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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 2026, 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 3.5 out of 5 stars in 2026.
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 $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-0006 (PPO) plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic drugs require a $10 copay for a 1-month supply at standard pharmacies, but you can save with no copay on a 3-month supply when using preferred mail order. For brand-name and specialty medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 15% coinsurance for standard pharmacy and mail-order fills. Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 42% and 26% coinsurance respectively for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC TX-0006 (PPO) plan offers comprehensive coverage for essential medical needs, featuring no copays and no coinsurance for primary care visits, telehealth, and routine preventive services. For specialized medical care, specialist visits range from a $0 to $50 copay, while inpatient hospital stays require a $460 daily copay for the first four to five days and no copay for subsequent days. Emergency services are available with a $130 copay, which is waived if you are admitted to the hospital within 24 hours. Routine dental, vision, and hearing exams are also covered with no copays or coinsurance, though comprehensive dental services and eyewear are not covered under this plan. Diagnostic lab services, cardiac rehabilitation, and home health care require no copay, while dialysis and durable medical equipment require a 20% coinsurance. Skilled nursing facility stays are covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
AARP Medicare Advantage from UHC TX-0006 (PPO) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. Covered acute stays require a $460 daily copay for days 1 through 5 and no copay for days 6 and beyond, while psychiatric stays require a $460 daily copay for days 1 through 4 and no copay for days 5 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC TX-0006 (PPO) with no coinsurance, though prior authorization is required for these benefits. There is no copay for ambulatory surgical center and blood services, while outpatient hospital services require a $0 to $460 copay and outpatient substance abuse services carry a $0 to $25 copay.
Partial Hospitalization See details
AARP Medicare Advantage from UHC TX-0006 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by the AARP Medicare Advantage from UHC TX-0006 (PPO) plan, featuring a $150 copay and no coinsurance for ground and air ambulance services. Routine transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC TX-0006 (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 copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC TX-0006 (PPO) covers primary care and telehealth services with no copay and no coinsurance. Specialist visits range from a $0 to $50 copay, physical, occupational, and speech therapies require a $25 copay, and mental health services range from a $0 to $25 copay, all with no coinsurance, while chiropractic services are not covered in practice.
Preventive Services See details
AARP Medicare Advantage from UHC TX-0006 (PPO) provides preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, glaucoma screenings, and a fitness benefit. This benefit is partially covered as several supplemental services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management programs, and home-based palliative care.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC TX-0006 (PPO), featuring one annual routine hearing exam with no copay and no coinsurance, though hearing aid fittings and evaluations are not covered. Up to two prescription hearing aids per year are covered with a $199 to $1,249 copay and no coinsurance, alongside OTC hearing aids with a $199 to $829 copay and no coinsurance, but inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
AARP Medicare Advantage from UHC TX-0006 (PPO) partially covers vision services, featuring one routine eye exam per year with no copay, no coinsurance, and no deductible, subject to prior authorization. Other eye exams and all eyewear services, including contact lenses, eyeglasses, frames, lenses, and upgrades, are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC TX-0006 (PPO), providing preventive care like cleanings, exams, and x-rays with no copay and no coinsurance. Medicare-covered dental services are available with no copay and a 20% coinsurance, though comprehensive treatments such as restorative, endodontic, periodontic, and orthodontic services are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC TX-0006 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B drugs—including chemotherapy, radiation, and insulin—have coinsurance ranging from no coinsurance to 20%, with insulin requiring a $35 copay and other covered drugs requiring no copay.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC TX-0006 (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC TX-0006 (PPO), featuring no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the AARP Medicare Advantage from UHC TX-0006 (PPO) with no coinsurance, although prior authorization is required. Members pay no copay for lab services and diagnostic radiology, a $5 copay for outpatient X-rays and diagnostic tests, and a $30 copay for therapeutic radiology services.
Home Health Services See details
AARP Medicare Advantage from UHC TX-0006 (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage from UHC TX-0006 (PPO) with no copay and no coinsurance, though prior authorization is required. While some services are covered under this benefit, specific sub-services such as standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are partially covered by AARP Medicare Advantage from UHC TX-0006 (PPO), which features no coinsurance and does not require a prior three-day hospital stay. Patients pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though prior authorization is required and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are not covered under the AARP Medicare Advantage from UHC TX-0006 (PPO) plan, which does not provide coverage or cost-sharing for acupuncture, over-the-counter (OTC) items, or meal benefits.
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