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AARP Medicare Advantage from UHC TX-0006 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC TX-0006 (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-0006 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC TX-0006 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Houston 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-0006 (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-0006 (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-0006 (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-0006 (PPO) plan has a $420 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For generic drugs at a standard pharmacy, you will pay a $10 or $47 copay. For preferred brand drugs, the copay is $100. For non-preferred drugs, you pay 28% coinsurance. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC TX-0006 (PPO) plan offers coverage for a wide range of services, including inpatient and outpatient hospital care, primary and preventive care, and emergency services. Many services have a $0 copay, including primary care physician visits, routine eye exams, and preventive services. The plan also covers hearing, vision, and dental services, with varying cost-sharing structures. This plan includes coverage for ambulance services, with a $275 copay for ground and air ambulance. Additional benefits include coverage for home health services with no copay, and skilled nursing facility services, with a copay for days 21-100. However, some services, such as acupuncture and private duty nursing, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered. For Inpatient Hospital-Acute, you will pay a $375 copay for days 1-5, and no copay for days 6-90, while additional days 91-999 have no copay; Non-Medicare-covered stays and upgrades are not covered. Inpatient Hospital Psychiatric care has a $375 copay for days 1-4, and no copay for days 5-90, and additional days and non-Medicare stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $375, while Observation Services have a $375 copay; Ambulatory Surgical Center Services and Outpatient Blood Services have no copay. Individual sessions for outpatient substance abuse have a copay between $0 and $25, and group sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC TX-0006 (PPO) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by AARP Medicare Advantage from UHC TX-0006 (PPO). Medicare-covered ground and air ambulance services have a $275 copay, with no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered. Emergency Services have a $125 copay, while Urgently Needed Services have a copay of $0-$55, and Worldwide Emergency Services have no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Primary Care includes coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a copay between $0 and $40, Physician Specialist Services with a copay between $0 and $40, Mental Health Specialty Services with a copay between $0 and $25 for individual sessions and $15 for group sessions, Podiatry Services with a $35 copay, Other Health Care Professional with a copay between $0 and $40, Psychiatric Services with a copay between $0 and $25 for individual sessions and $15 for group sessions, Physical Therapy and Speech-Language Pathology Services with a copay between $0 and $45, 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, an annual physical exam with no copay, and additional preventive services. Additional preventive services include coverage for Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing exams are covered with no copay, while routine hearing exams are limited to one visit per year. Prescription hearing aids have a copay between $199 and $1249 for two hearing aids per year, and OTC hearing aids have a copay between $99 and $829 for two hearing aids per year. Fitting/evaluation for hearing aids, and prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include routine eye exams with no copay, but are limited to one exam per year. Eyewear is partially covered, with contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades not covered.
Dental Services See details
Dental Services are covered and include 20% coinsurance for Medicare Dental Services, and no copay for Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics, 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 and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME and Prosthetic Devices have a 20% coinsurance, while Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a $60 copay, lab services with no copay, diagnostic radiological services with a copay up to $190, therapeutic radiological services with 20% coinsurance, and outpatient X-ray services with a $35 copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC TX-0006 (PPO) with no copay and no coinsurance, however additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for Cardiac Rehabilitation Services, and you will need to check the plan details for copay information.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC TX-0006 (PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100; there is no coinsurance. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays are not covered.
Other Services See details
Other Services are not covered under the AARP Medicare Advantage from UHC TX-0006 (PPO) plan. The plan does not cover acupuncture, over-the-counter items, meal benefits, 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.
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