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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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
AARP Medicare Advantage from UHC WA-0002 (PPO) is a PPO plan offered by Care Improvement Plus South Central Insurance Co. available for the 2026 plan year 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 that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $8500.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $8500.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $13900.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $13900.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
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.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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