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AARP Medicare Advantage from UHC CA-0036 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC CA-0036 (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-0036 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC CA-0036 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Kern 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-0036 (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-0036 (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-0036 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $36.00. 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 CA-0036 (PPO) plan has a $420 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you may pay a $12 copay for a standard generic drug at a standard pharmacy. For non-preferred drugs, you will pay 28% coinsurance.
Additional Benefits
The AARP Medicare Advantage from UHC CA-0036 (PPO) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays. It also covers emergency services with a $125 copay and provides coverage for primary care, preventive services, and home health services with no copay. Additionally, the plan offers benefits for hearing, vision, and dental services, with specific costs and limitations for each.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with a copay of $425 per day for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered stays 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 $425, observation services have a $425 copay, ambulatory surgical center services have no copay, individual outpatient substance abuse sessions have a copay between $0 and $25, group outpatient substance abuse sessions have a $15 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services, and transportation services to plan-approved health-related locations. Ground and air ambulance services have a $290 copay, while transportation services to plan-approved health-related locations have no copay for up to 24 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage from UHC CA-0036 (PPO) with a $125 copay, and no coinsurance. Urgently needed services have a copay between $0 and $55, and no coinsurance, while worldwide emergency services have no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage from UHC CA-0036 (PPO) plan covers primary care physician services with no copay. Chiropractic services have a $20 copay, and routine chiropractic care is not covered. Occupational therapy services, and physical therapy and speech-language pathology services have a copay between $0 and $20. Physician specialist services have a copay between $0 and $20. Mental health specialty services have a copay that varies between $0 and $25 for individual sessions, and $15 for group sessions. Podiatry services and other health care professional services have a $20 copay. Psychiatric services have a copay that varies between $0 and $25 for individual sessions, and $15 for group sessions. Additional telehealth benefits have no copay. Finally, opioid treatment program services have no copay.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, additional services with varying copays, and kidney disease education services, also with no copay. Glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit are also covered with no copay. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other services are not covered.
Hearing Services See details
Hearing exams are covered with no copay. Prescription hearing aids are covered with a copay between $199 and $1249, depending on the type. Over-the-counter 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, including routine eye exams. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames with no copay, and a combined maximum plan benefit coverage of $300 every two years, but eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, including Medicare dental services with 20% coinsurance. Other dental services have a $750 maximum benefit per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. Restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay. Prosthodontics (removable and fixed) have a coinsurance of 0% - 50%. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by AARP Medicare Advantage from UHC CA-0036 (PPO). For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC CA-0036 (PPO) plan, with prior authorization required. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires prior authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay. 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 $150, Therapeutic Radiological Services with coinsurance up to 20%, and Outpatient X-Ray Services with a $15 copay.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC CA-0036 (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 covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required, and copays may apply.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC CA-0036 (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered, and non-Medicare-covered stays, are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items with no copay, but Acupuncture, Meal Benefit, 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.
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