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AARP Medicare Advantage from UHC TX-0005 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC TX-0005 (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-0005 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC TX-0005 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Dallas 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-0005 (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-0005 (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-0005 (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-0005 (PPO) plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, there is no copay for 1-month or 3-month supplies at standard pharmacies, as well as 3-month supplies through mail order. Tier 2 generic drugs carry a $14 copay for a 1-month supply at standard pharmacies, though a 3-month supply has no copay when filled through preferred mail order. For brand-name and specialty medications, costs transition to coinsurance. Tier 3 preferred brand drugs require a 15% coinsurance for both standard pharmacy and mail order fills. Tier 4 non-preferred drugs require a 37% coinsurance, while Tier 5 specialty drugs carry a 26% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC TX-0005 (PPO) plan offers robust coverage with no copay and no coinsurance for primary care visits, preventive care, home health services, and diagnostic lab tests. Specialist visits require a copay of $0 to $55, while emergency room visits have a $130 copay and ambulance services require a $125 copay. Inpatient hospital stays feature a $405 daily copay for the first six days of acute stays, with no copay required for subsequent days. Routine vision and hearing exams are fully covered with no copay, though corrective eyewear and hearing aids require specific copays. Preventive dental care is also available with no copay, while Medicare-covered dental services, dialysis, and durable medical equipment require a 20% coinsurance. Diabetic supplies are covered with no copay and no coinsurance, helping members manage ongoing health needs affordably.
Inpatient Hospital See details
AARP Medicare Advantage from UHC TX-0005 (PPO) partially covers inpatient hospital services with no coinsurance, featuring a $405 daily copay for days 1-6 of acute stays (no copay for days 7 and beyond) and a $405 daily copay for days 1-5 of psychiatric stays (no copay for days 6-90). Non-Medicare-covered stays, room upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services covered by AARP Medicare Advantage from UHC TX-0005 (PPO) feature no coinsurance, including no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay between $0 and $405 (with observation services at $405 per day), while outpatient substance abuse services have no coinsurance and copays ranging from $0 to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
Partial hospitalization services are covered under the AARP Medicare Advantage from UHC TX-0005 (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by AARP Medicare Advantage from UHC TX-0005 (PPO) with a $125 copay and no coinsurance for both ground and air transportation, though prior authorization is required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage from UHC TX-0005 (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 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-0005 (PPO) provides primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $55 copay and no coinsurance. Physical and occupational therapy have a $30 copay with no coinsurance, and some chiropractic services are covered but routine and other chiropractic services are not covered. Mental health, psychiatric, and podiatry services are also covered with no coinsurance and copays ranging from $0 to $45.
Preventive Services See details
AARP Medicare Advantage from UHC TX-0005 (PPO) covers preventive services with no copay and no coinsurance, including annual physical exams, fitness benefits, and routine screenings. This benefit is partially covered, as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access technologies, and counseling are not covered.
Hearing Services See details
AARP Medicare Advantage from UHC TX-0005 (PPO) partially covers hearing services, offering one routine hearing exam per year with no copay and no coinsurance, but excluding coverage for hearing aid fittings and evaluations. Up to two OTC hearing aids per year are covered with a $199.00 to $829.00 copay and no coinsurance, and up to two prescription hearing aids are covered with a $199.00 to $1,249.00 copay and no coinsurance, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC TX-0005 (PPO) with no deductible, no coinsurance, and no copay for annual routine eye exams. While contact lenses, frames, and lenses (with copays ranging from $0 to $153) are covered up to a $150 limit every two years, other eye exams, upgrades, and combined eyeglasses packages are not covered.
Dental Services See details
AARP Medicare Advantage from UHC TX-0005 (PPO) partially covers dental services, offering Medicare-covered dental care with no copay and a 20% coinsurance, alongside preventive and diagnostic services with no copay and no coinsurance. However, comprehensive dental services such as 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-0005 (PPO) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and range from no coinsurance up to 20% coinsurance, while covered insulin has a $35 copay and ranges from no coinsurance up to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC TX-0005 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for this covered benefit.
Medical Equipment See details
Medical equipment covered by AARP Medicare Advantage from UHC TX-0005 (PPO) features no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay and no coinsurance, though prior authorization is required for most of these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC TX-0005 (PPO) with no coinsurance, though prior authorization is required. Lab services and diagnostic radiology have no copay, outpatient X-rays and diagnostic tests require a $5 copay, and therapeutic radiology services require a minimum copay of $25.
Home Health Services See details
Home health services are covered under the AARP Medicare Advantage from UHC TX-0005 (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC TX-0005 (PPO) covers some services for cardiac rehabilitation with no copay and no coinsurance, though prior authorization is required. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC TX-0005 (PPO) with no coinsurance and no required prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with prior authorization required and additional days beyond day 100 not covered.
Other Services See details
Other Services are partially covered by the AARP Medicare Advantage from UHC TX-0005 (PPO), which features over-the-counter (OTC) items with no copay and no coinsurance. However, acupuncture, meal benefits, and certain drugs on the CMS OTC list are not covered.
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