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AARP Medicare Advantage from UHC WI-0009 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC WI-0009 (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-0009 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC WI-0009 (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 from UHC WI-0009 (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-0009 (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-0009 (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.
This plan has a $420.00 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-0009 (PPO) plan has an enhanced alternative drug benefit. The plan includes a $420 deductible for prescription drugs. After the deductible is met, you will pay a copay for your prescriptions, depending on the drug tier and pharmacy. For example, you'll pay a $14 copay for preferred generic drugs at a standard pharmacy.
Additional Benefits
The AARP Medicare Advantage from UHC WI-0009 (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services offer a mix of copays, and some services have no copay. Emergency services, primary care, preventive services, hearing exams, and vision exams all have no copay, offering cost-effective access to essential healthcare. The plan also covers services like ambulance, home health, and skilled nursing facilities with copays or coinsurance. Medical equipment and home infusion services are covered with coinsurance, while dental services are covered with a 20% coinsurance. Some services like cardiac rehabilitation and certain vision and dental services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $385 copay for days 1-5, and no copay for days 6-90, and no copay for days 91-999. For Inpatient Hospital Psychiatric, you will pay a $385 copay for days 1-4 and no copay for days 5-90.
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, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered with a copay between $0 and $5 for individual sessions, and no copay for group sessions. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the AARP Medicare Advantage from UHC WI-0009 (PPO) plan, with a $275 copay for both ground and air ambulance services and 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 the AARP Medicare Advantage from UHC WI-0009 (PPO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
The AARP Medicare Advantage from UHC WI-0009 (PPO) plan covers primary care physician services with no copay. Chiropractic services have a $20 copay, but routine care is not covered. Occupational therapy services have a copay between $0 and $30. Physician specialist services have a copay between $0 and $45. Mental health specialty services, including individual and group sessions, and psychiatric services, including individual and group sessions, have a copay between $0 and $5. Podiatry services and routine foot care have a $45 copay. Other health care professional services have a copay between $0 and $45. Physical therapy and speech-language pathology services have a copay between $0 and $30. Additional telehealth benefits have no copay, and opioid treatment program services have no copay.
Preventive Services See details
Preventive Services include a no copay for the annual physical exam, Medicare-covered zero dollar preventive services, and other preventive services. Additional preventive services, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visit all have no copay. The plan does not cover health education, in-home safety assessment, personal emergency response system (PERS), medical nutrition therapy (MNT), post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefit, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, and counseling services.
Hearing Services See details
Hearing Services includes coverage for hearing exams with no copay, and routine hearing exams with no copay for one visit per year. Prescription and OTC hearing aids are covered, with a copay between $99 and $1249 depending on the type of hearing aid. Fitting/Evaluation for Hearing Aid, 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 with no copay, routine eye exams with no copay, and eyewear with a combined maximum benefit of $300 every two years. Eyeglasses (lenses and frames) and upgrades are not covered, and eyeglass lenses have a copay between $0 and $153.
Dental Services See details
The AARP Medicare Advantage from UHC WI-0009 (PPO) plan covers Medicare dental services with a 20% coinsurance and requires prior authorization. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services are covered with no copay. However, orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery 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 a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis services are covered by the AARP Medicare Advantage from UHC WI-0009 (PPO) plan. There is a 20% coinsurance for dialysis services, and prior authorization is required.
Medical Equipment See details
Medical equipment, including Durable Medical Equipment (DME), Prosthetic Devices, Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires authorization, while the plan covers Prosthetic Devices and Medical Supplies with a 20% coinsurance, and Diabetic Supplies with no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services, diagnostic procedures/tests, lab services, all radiological services, diagnostic radiological services, therapeutic radiological services, and outpatient X-Ray services. Diagnostic procedures/tests have a copay of $50, and lab services have no copay. Diagnostic radiological services have a maximum copay of $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 AARP Medicare Advantage from UHC WI-0009 (PPO) 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 not covered by the AARP Medicare Advantage from UHC WI-0009 (PPO) plan. This includes services such as Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC WI-0009 (PPO), but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203.
Other Services See details
The AARP Medicare Advantage from UHC WI-0009 (PPO) plan covers over-the-counter items and meal benefits with no copay, but acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many other services are not covered. The plan offers over-the-counter items as a supplemental benefit under Part C, but does not cover all of the drugs on the CMS OTC list.
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