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AARP Medicare Advantage from UHC CA-0030 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC CA-0030 (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 CA-0030 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC CA-0030 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Orange County. 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 CA-0030 (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 CA-0030 (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 CA-0030 (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 $570.00 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 CA-0030 (PPO) plan has a $570 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, in the initial coverage phase, you will pay a $14 copay for preferred generic drugs at a standard pharmacy, and a $47 copay for standard generic drugs. For preferred brand drugs, you will pay a $100 copay. Once your total drug costs reach $2000, you will enter the catastrophic coverage phase where you will pay nothing for your Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC CA-0030 (PPO) plan offers a wide range of benefits with varying cost-sharing. Many services have no copay, including primary care visits, preventive services like annual physical exams, hearing exams, vision eye exams, and home health services. The plan also covers inpatient hospital stays, outpatient services, emergency services, and more, with copays and coinsurance amounts varying by service. For example, you'll pay a copay for inpatient hospital stays, outpatient services, and diagnostic procedures. Other services like dental, dialysis, and medical equipment have coinsurance costs.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with a $425 copay for days 1-5 and days 1-4 respectively, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute have no copay for days 91-999, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $425, and observation services with a $425 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and outpatient substance abuse services have a copay between $0 and $25 for individual sessions, and a $15 copay for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered under the AARP Medicare Advantage from UHC CA-0030 (PPO) plan, but requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground and Air Ambulance Services have a $290 copay, and there is no coinsurance; however, 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. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Services has a copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, but the copay is $0 for each. There is no coinsurance for any of these services.
Primary Care See details
The AARP Medicare Advantage from UHC CA-0030 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a copay between $0 and $35, physician specialist services with a copay between $0 and $40, mental health specialty services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, podiatry services with a $25 copay, other health care professional services with a copay between $0 and $40, psychiatric services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, physical therapy and speech-language pathology services with a copay between $0 and $40, 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 include an annual physical exam with no copay, and additional preventive services that may require a copay. This plan also covers Kidney Disease Education Services, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing exams are covered with no copay, and prescription hearing aids are covered with a copay between $199 and $1249. OTC hearing aids are covered with a copay between $99 and $829, while 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 with no copay for one exam every year. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, each with a combined maximum plan benefit of $300 every two years, and no copay except for eyeglass lenses, which have a copay between $0 and $153. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include 20% coinsurance for Medicare dental services, and no copay for oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services. 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. For Medicare Part B Insulin Drugs, there is a $35 copay, and the coinsurance ranges from 0% to 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered, with coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC CA-0030 (PPO) plan. You will pay 20% coinsurance for this service.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for Diagnostic Procedures/Tests with a $50 copay, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $250, Therapeutic Radiological Services with 20% coinsurance, and Outpatient X-Ray Services with a $25 copay.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC CA-0030 (PPO) with no copay and no coinsurance, but 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 Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required, and there is a copay for the services that are covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage from UHC CA-0030 (PPO) plan. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services are not covered by the AARP Medicare Advantage from UHC CA-0030 (PPO) plan, including acupuncture, over-the-counter items, meal benefits, and more. No authorization or referrals are required for these services.
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