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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 2025, 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 4 out of 5 stars in 2025.
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 $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-0005 (PPO) plan has a $420 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for your prescriptions. The copay for standard generic drugs is $14, $47 for standard generic, and $100 for preferred brand drugs. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for your covered drugs. If you qualify for the low-income subsidy, you will pay no copay for your drugs.
Additional Benefits
The AARP Medicare Advantage from UHC TX-0005 (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services may have copays, depending on the service. Emergency, primary care, hearing, vision, and dental services are covered, with some services having no copay. This plan includes coverage for ambulance services with a copay, and home health services with no copay. The plan also includes coverage for durable medical equipment, and skilled nursing facility stays with copays. Preventative services and other services such as over-the-counter items and lab services have no copay.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including acute and psychiatric care. For Inpatient Hospital-Acute, you'll pay a $335 copay for days 1-6, and no copay for days 7-90, with additional days 91-999 covered with no copay; however, non-Medicare-covered stays and upgrades are not covered. For Inpatient Hospital Psychiatric, you'll pay a $335 copay for days 1-5, and no copay for days 6-90; however, additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $335, and observation services with a copay of $335 per day. Ambulatory Surgical Center (ASC) Services have no copay, and Outpatient Substance Abuse Services have a copay between $0 and $25 for individual sessions, and a $15 copay for group sessions. Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC TX-0005 (PPO) plan. This benefit has a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $275 copay for both ground and air ambulance services; however, transportation services to any health-related location are not covered. There is no coinsurance for ambulance services.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under this plan. Emergency Services have a $125 copay, Urgently Needed Services have a copay between $0 and $55, and Worldwide Emergency Services have a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage from UHC TX-0005 (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 $35, and physician specialist services with a copay between $0 and $35. Mental health specialty services, psychiatric services, and podiatry services are covered, with copays that vary depending on the service, and other health care professional services have a copay between $0 and $35. Physical therapy and speech-language pathology services have a copay between $0 and $35, and additional telehealth benefits have no copay. Opioid treatment program services are covered with no copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional services with copays. The plan does not cover health education, in-home safety assessment, personal emergency response system, medical nutrition therapy, 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, or counseling services. Fitness benefits, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visit have no copay. Home and bathroom safety devices and modifications also have no copay.
Hearing Services See details
Hearing exams are covered with no copay. Prescription hearing aids are covered with a copay between $199 and $1249, depending on the type of hearing aid. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision Services include eye exams with no copay, routine eye exams with no copay for one visit every year, and eyewear. Eyewear includes contact lenses with no copay, eyeglass lenses with a copay between $0 and $153, and eyeglass frames with no copay for one pair every two years, but does not cover eyeglasses or upgrades.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare dental services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), maxillofacial prosthetics, implant services, prosthodontics (fixed), oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, you will pay a $35 copay, and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC TX-0005 (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment benefits are covered, including durable medical equipment with 20% coinsurance and prosthetics/medical supplies with 20% coinsurance. Diabetic equipment is also covered, with no copay for diabetic supplies, and diabetic therapeutic shoes/inserts with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for Diagnostic Procedures/Tests with a $60 copay, and Lab Services with no copay. Diagnostic Radiological Services have a copay up to $250, while Therapeutic Radiological Services have up to 20% coinsurance. Outpatient X-Ray Services have a $30 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC TX-0005 (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, 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 for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC TX-0005 (PPO) plan. There is no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items with no copay, but Acupuncture, Meal Benefit, 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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