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AARP Medicare Advantage Patriot No Rx TX-MA06 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx TX-MA06 (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 TX-MA06 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx TX-MA06 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Texas. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage Patriot No Rx TX-MA06 (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 TX-MA06 (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 TX-MA06 (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 $75.00. 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 $14000.00 (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 $14000.00 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:
Sign up for AARP Medicare Advantage Patriot No Rx TX-MA06 (PPO)
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Drug Coverage
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx TX-MA06 (PPO).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx TX-MA06 (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services may have copays. Primary care, preventive services, hearing exams, vision exams, and many dental services are covered with no copay. Additional benefits include ambulance services with a copay, emergency services with a copay, and home health services with no copay. The plan also covers medical equipment and dialysis services with coinsurance. Prescription hearing aids, certain outpatient services, and some diagnostic and radiological services have copays.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a $380 copay for days 1-5 and no copay for days 6-90 for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Additional days for Inpatient Hospital-Acute have no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay ranging from $0 to $380, and observation services with a $380 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, while Outpatient Substance Abuse Services have copays ranging from $0 to $25 for individual sessions and a $15 copay for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage Patriot No Rx TX-MA06 (PPO) plan. This benefit has a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground and air ambulance services each have a $275 copay, and there is no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay, while Urgently Needed Services have a $0-$45 copay. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
The AARP Medicare Advantage Patriot No Rx TX-MA06 (PPO) plan offers primary care services with no copay, chiropractic services with a $15 copay, and occupational therapy services with a copay between $0 and $35. This plan also covers physician specialist services with a copay between $0 and $55, mental health specialty services with a copay between $0 and $25 for individual sessions and $15 for group sessions, and podiatry services with a $45 copay. Other health care professional visits have a copay between $0 and $55, psychiatric services have a copay between $0 and $25 for individual sessions and $15 for group sessions, and physical therapy and speech-language pathology services have a copay between $0 and $50. Additional telehealth benefits have no copay, and opioid treatment program services have no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, as well as additional preventive services, like fitness benefits, and home and bathroom safety devices, all with no copay. Other preventive services, such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, are covered with no copay. However, health education, in-home safety assessments, personal emergency response systems, and other services are not covered.
Hearing Services See details
Hearing services include hearing exams with no copay, and prescription hearing aids with a copay between $199 and $1249. Routine hearing exams are covered with no copay, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/Evaluation for Hearing Aids, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
The AARP Medicare Advantage Patriot No Rx TX-MA06 (PPO) plan covers vision services including eye exams with no copay, and eyewear with no copay, with a combined maximum benefit of $200 every two years. Eyeglass lenses have a copay of $0-$153, and eyeglasses frames, and contact lenses have no copay; however, eyeglass lenses and upgrades are not covered.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare dental services. Other services, such as oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, oral and maxillofacial surgery have no copay. Prosthodontics, removable, and prosthodontics, fixed, have a coinsurance of 0% to 50%. Orthodontic services are covered under diagnostic and preventive dental. The plan does not cover implant services or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered, with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage Patriot No Rx TX-MA06 (PPO) plan. You will pay 20% coinsurance for dialysis services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices with 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a $60 copay for Diagnostic Procedures/Tests, and no copay for Lab Services. Diagnostic Radiological Services have a copay up to $250, Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have a $30 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Patriot No Rx TX-MA06 (PPO) plan 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 not covered by the AARP Medicare Advantage Patriot No Rx TX-MA06 (PPO) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, or Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items with no copay, while acupuncture, meal benefits, dual eligible SNPs, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, case management, institution for mental disease services, services in an intermediate care facility, case management, tobacco cessation counseling, 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. This plan offers OTC items as a supplemental benefit, including nicotine replacement therapy and Naloxone.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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