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AARP Medicare Advantage from UHC WA-0003 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC WA-0003 (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-0003 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC WA-0003 (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 4 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC WA-0003 (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-0003 (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-0003 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.00. 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 $495.00 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 $10100.00 (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 $10100.00 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-0003 (PPO) plan has a $495 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy used. For example, you will pay a $12 copay for a preferred generic drug at a standard pharmacy. For preferred brand drugs, you will pay a $100 copay regardless of the pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC WA-0003 (PPO) plan offers comprehensive coverage with no copay for many services, including primary care, preventive services, vision exams, dental exams, and home health services. For inpatient hospital stays, you'll pay a $450 copay for days 1-5, with no copay for days 6-90. Other services like ambulance, emergency care, and specialist visits have varying copays. This plan also covers services like hearing exams, and hearing aids, with copays for prescription and OTC hearing aids. Additionally, the plan includes benefits for home infusion, dialysis, medical equipment, diagnostic and radiological services, and skilled nursing facilities. Some services, like outpatient services, partial hospitalization, and cardiac rehabilitation, require prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered under the AARP Medicare Advantage from UHC WA-0003 (PPO) plan. For inpatient hospital acute care, you will pay a $450 copay for days 1-5, and no copay for days 6-90, while additional days have no copay; inpatient hospital psychiatric care has a $450 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services include outpatient hospital services with a copay between $0 and $450, observation services with a $450 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services with no copay. These services require prior authorization.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $290 copay for both ground and air ambulance services and 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 under the AARP Medicare Advantage from UHC WA-0003 (PPO) plan. Emergency Services have a $125 copay and no coinsurance, Urgently Needed Services have a copay between $0 and $55, and Worldwide Emergency Services have a copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage from UHC WA-0003 (PPO) plan covers primary care physician services with no copay. Chiropractic services have a $20 copay, while occupational therapy services have a copay between $0 and $45. Physician specialist services have a copay between $0 and $55, and physical therapy and speech-language pathology services have a copay between $0 and $50. Mental health and psychiatric individual sessions have copays between $0 and $25, while group sessions have a $15 copay. Podiatry services and other health care professional services have copays between $45 and $55, and opioid treatment program services have no copay. Additional telehealth benefits have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, an annual physical exam with no copay, and additional services like Fitness Benefit, Glaucoma Screening, Diabetes Self-Management Training, and more with no copay. However, Health Education, In-Home Safety Assessment, and other services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year with no copay. Prescription hearing aids are covered, but inner ear, outer ear, and over-the-ear hearing aids are not covered; there is a copay between $199 and $1249 for prescription hearing aids (all types). OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision services include eye exams with no copay, and eyewear, with no copay for contact lenses, eyeglass frames, and eyeglass lenses. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC WA-0003 (PPO) plan covers dental services, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services. There is no copay for oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services. Medicare dental services have a 20% coinsurance. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, 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 with a $35 copay and between 0% and 20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with between 0% and 20% coinsurance, and Other Medicare Part B Drugs with between 0% and 20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC WA-0003 (PPO) plan, but prior authorization is required. You will pay 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment (DME) with 20% coinsurance and requires authorization, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment, including Diabetic Supplies with no copay and 20% coinsurance for Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services includes coverage for all diagnostic services, diagnostic procedures/tests with a $50 copay, lab services with no copay, and outpatient X-ray services with a $25 copay. Diagnostic Radiological Services have a maximum copay of $250, and Therapeutic Radiological Services have a minimum coinsurance of 20%.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC WA-0003 (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the AARP Medicare Advantage from UHC WA-0003 (PPO) plan, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage from UHC WA-0003 (PPO) plan. There is no copay for days 1-20, and a $203 copay for days 21-100; however, additional days beyond Medicare-covered, and non-Medicare-covered stays are not covered.
Other Services See details
The AARP Medicare Advantage from UHC WA-0003 (PPO) plan covers Over-the-Counter (OTC) Items with no copay, and Meal Benefit with no copay and requires prior authorization. Acupuncture, 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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