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AARP Medicare Advantage from UHC WA-0002 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC WA-0002 (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-0002 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC WA-0002 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Washington. 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-0002 (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-0002 (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-0002 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $22.00. 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-0002 (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, as well as for a 3-month supply through mail order. Tier 2 generic drugs cost a $14 copay for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay through preferred mail order. For higher-tier medications, cost-sharing is based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 15% coinsurance, while Tier 4 non-preferred drugs carry a 38% coinsurance. Specialty drugs in Tier 5 require a 26% coinsurance for a 1-month supply at both standard pharmacies and mail-order services.
Additional Benefits
The AARP Medicare Advantage from UHC WA-0002 (PPO) plan offers coverage with no copay and no coinsurance for primary care, telehealth, and preventive services, while specialist visits range from no copay to a $55 copay. For hospital stays, inpatient acute care requires a $550 daily copay for the first four days with no copay thereafter, and emergency room visits carry a $115 copay that is waived if you are admitted. Outpatient hospital services feature copays ranging from no copay up to $550, while standard diagnostic labs and home health services are available with no copay and no coinsurance. Routine vision and hearing exams are covered with no copay, and the plan provides a $200 eyewear allowance every two years alongside hearing aid coverage with copays starting at $199. Preventive dental care features no copay and no coinsurance, though Medicare-covered dental services, dialysis, and durable medical equipment require a 20% coinsurance with no copay. Additionally, skilled nursing facility stays require 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 WA-0002 (PPO) partially covers inpatient hospital services with no coinsurance, requiring prior authorization. Acute stays carry a $550 daily copay for days 1 to 4 with no copay thereafter, while psychiatric stays require a $550 daily copay for days 1 to 3 with no copay for days 4 to 90; upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC WA-0002 (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services which feature no copay and no coinsurance. Outpatient hospital services require a copay ranging from no copay to $550 with no coinsurance, while outpatient substance abuse services carry a copay of up to $25 per session with no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by AARP Medicare Advantage from UHC WA-0002 (PPO) with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC WA-0002 (PPO) covers ground and air ambulance services with a $290 copay and no coinsurance, requiring prior authorization. While some transportation services are covered, trips to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage from UHC WA-0002 (PPO) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature no coinsurance and a copay ranging from no copay to $40, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC WA-0002 (PPO) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits range from a $0 to $55 copay and therapy services require a $25 to $45 copay, all with no coinsurance. Some chiropractic services are covered with a $15 copay and no coinsurance, but routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by AARP Medicare Advantage from UHC WA-0002 (PPO) with no copay and no coinsurance for covered benefits such as annual physical exams, fitness benefits, kidney disease education, glaucoma screenings, diabetes self-management training, digital rectal exams, and post-welcome visit EKGs. Sub-services that are not covered under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs for chemotherapy-related hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, home and bathroom safety modifications, and counseling services.
Hearing Services See details
AARP Medicare Advantage from UHC WA-0002 (PPO) partially covers hearing services, offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation services are not covered. Up to two prescription hearing aids per year are covered with a copay of $199.00 to $1,249.00 and no coinsurance (excluding inner, outer, and over-the-ear models), while up to two OTC hearing aids are covered with a copay of $199.00 to $829.00 and no coinsurance.
Vision Services See details
AARP Medicare Advantage from UHC WA-0002 (PPO) provides partially covered vision services with no coinsurance, featuring no copay for annual routine eye exams and eyeglass frames, alongside a $0 to $153 copay for eyeglass lenses. A combined eyewear allowance of $200 is offered every two years for contact lenses and frames, though other eye exams, upgrades, and complete eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC WA-0002 (PPO) provides partially covered dental services, featuring Medicare-covered dental with no copay and 20% coinsurance, and preventive care with no copay and no coinsurance. However, restorative, endodontic, periodontic, prosthodontic, maxillofacial prosthetic, implant, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC WA-0002 (PPO) covers Home Infusion bundled Services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance up to 20% coinsurance, while covered insulin has a $35 copay and ranges from no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC WA-0002 (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
AARP Medicare Advantage from UHC WA-0002 (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies feature no copay, while diabetic therapeutic shoes and inserts are covered with no copay and a 20% coinsurance.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC WA-0002 (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. There is no copay for lab services and diagnostic radiology, while diagnostic procedures and outpatient X-rays require a $5 copay, and therapeutic radiological services carry a $50 copay.
Home Health Services See details
AARP Medicare Advantage from UHC WA-0002 (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 from UHC WA-0002 (PPO) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all not covered in practice.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC WA-0002 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not necessary for admission, and additional days beyond the standard 100 days are not covered.
Other Services See details
Other services are partially covered by AARP Medicare Advantage from UHC WA-0002 (PPO), featuring a meal benefit for chronic illnesses with no copay, no coinsurance, and no maximum coverage limit, though prior authorization is required. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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