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AARP Medicare Advantage from UHC TX-0001 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC TX-0001 (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 TX-0001 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC TX-0001 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in West Texas. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC TX-0001 (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 TX-0001 (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 TX-0001 (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 TX-0001 (PPO) plan has an enhanced alternative drug benefit. The plan has a deductible of $420. During the initial coverage phase, you'll pay a copay for your prescriptions. For preferred generic drugs, you'll pay a $14 copay at a standard pharmacy. Standard generic drugs have a $47 copay. Preferred and standard brand drugs have a $100 copay. Non-preferred drugs have a 28% coinsurance. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC TX-0001 (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, and outpatient services have copays ranging from $0 to $305. Primary care, preventive services, hearing exams, vision services, dental services, and home health services are covered with no copay for many services. The plan also covers ambulance and emergency services with a copay, and offers coverage for home infusion, dialysis, and medical equipment with coinsurance. Skilled nursing facility stays have a copay for some days, and the plan covers other services like cardiac rehabilitation and diagnostic services. Additional benefits include coverage for over-the-counter items and meal benefits, both with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for acute and psychiatric inpatient hospital stays, with a copay of $305 for days 1-6, and no copay for days 7-90 for acute stays, and a copay of $305 for days 1-5, and no copay for days 6-90 for psychiatric stays. Additional days for inpatient hospital-acute are covered with no copay for days 91-999. 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, with copays ranging from $0 to $305, and for observation services with a $305 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Individual Sessions for Outpatient Substance Abuse have copays between $0 and $25, while Group Sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under this 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 prior authorization required for all ambulance services. Ground and Air Ambulance Services have a $290 copay, and there is no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered, with a $125 copay and no coinsurance. Urgently Needed Services are covered with a copay between $0 and $55, and no coinsurance. Worldwide Emergency Services are covered, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, all with no coinsurance and no copay.
Primary Care See details
The AARP Medicare Advantage from UHC TX-0001 (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 $40, and physician specialist services with a copay between $0 and $40. Mental health specialty services have copays, with individual sessions ranging from $0 to $25, and group sessions costing $15. Podiatry services and other health care professional services have copays, with routine foot care costing $35. Physical therapy and speech-language pathology services have a copay between $0 and $40. Additional telehealth benefits have no copay, and opioid treatment program services have no copay.
Preventive Services See details
The AARP Medicare Advantage from UHC TX-0001 (PPO) plan covers preventive services, including an annual physical exam with no copay, and additional preventive services, such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, all with no copay. However, services like health education, in-home safety assessments, and counseling services are not covered.
Hearing Services See details
The AARP Medicare Advantage from UHC TX-0001 (PPO) plan covers hearing exams with no copay, and routine hearing exams with no copay for one visit per year. Prescription hearing aids are covered with a copay between $199 and $1249 for two hearing aids every year, while OTC hearing aids have a copay between $99 and $829 for two hearing aids every year. 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
The AARP Medicare Advantage from UHC TX-0001 (PPO) plan covers vision services, including routine eye exams and eyewear. Routine eye exams and contact lenses have no copay, while eyeglass lenses have a copay of $0-$153 and eyeglass frames have no copay. Eyeglass frames are limited to one every two years with a combined maximum of $200 for all eyewear every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC TX-0001 (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 have no copay, and some services are limited to a certain number of visits per year. Orthodontic services, restorative services, and other services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by AARP Medicare Advantage from UHC TX-0001 (PPO), including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, as well as Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC TX-0001 (PPO) plan, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires authorization, while 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, including diagnostic procedures/tests, lab services, and radiological services, are covered. Diagnostic Procedures/Tests have a $35 copay, and Diagnostic Radiological Services have a copay up to $250, while Therapeutic Radiological Services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC TX-0001 (PPO) plan with no copay and no coinsurance. However, 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 any of the sub-services, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203 per day; there is no coinsurance.
Other Services See details
The AARP Medicare Advantage from UHC TX-0001 (PPO) plan covers over-the-counter items with no copay, and meal benefits with no copay, but requires prior authorization. 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.
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