. Although some services are covered, specific options such as cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC WI-6 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance and no prior three-day hospital stay required. You will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though prior authorization is required and additional days are not covered.
Other Services See details
Other services are partially covered by AARP Medicare Advantage from UHC WI-6 (PPO), which includes 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.
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