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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 2026, 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 3.5 out of 5 stars in 2026.
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 $600.00 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) prescription drug plan has an annual drug deductible of $600. Tier 1 preferred generic drugs feature no copay for 1-month or 3-month supplies at standard pharmacies and mail order options. Tier 2 generic drugs have a $14 copay for a 1-month standard pharmacy supply, though a 3-month supply has no copay when using preferred mail order. For brand name and specialty drugs, this plan utilizes coinsurance percentages instead of flat copays. Tier 3 preferred brand drugs require a 15% coinsurance, while Tier 4 non-preferred drugs require a 42% coinsurance. Tier 5 specialty tier drugs carry a 26% coinsurance for a 1-month supply across standard pharmacies and mail order services.
Additional Benefits
The AARP Medicare Advantage from UHC TX-0001 (PPO) plan offers robust healthcare coverage featuring no copay and no coinsurance for primary care visits, telehealth, and routine preventive services. For inpatient hospital stays, members pay a $325 daily copay for days 1 through 6, with no copay for days 7 through 90. Outpatient hospital care and specialist visits are also highly accessible, requiring no coinsurance and low copays ranging up to $325 and $55, respectively. Members enjoy additional savings with no copay for routine dental, vision, and hearing exams, alongside allowance benefits for eyewear and hearing aids. For specialized medical needs like durable medical equipment and dialysis, the plan requires no copay and a 20% coinsurance. Skilled nursing facility care is also covered with no copay for the first 20 days and a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
AARP Medicare Advantage from UHC TX-0001 (PPO) covers inpatient hospital and psychiatric care with no coinsurance, requiring a $325 daily copay for days 1 through 6 and no copay for days 7 through 90. This benefit is partially covered, as unlimited additional acute care days are covered with no copay, while additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC TX-0001 (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require copays ranging from $0 to $325, while outpatient substance abuse services carry a copay of $0 to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
AARP Medicare Advantage from UHC TX-0001 (PPO) covers partial hospitalization services with a $55 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by AARP Medicare Advantage from UHC TX-0001 (PPO), with ground and air ambulance services requiring prior authorization, a $240 copay, and no coinsurance. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC TX-0001 (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC TX-0001 (PPO) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $55 copay and no coinsurance. Therapy, mental health, and podiatry services feature copays ranging from $0 to $55 with no coinsurance, though chiropractic benefits are only partially covered as routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage from UHC TX-0001 (PPO) with no copay and no coinsurance for covered services, including annual physical exams, diabetes training, and fitness benefits. However, several supplemental options are not covered, such as health education, weight management programs, and personal emergency response systems.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC TX-0001 (PPO), featuring one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. The plan also covers up to two OTC hearing aids (copays of $199 to $829) and two prescription hearing aids (copays of $199 to $1,249) per year with no coinsurance, excluding inner ear, outer ear, and over-the-ear prescription models.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC TX-0001 (PPO) with no deductible and no coinsurance. You will pay no copay for annual routine eye exams, contact lenses, and eyeglass frames, and a $0 to $153 copay for eyeglass lenses up to a $150 combined eyewear limit every two years, though other eye exams, upgrades, and combined eyeglasses are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC TX-0001 (PPO), offering preventive services like exams, cleanings, and x-rays with no copay and no coinsurance, and Medicare-covered dental services with no copay and a 20% coinsurance. Restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the AARP Medicare Advantage from UHC TX-0001 (PPO) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, are covered with copays ranging from no copay up to $35 and coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC TX-0001 (PPO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage from UHC TX-0001 (PPO) covers durable medical equipment, prosthetics, and diabetic services with no copays and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC TX-0001 (PPO) covers diagnostic and radiological services with no coinsurance, although prior authorization is required. There is no copay for lab services and diagnostic radiological services, while outpatient x-rays and diagnostic tests cost a $5 copay, and therapeutic radiological services require a $60 copay.
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, though prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC TX-0001 (PPO) covers Cardiac Rehabilitation Services with no copay and no coinsurance, though prior authorization is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC TX-0001 (PPO) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, a $218 copay for days 21 through 100, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC TX-0001 (PPO) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered, and the meal benefit requires prior authorization.
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