AARP Medicare Advantage from UHC MI-0001 (PPO)

Inpatient Hospital See details

Inpatient Hospital benefits, including acute and psychiatric care, are covered. For acute care, you will pay a $385 copay for days 1-7, and no copay for days 8-90, with additional days 91-999 covered with no copay; non-Medicare covered stays and upgrades are not covered.

Psychiatric care has a $385 copay for days 1-5, and no copay for days 6-90, while additional days and non-Medicare-covered stays are not covered.

Outpatient Services See details

Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $385, observation services with a $385 copay per day, and outpatient substance abuse services with a copay between $0 and $5 for individual sessions. This plan also covers Ambulatory Surgical Center (ASC) Services with no copay, and Outpatient Blood Services with no copay.

Partial Hospitalization See details

Partial Hospitalization is covered by the AARP Medicare Advantage from UHC MI-0001 (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 MI-0001 (PPO) plan. Ground and Air Ambulance Services have a $275 copay, but 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 by AARP Medicare Advantage from UHC MI-0001 (PPO). Emergency Services has a $125 copay, while Urgently Needed Services has a copay between $0 and $55, and Worldwide Emergency Services has a copay depending on the service.

Primary Care See details

Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy, Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic Services are covered, but Routine Care is not covered, and a $20 copay applies.

Preventive Services See details

Preventive Services include an annual physical exam with no copay, and additional preventive services, including fitness benefits, and home and bathroom safety devices and modifications, with no copay. Other preventive services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit are covered with no copay. However, health education, in-home safety assessments, personal emergency response systems, and other services are not covered.

Hearing Services See details

Hearing exams are covered with no copay, and routine hearing exams are covered once per year with no copay. Prescription hearing aids are covered with a copay between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/evaluation for hearing aids, 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 and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear has no copay, and contact lenses, eyeglass lenses, and eyeglass frames are covered, with a combined maximum of $300 every two years, while eyeglass lenses are covered with a copay between $0-$153. Eyeglasses (lenses and frames) and upgrades are not covered.

Dental Services See details

Dental services include coverage for Medicare dental services with a 20% coinsurance, while other dental services are covered up to a maximum of $1750 per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, and other preventive dental services have no copay. Restorative services, maxillofacial prosthetics, prosthodontics (removable and fixed), oral and maxillofacial surgery, and endodontics have no copay, with the coinsurance ranging from 0% to 50%. Orthodontic services are not covered. Implant services and orthodontics are not covered.

Home Infusion bundled Services See details

Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and the coinsurance is between 0% and 20%, while the coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs is between 0% and 20%.

Dialysis Services See details

Dialysis Services are covered under the AARP Medicare Advantage from UHC MI-0001 (PPO) plan. This benefit has a coinsurance of 20%.

Medical Equipment See details

The AARP Medicare Advantage from UHC MI-0001 (PPO) plan covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment. Durable Medical Equipment has a 20% coinsurance, and there is no copay. Prosthetic devices and medical supplies have a 20% coinsurance, and no copay. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.

Diagnostic and Radiological Services See details

Diagnostic and Radiological Services include coverage for all diagnostic services and radiological services. Diagnostic Procedures/Tests have a $50 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $225, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a $20 copay.

Home Health Services See details

Home Health Services are covered by the AARP Medicare Advantage from UHC MI-0001 (PPO) plan 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 the following services: Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. 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 from UHC MI-0001 (PPO) plan. There is no copay for days 1-20, but a $203 copay applies for days 21-100; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.

Other Services See details

The "Other Services" benefit for AARP Medicare Advantage from UHC MI-0001 (PPO) includes coverage for Over-the-Counter (OTC) Items and Meal Benefits with no copay. Acupuncture, 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.