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AARP Medicare Advantage from UHC SD-0001 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC SD-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 SD-0001 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC SD-0001 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Rapid City Area. 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 SD-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 SD-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 SD-0001 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $57.00. 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 $495.00 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 SD-0001 (PPO) plan has an enhanced alternative drug benefit. The plan has a $495 deductible for prescription drugs. During the initial coverage phase, you will pay a copay for your prescriptions. For example, you will pay a $14 copay for preferred generic drugs at a standard pharmacy. You will pay 27% coinsurance for non-preferred drugs. Once you reach $2000 in out-of-pocket drug costs, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC SD-0001 (PPO) plan offers a range of benefits with varying costs. This plan includes coverage for inpatient hospital stays with a copay, as well as outpatient services, emergency services, and primary care, often with no copay. You'll also find coverage for hearing, vision, and dental services, with some services requiring a copay or coinsurance, and others being covered with no cost to you.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric, are covered. For acute inpatient hospital stays, you will pay a $450 copay for days 1-4, and no copay for days 5-90, and for psychiatric stays, you will pay a $450 copay for days 1-3, and no copay for days 4-90. 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 for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a copay of $0 - $450, observation services with a $450 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with no copay, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by 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 with a $290 copay, and no coinsurance. Transportation Services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the AARP Medicare Advantage from UHC SD-0001 (PPO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
Primary Care services include coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, and Occupational Therapy Services with a copay between $0 and $35. The plan also covers Physician Specialist Services with a copay between $0 and $45, Mental Health Specialty Services with no copay for individual and group sessions, Podiatry Services with a $45 copay, Other Health Care Professional services with a copay between $0 and $45, Psychiatric Services with no copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services with a copay between $0 and $35, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, annual physical exams with no copay, and additional preventive services like Fitness Benefits, Home and Bathroom Safety Devices and Modifications, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with no copay. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, and Counseling Services are not covered.
Hearing Services See details
Hearing services include routine hearing exams with no copay, and prescription hearing aids, including all types, with a copay between $199 and $1249. OTC hearing aids are also covered with a copay between $99 and $829, and fitting/evaluation for hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams with no copay, and eyewear benefits with no copay. Eyeglass lenses have a copay of $0 - $153, contact lenses have no copay, and eyeglass frames have no copay. Eyewear has a combined maximum plan benefit coverage of $300 every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC SD-0001 (PPO) plan covers Medicare Dental Services with 20% coinsurance, and other dental services like oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services, all with no copay. Orthodontic, restorative, and other services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. The cost for Medicare Part B Insulin Drugs includes a $35 copay and coinsurance between 0% and 20%, while the cost for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs includes coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC SD-0001 (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered by the AARP Medicare Advantage from UHC SD-0001 (PPO) plan. Durable Medical Equipment (DME) has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetics 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 are covered, including diagnostic procedures/tests with a $25 copay, lab services with no copay, diagnostic radiological services with a copay of at most $200, therapeutic radiological services with a copay of at least $80, and outpatient X-ray services with a $25 copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC SD-0001 (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 under the AARP Medicare Advantage from UHC SD-0001 (PPO) plan, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required, and copay information is available in the plan details.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC SD-0001 (PPO) plan. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services includes Over-the-Counter (OTC) Items and a Meal Benefit, with OTC items covered with no copay, and the meal benefit requiring prior authorization and no copay. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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