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AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx WA-MA01 (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 Patriot No Rx WA-MA01 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx WA-MA01 (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 Patriot No Rx WA-MA01 (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage Patriot No Rx WA-MA01 (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 Patriot No Rx WA-MA01 (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. Additionally, this plan comes with a Part B Premium reduction of $105.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, telehealth, annual physicals, and home health services. For inpatient hospital stays, members pay no coinsurance but will face a daily copay of $550 for the first few days of acute or psychiatric care. Outpatient services, emergency care, and diagnostic tests are also covered with no coinsurance, featuring low to no copays for most services and a $130 copay for emergency room visits. This plan also includes valuable supplemental coverage, featuring a $2,000 annual limit for dental services with no copay for preventive care and a 50% coinsurance for comprehensive care. Vision and routine hearing exams are available with no copays or coinsurance, while prescription hearing aids require copays ranging from $199 to $1,249. Additionally, skilled nursing facility stays offer no copay for the first 20 days, and durable medical equipment is covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute care, there is a $550 daily copay for days 1-5 and no copay for days 6 and beyond, while psychiatric stays require a $550 daily copay for days 1-4 and no copay for days 5-90; however, upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital and observation services require a copay ranging from $0 to $550, while outpatient substance abuse sessions carry a copay of $0 to $25, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization services are covered by the AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) covers Medicare-approved ground and air ambulance services with a $290 copay per trip and no coinsurance, subject to prior authorization. Transportation services to health-related locations are not covered by this plan.
Emergency Services See details
Emergency services are covered under the AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a $0 to $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Primary care services under the AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan are covered with no copay and no coinsurance for primary care doctor visits and telehealth. Other professional services, including specialist visits, physical therapy, and mental health sessions, are covered with no coinsurance and copays ranging from $0 to $60, while chiropractic services are not covered in practice.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) with no copay and no coinsurance for annual physicals, kidney disease education, and screenings like glaucoma and diabetes self-management. Additional preventive services are partially covered, offering fitness benefits and home safety devices at no copay and no coinsurance. However, sub-services such as health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) provides partially covered hearing services, featuring one annual routine hearing exam with no copay and no coinsurance, although fitting and evaluation exams are not covered. The plan also covers up to two prescription hearing aids per year with a $199 to $1,249 copay and up to two OTC hearing aids with a $199 to $829 copay (both with no coinsurance), though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) vision services are partially covered with no deductible and no coinsurance. Routine eye exams, contact lenses, and eyeglass frames have no copay, while eyeglass lenses have a $0 to $153 copay up to a combined $200 limit every two years; however, other eye exams, complete eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) offers partially covered dental services up to a $2,000 annual limit for both in- and out-of-network care. Preventive services have no copay and no coinsurance, while Medicare-covered services carry a 20% coinsurance and comprehensive services carry a 50% coinsurance, both with no copay. Implant services and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) with no copay, though prior authorization is required. Covered Part B chemotherapy, radiation, and other Part B drugs have no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) covers medical equipment, offering no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Members pay no copay for lab services and diagnostic radiology, a $5 copay for diagnostic tests and outpatient X-rays, and a $60 copay for therapeutic radiology services.
Home Health Services See details
Home health services are covered by the AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) 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 Patriot No Rx WA-MA01 (PPO) plan. This non-coverage applies to all related rehabilitation services, including standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services.
Skilled Nursing Facility (SNF) See details
The AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required and additional days beyond the Medicare-covered limit are not covered, though a prior three-day inpatient hospital stay is not required for admission.
Other Services See details
AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) partially covers other services, which include over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required to receive the meal benefit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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