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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 2026, 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 3.5 out of 5 stars in 2026.
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 $42.00. 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 $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 $600 drug deductible. For Tier 1 preferred generic drugs, you will pay no copay for 1-month and 3-month supplies at standard pharmacies or through mail order. Tier 2 generic drugs require a $12 copay for a 1-month supply at standard pharmacies, but you can enjoy no copay on a 3-month supply when using preferred mail order. Higher-tier medications transition to coinsurance, starting with a 15% coinsurance for Tier 3 preferred brand drugs at standard pharmacies and through mail order. Tier 4 non-preferred drugs require a 40% coinsurance for a 1-month supply. Finally, Tier 5 specialty drugs carry a 26% coinsurance across standard pharmacies and mail-order services.
Additional Benefits
The AARP Medicare Advantage from UHC WA-0003 (PPO) plan offers robust coverage for everyday healthcare needs with no copays or coinsurance for primary care visits, telehealth services, and routine preventive care. Specialist visits feature a copay of up to $55 with no coinsurance, while inpatient hospital stays require a $485 daily copay for the first few days and no copay for subsequent days. Emergency care is accessible with a $130 copay, which is waived upon admission, and worldwide emergency services are covered with no copay. Routine vision and hearing exams are covered with no copays, and the plan provides coverage for hearing aids and eyewear with low to no copays. While preventive dental has no copay, other services like durable medical equipment, dialysis, and Part B drugs require up to a 20% coinsurance with no copay. Diagnostic lab work, home health services, and the first 20 days of skilled nursing facility stays are also covered with no copays or coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC WA-0003 (PPO) covers inpatient hospital services with no coinsurance, requiring a $485 daily copay for days 1 to 5 of acute stays and days 1 to 4 of psychiatric stays, with no copay for subsequent covered days. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC WA-0003 (PPO) with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Medicare-covered outpatient hospital services require a copay of $0 to $485, and outpatient substance abuse services have copays ranging from $0 to $25, both with no coinsurance.
Partial Hospitalization See details
AARP Medicare Advantage from UHC WA-0003 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC WA-0003 (PPO) covers ground and air ambulance services with a $290 copay and no coinsurance per service. While some transportation services are covered, transportation to plan-approved health-related locations or any health-related locations is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC WA-0003 (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care and telehealth services are covered by AARP Medicare Advantage from UHC WA-0003 (PPO) with no copay and no coinsurance, while specialist visits require a $0 to $55 copay and no coinsurance. Other services like physical, occupational, mental health, and podiatry therapies are covered with copays ranging from $0 to $50 and no coinsurance, although chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage from UHC WA-0003 (PPO) with no copay and no coinsurance for covered services such as annual physical exams, kidney disease education, glaucoma screenings, and fitness benefits. However, several sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access, home modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC WA-0003 (PPO), offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Up to two prescription hearing aids per year are covered with a $199 to $1,249 copay and no coinsurance (excluding inner, outer, and over-the-ear types), and up to two OTC hearing aids are covered with a $199 to $829 copay and no coinsurance.
Vision Services See details
AARP Medicare Advantage from UHC WA-0003 (PPO) covers one routine eye exam per year with no copay and no coinsurance, while other eye exam services are not covered. Covered eyewear has no coinsurance and a $0 copay (except for eyeglass lenses, which have a copay of $0 to $153) up to a $200 combined maximum limit every two years, but upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC WA-0003 (PPO), featuring Medicare-covered dental with no copay and 20% coinsurance, and preventive services with no copay or coinsurance. Restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC WA-0003 (PPO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance of no coinsurance to 20%, while Part B insulin has a $35 copay and a coinsurance of no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under the AARP Medicare Advantage from UHC WA-0003 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
AARP Medicare Advantage from UHC WA-0003 (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance with no copay, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC WA-0003 (PPO) with no coinsurance, though prior authorization is required. There is no copay for lab services and diagnostic radiology, while diagnostic procedures and tests cost a $5 copay, outpatient X-rays cost a $25 copay, and therapeutic radiological services require a minimum $60 copay.
Home Health Services See details
AARP Medicare Advantage from UHC WA-0003 (PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage from UHC WA-0003 (PPO) plan, as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC WA-0003 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. 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-0003 (PPO) partially covers other services, offering a meal benefit for chronic illnesses with no copay and no coinsurance, subject to prior authorization. Acupuncture, over-the-counter (OTC) items, and other additional services are not covered under this benefit.
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