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AARP Medicare Advantage from UHC WA-0001 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC WA-0001 (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 WA-0001 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC WA-0001 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Spokane County. 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 WA-0001 (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 WA-0001 (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 WA-0001 (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 $570.00 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 $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:
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Drug Coverage
The AARP Medicare Advantage from UHC WA-0001 (PPO) plan has an enhanced alternative drug benefit. The plan has a $570 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for standard pharmacy prescriptions, with costs varying by tier. For example, preferred generic drugs have no copay, while standard generic drugs have a $47 copay. You will pay 26% coinsurance for non-preferred drugs. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC WA-0001 (PPO) plan offers a range of benefits. This plan covers inpatient hospital stays with a copay, as well as outpatient services, including primary care, with varying copays. The plan also provides coverage for emergency services, preventive services, hearing, vision, and dental services. Additional benefits include home health services with no copay, and coverage for medical equipment, diagnostic and radiological services, and skilled nursing facilities. The plan also offers acupuncture and a meal benefit. However, it's important to note that some services, such as cardiac rehabilitation, and certain dental, vision, and other services, may not be covered or may have limitations.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered. For acute care, you pay a $435 copay for days 1-4, and no copay for days 5-90, while additional days have no copay; psychiatric care has a $435 copay for days 1-3 and no copay for days 4-90.
Outpatient Services See details
Outpatient Services are covered, including 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 $435, observation services have a $435 copay, ambulatory surgical center services have no copay, individual substance abuse sessions have a copay between $0 and $25, group substance abuse sessions have a $15 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. For this benefit, you will pay a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by AARP Medicare Advantage from UHC WA-0001 (PPO). Ground and air ambulance services have a $290 copay, and there is no coinsurance; however, transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered by the AARP Medicare Advantage from UHC WA-0001 (PPO) plan. For Emergency Services, there is a $110 copay, and no coinsurance, and for Urgently Needed Services, there is a $0-$45 copay, and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care services include no copay for Primary Care Physician Services, a $10 copay for Chiropractic Services, a $0-$20 copay for Occupational Therapy Services, and a $0-$40 copay for Physician Specialist Services. Mental Health Specialty Services have a copay of $0-$25 for individual sessions and $15 for group sessions, and Podiatry Services have a $30 copay. Other Health Care Professional services have a copay of $0-$40, and Psychiatric Services have a copay of $0-$25 for individual sessions and $15 for group sessions. Physical Therapy and Speech-Language Pathology Services have a copay of $0-$35, Additional Telehealth Benefits have no copay, and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, as well as an annual physical exam with no copay. Additional preventive services like fitness benefits and alternative therapies are covered with a $10 copay. Other preventive services are covered with no copay including glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visits.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year. Prescription hearing aids are covered with a copay between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829. 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 coverage for eye exams with no copay, and eyewear, which includes contact lenses, eyeglass lenses, and eyeglass frames, with no copay for contact lenses and eyeglass frames, and a copay between $0.00 and $153.00 for eyeglass lenses; however, eyeglasses (lenses and frames) and upgrades are not covered. The plan covers one routine eye exam per year, one pair of eyeglass lenses every two years, and one eyeglass frame every two years, with a combined maximum benefit of $200.00 for all eyewear every two years.
Dental Services See details
Dental Services includes coverage for oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay, and a 20% coinsurance for Medicare Dental Services. 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, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay with coinsurance between 0% and 20%, with other drugs having coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC WA-0001 (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay, but 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 $50 copay, and lab services with no copay. Radiological services are covered with a copay of up to $250 for diagnostic services, and a 20% coinsurance for therapeutic services, and a $25 copay for outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC WA-0001 (PPO) 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 not covered by the AARP Medicare Advantage from UHC WA-0001 (PPO) plan. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC WA-0001 (PPO) plan. There is no copay for days 1-20, and a $203 copay per day for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include coverage for acupuncture and a meal benefit. Acupuncture has a $10 copay for up to 12 treatments per year, and the meal benefit has no copay. Over-the-counter items, 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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