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AARP Medicare Advantage from UHC TX-0003 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC TX-0003 (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-0003 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC TX-0003 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in San Antonio Metro Area. 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-0003 (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-0003 (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-0003 (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 $520.00 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-0003 (PPO) plan features an annual drug deductible of $520. Tier 1 preferred generic drugs have no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic drugs require a $14 copay for a 1-month supply at standard pharmacies, but you can obtain a 3-month supply with no copay using preferred mail order. For brand name and specialty medications, the plan utilizes coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 15% coinsurance for both standard pharmacies and mail order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 38% and 27% coinsurance, respectively, for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC TX-0003 (PPO) plan offers comprehensive medical coverage featuring no copays and no coinsurance for primary care visits, preventive care, and home health services. For hospital stays, members pay a daily copay of $395 for the first five days of inpatient care and no copay for days six through ninety. Outpatient services and emergency care are also covered with no coinsurance, requiring copays ranging up to $395 depending on the specific service. This plan provides routine vision and hearing exams with no copays, alongside allowances and predictable copays for corrective eyewear and hearing aids. Preventive dental services are fully covered with no copay, while Medicare-covered dental care, dialysis, and durable medical equipment require a twenty percent coinsurance. Additionally, members can benefit from covered over-the-counter items and chronic illness meals at no cost.
Inpatient Hospital See details
AARP Medicare Advantage from UHC TX-0003 (PPO) covers inpatient hospital services with no coinsurance, requiring a $395 daily copay for days 1 through 5 and no copay for days 6 through 90. This benefit is partially covered as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC TX-0003 (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copay. Outpatient hospital services have a copay of $0 to $395, and outpatient substance abuse sessions require copays up to $25, all with no coinsurance.
Partial Hospitalization See details
AARP Medicare Advantage from UHC TX-0003 (PPO) covers partial hospitalization with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services under AARP Medicare Advantage from UHC TX-0003 (PPO) require a $150 copay and no coinsurance for both ground and air ambulance trips, which require prior authorization. Although transportation is technically covered, some services are covered but trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC TX-0003 (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 feature a copay ranging from no copay to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC TX-0003 (PPO) provides primary care physician and telehealth services with no copay and no coinsurance, while specialist visits feature a $0 to $60 copay and no coinsurance. Therapy services require a $20 copay with no coinsurance, and chiropractic services are only partially covered at a $15 copay and no coinsurance, excluding routine and other chiropractic care.
Preventive Services See details
AARP Medicare Advantage from UHC TX-0003 (PPO) offers partially covered preventive services with no copay and no coinsurance for covered care, such as annual physical exams, kidney disease education, and fitness benefits. However, several supplemental services are not covered, including health education, personal emergency response systems, weight management, alternative therapies, and in-home support.
Hearing Services See details
AARP Medicare Advantage from UHC TX-0003 (PPO) provides partially covered hearing services, which include one routine annual hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Up to two prescription hearing aids per year are covered with a copay of $199 to $1,249 and no coinsurance, and up to two over-the-counter hearing aids are covered with a copay of $199 to $829 and no coinsurance. Inner ear, outer ear, and over-the-ear prescription hearing aids are not covered under this plan.
Vision Services See details
Vision Services are partially covered by AARP Medicare Advantage from UHC TX-0003 (PPO), featuring one routine eye exam annually with no copay and no coinsurance, though other eye exam services are not covered. Eyewear benefits include a $150 maximum coverage limit every two years with no coinsurance for contact lenses (no copay), eyeglass frames (no copay), and eyeglass lenses ($0 to $153 copay), while upgrades and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by the AARP Medicare Advantage from UHC TX-0003 (PPO) plan, which features Medicare-covered dental services with no copay and a 20% coinsurance, and preventive services with no copay and no coinsurance. Major services, including restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by AARP Medicare Advantage from UHC TX-0003 (PPO) with no copay, subject to prior authorization. Associated Medicare Part B drugs, such as chemotherapy, require no copay and a coinsurance of no coinsurance up to 20%, while Part B insulin has a $35 copay and a coinsurance of no coinsurance up to 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC TX-0003 (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered under the AARP Medicare Advantage from UHC TX-0003 (PPO) plan, with durable medical equipment, prosthetics, and medical supplies requiring no copay and a 20% coinsurance. Diabetic supplies feature no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC TX-0003 (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Under this plan, lab services and diagnostic radiology have no copay, outpatient X-rays and diagnostic procedures cost $5, and therapeutic radiological services require a $60 copay.
Home Health Services See details
AARP Medicare Advantage from UHC TX-0003 (PPO) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage from UHC TX-0003 (PPO) with no copay and no coinsurance, subject to prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC TX-0003 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not required for admission, and additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
AARP Medicare Advantage from UHC TX-0003 (PPO) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and other miscellaneous services are not covered under this plan, and the meal benefit requires prior authorization.
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