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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 2026, 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 3.5 out of 5 stars in 2026.
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 $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 $13900.00 (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 $13900.00 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 annual drug deductible of $600. Tier 1 preferred generic drugs are highly affordable, requiring no copay for standard pharmacy fills and mail-order services. For Tier 2 generic drugs, you will pay a $12 copay for a one-month supply at standard pharmacies, or no copay for a three-month supply when using preferred mail order. For brand-name and specialized medications, the plan transitions to coinsurance costs. Tier 3 preferred brand drugs require a 15% coinsurance for pharmacy and mail-order fills. Tier 4 non-preferred drugs have a 37% coinsurance, while Tier 5 specialty medications carry a 26% coinsurance for a one-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC WA-0001 (PPO) plan offers affordable medical coverage with no copay or coinsurance for primary care visits, telehealth, and routine preventive care. For hospital stays, members pay a $450 daily copay for the first four days of inpatient care and no copay thereafter, while outpatient services range from no copay to a $450 copay. Emergency room visits carry a $115 copay, which is waived upon admission, and ambulance services require a $150 copay. Routine vision and hearing exams are covered with no copay, and the plan includes coverage for eyewear and hearing aids. Preventive dental cleanings and exams also feature no copay, though Medicare-covered dental services, dialysis, and durable medical equipment require a 20% coinsurance. Additionally, home health services are fully covered with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered under the AARP Medicare Advantage from UHC WA-0001 (PPO) plan, featuring no coinsurance, a $450 daily copay for days 1-4, and no copay for days 5 and beyond. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC WA-0001 (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services require a copay of $0 to $450, observation services carry a $450 daily copay, and outpatient substance abuse sessions have copays ranging from $0 to $25.
Partial Hospitalization See details
Partial hospitalization is covered by AARP Medicare Advantage from UHC WA-0001 (PPO) with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered under the AARP Medicare Advantage from UHC WA-0001 (PPO) plan with a $150 copay and no coinsurance for both ground and air services, subject to prior authorization. Transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage from UHC WA-0001 (PPO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services carry a copay ranging from $0 to $40 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 WA-0001 (PPO) covers primary care physician visits, telehealth, and opioid treatment programs with no copay and no coinsurance. Specialist visits, physical, occupational, speech, mental health, psychiatric, and podiatry therapies are covered with copayments ranging from $0 to $55 and no coinsurance, while chiropractic benefits are partially covered because other chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC WA-0001 (PPO) provides partially covered preventive services with no copay and no coinsurance, which includes annual physical exams, kidney disease education, diabetes self-management, glaucoma screenings, and a fitness benefit. However, several supplemental services are not covered under this plan, including health education, in-home safety assessments, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
Hearing services are partially covered under the AARP Medicare Advantage from UHC WA-0001 (PPO) plan, which features one routine hearing exam per year with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids (up to two per year) have a copay of $199.00 to $1,249.00 and no coinsurance, while OTC hearing aids (up to two per year) have a copay of $199.00 to $829.00 and no coinsurance, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC WA-0001 (PPO) with no deductible and no coinsurance, featuring one routine eye exam annually with no copay. Eyewear benefits include contact lenses and frames with no copay, as well as lenses with a copay of $0 to $153, up to a combined $200 limit every two years, though upgrades, complete eyeglasses, and other eye exams are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC WA-0001 (PPO), featuring Medicare-covered dental with no copay and 20% coinsurance, and preventive care like cleanings and exams with no copay and no coinsurance. However, comprehensive services including restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC WA-0001 (PPO) covers home infusion bundled services with no copay, though associated Medicare Part B chemotherapy, radiation, and other drugs have no coinsurance to 20% coinsurance. Covered Part B insulin has a $35 copay and no coinsurance to 20% coinsurance, with prior authorization required for these services.
Dialysis Services See details
AARP Medicare Advantage from UHC WA-0001 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for this covered benefit.
Medical Equipment See details
AARP Medicare Advantage from UHC WA-0001 (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and medical supplies, with no copay and a 20% coinsurance. Diabetic supplies are offered with no copay from select manufacturers, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC WA-0001 (PPO) covers diagnostic and radiological services with no coinsurance, subject to prior authorization. There is no copay for lab services and diagnostic radiological services, a $5 copay for diagnostic procedures and outpatient X-rays, and a minimum $25 copay for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage from UHC WA-0001 (PPO) plan with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no coinsurance under the AARP Medicare Advantage from UHC WA-0001 (PPO) plan. In practice, some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC WA-0001 (PPO) covers skilled nursing facility (SNF) care with no coinsurance and no prior three-day inpatient hospital stay requirement. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC WA-0001 (PPO) partially covers other services, offering acupuncture for a $10 copay and no coinsurance for up to 12 treatments per year, alongside a chronic illness meal benefit with no copay and no coinsurance, which requires prior authorization. Over-the-counter (OTC) items are not covered under this plan.
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