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AARP Medicare Advantage from UHC CA-0039 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC CA-0039 (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-0039 (PPO) in 2025, please refer to our full plan details page.
This summary reflects 2025 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
AARP Medicare Advantage from UHC CA-0039 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for the 2025 plan year to people living in San Luis Obispo 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-0039 (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-0039 (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-0039 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $40.00. 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 that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6700.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $6700.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $10100.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $10100.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
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-0039 (PPO) plan has an "Enhanced Alternative" drug benefit. The plan has a deductible of $420. After the deductible, you will pay copays or coinsurance depending on the drug tier and pharmacy. In the initial coverage phase, you'll pay different copays for your prescriptions depending on the drug tier and pharmacy. For example, the copay for a standard generic drug is $47. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for your Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC CA-0039 (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services may have copays depending on the specific service. Emergency services have a copay, but some urgent and worldwide emergency services have no copay. This plan covers primary care, preventive, hearing, vision, and dental services, often with no or low copays. Additionally, the plan covers home health services, skilled nursing facilities, and durable medical equipment. Some services require coinsurance or have copays, so it's important to review the details to understand your potential out-of-pocket costs.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $425 copay for days 1-6, and no copay for days 7-90, with no coinsurance. For Inpatient Hospital Psychiatric, you will pay a $425 copay for days 1-5, and no copay for days 6-90, with no coinsurance.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services with a copay between $0 and $425, observation services with a $425 copay, ambulatory surgical center services with no copay, and outpatient substance abuse services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Outpatient blood services are also covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC CA-0039 (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, with no coinsurance. Ground and Air Ambulance Services have a copay of $290. Transportation Services to a health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under this plan. Emergency Services have a $125 copay, and no coinsurance, and the copay is waived if admitted to the hospital within 24 hours. Urgently Needed Services have a copay between $0 and $55, and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay, and no coinsurance.
Primary Care See details
Primary Care Physician Services, Physician Specialist Services, and Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $25. Chiropractic Services have a $20 copay, and Routine Foot Care and Medicare-covered Podiatry Services have a $25 copay. Individual and Group Sessions for Mental Health and Psychiatric Services have a copay between $0 and $25, and $15 respectively. Occupational Therapy Services, Additional Telehealth Benefits, and Opioid Treatment Program Services have no copay. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, while some additional preventive services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), and more, are not covered. The plan covers Fitness Benefit, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with no copay.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered with no copay for one visit per year. Prescription hearing aids are covered, with a copay between $199 and $1249 for two aids every year, and OTC hearing aids are covered with a copay between $99 and $829 for two aids per year. Fitting/evaluation for hearing aids, and prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision Services includes coverage for eye exams with no copay, and for eyewear including contact lenses, eyeglass lenses, and eyeglass frames. Eyeglasses (lenses and frames) and upgrades are not covered. Eyeglass lenses have a copay between $0 and $153, while contact lenses and eyeglass frames have no copay.
Dental Services See details
The AARP Medicare Advantage from UHC CA-0039 (PPO) plan covers Medicare Dental Services with 20% coinsurance, and other dental services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services includes coverage for Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. Medicare Part B Insulin Drugs have a $35 copay and 0-20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices with 20% coinsurance, while Diabetic Supplies have no copay and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures/tests with a $50 copay, and lab services with no copay. Radiological services are also covered, with a copay of at most $250 for diagnostic services, a 20% coinsurance for therapeutic services, and a $25 copay for outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC CA-0039 (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 not the Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required, and there is a copay, but the specific amount is not listed.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage from UHC CA-0039 (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 stays for SNF are not covered.
Other Services See details
The AARP Medicare Advantage from UHC CA-0039 (PPO) plan covers over-the-counter items and meal benefits with no copay, but 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.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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