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AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx NE-MA01 (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 Patriot No Rx NE-MA01 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Iowa and Nebraska. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage Patriot No Rx NE-MA01 (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 Patriot No Rx NE-MA01 (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. Additionally, this plan comes with a Part B Premium reduction of $150.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) plan offers robust coverage for essential medical services with predictable out-of-pocket costs. You will pay no copay and no coinsurance for primary care visits, preventive care, and home health services. For specialized needs, inpatient hospital stays require a $425 daily copay for the first few days with no coinsurance, while emergency room visits carry a $130 copay. Vision and dental benefits feature generous allowances, including no copay for routine eye exams and preventive dental care, with comprehensive dental covered at a 50% coinsurance up to a $4,000 annual limit. Diagnostic labs and routine hearing exams also feature no copay, while medical equipment and dialysis services require a 20% coinsurance with no copay. Additionally, covered prescription hearing aids require copays ranging from $199 to $1,249.
Inpatient Hospital See details
AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) partially covers inpatient hospital services with no coinsurance, requiring prior authorization and a $425 daily copay for days 1 to 7 of acute stays and days 1 to 5 of psychiatric stays, with no copay for subsequent covered days. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $425 for outpatient hospital services and a $425 daily copay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services have a maximum $10 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by the AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required to access these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) covers ground and air ambulance services with a $290 copay and no coinsurance, although prior authorization is required. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) covers emergency services with a $130 copay (waived if admitted within 24 hours) and no coinsurance. Urgently needed services are covered with no copay to a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services feature no copay and no coinsurance. These services do not count toward the plan deductible.
Primary Care See details
AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) offers primary care, telehealth, and opioid treatment services with no copay and no coinsurance. Other covered benefits feature no coinsurance, with copays ranging from $0 to $10 for mental health, $0 to $50 for specialists, and $45 for physical, occupational, speech, and podiatry therapies, while chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) preventive services are partially covered with no copay and no coinsurance for covered care, including annual physicals, kidney disease education, glaucoma screenings, fitness benefits, and home safety devices. However, several supplemental services are not covered, such as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, alternative therapies, and caregiver support.
Hearing Services See details
AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) offers partially covered hearing services with no deductible and no coinsurance, including no copay for annual routine exams. Fitting and evaluation services, along with inner ear, outer ear, and over-the-ear prescription hearing aids are not covered, but other prescription hearing aids have a $199 to $1,249 copay and OTC hearing aids have a $199 to $829 copay.
Vision Services See details
Vision services are partially covered by the AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) plan, offering no coinsurance and no deductible. Covered benefits include annual routine eye exams and contact lenses with no copay, eyeglass frames with no copay, and eyeglass lenses with a $0 to $153 copay up to a $300 eyewear limit every two years; however, other eye exam services, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) up to a $4,000 annual limit, with implant services and orthodontics not covered. Diagnostic and preventive services have no copay and no coinsurance, while covered comprehensive services require no copay and 50% coinsurance, and Medicare-covered dental services have no copay and 20% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) with no copay, though prior authorization is required. Medicare Part B drugs associated with these services, including chemotherapy and insulin, require a coinsurance ranging from no coinsurance up to 20%, with insulin specifically carrying a $35 copay and no deductible.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by the AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) plan, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment. These covered services feature no copays and a 20% coinsurance, with prior authorization required for most items.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) plan, requiring prior authorization but offering diagnostic services with no coinsurance, lab services with no copay, and diagnostic tests for a $45 copay. Radiological services feature no copay for diagnostic radiology, a $25 copay for X-rays, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
AARP Medicare Advantage Patriot No Rx NE-MA01 (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 not covered under the AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all excluded. Although the category technically features no coinsurance, in practice, none of these specific sub-services are covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
AARP Medicare Advantage Patriot No Rx NE-MA01 (PPO) partially covers other services, providing over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit, and prior authorization is required for meals.
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