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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 2025, 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 4 out of 5 stars in 2025.
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 $75.00. 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 coverage with a variety of benefits. It includes no copay for primary care, preventive services, vision exams, and many dental services. The plan also covers inpatient hospital stays, outpatient services, and emergency services, with varying copays. This plan also provides additional benefits such as hearing exams and hearing aids, along with medical equipment coverage. Furthermore, the plan covers home health services, and skilled nursing facility care with specific copays and coinsurance. You will also receive coverage for home infusion, dialysis, and diagnostic services.
Inpatient Hospital See details
Inpatient Hospital services are covered, with a copay of $515 for days 1-5 and no copay for days 6-90 for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. Additional days for Inpatient Hospital-Acute have no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $515, Observation Services with a $515 copay, Ambulatory Surgical Center (ASC) Services with no copay, Individual Sessions for Outpatient Substance Abuse with a copay between $0 and $25, Group Sessions for Outpatient Substance Abuse with a $15 copay, and Outpatient Blood Services with no copay. Prior authorization is required for all of these services.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan. This benefit has a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services, each with a $290 copay and no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by the AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan, with a $125 copay and no coinsurance. Urgently Needed Services have a copay between $0 and $55, and no coinsurance, while Worldwide Emergency Services have no copay or coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services have a $20 copay and require prior authorization, while Routine Chiropractic Care is not covered. Occupational Therapy Services have a copay between $0 and $45 and require prior authorization. Physician Specialist Services have a copay between $0 and $55 and require prior authorization. Mental Health Specialty Services, including Individual Sessions and Group Sessions, have copays between $0 and $25, and $15 respectively and require prior authorization. Podiatry Services, including Routine Foot Care, have a $45 copay and are limited to 6 visits per year. Other Health Care Professional visits have a copay between $0 and $55 and require prior authorization. Psychiatric Services, including Individual and Group Sessions, have copays between $0 and $25, and $15 respectively and require prior authorization. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $50 and require prior authorization. Additional Telehealth Benefits have no copay. Opioid Treatment Program Services have no copay and require prior authorization.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, an annual physical exam with no copay, and additional preventive services, along with other services like Glaucoma Screening, Diabetes Self-Management Training, and Barium Enemas, all with no copay. However, Health Education, In-Home Safety Assessment, and other services are not covered.
Hearing Services See details
The AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan covers hearing exams with no copay, and routine hearing exams with no copay for one visit every year. Prescription hearing aids have a copay between $199 and $1249 for two hearing aids every year, while OTC hearing aids have a copay between $99 and $829. Fitting/evaluation for hearing aids, prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan covers vision services, including eye exams with no copay, and eyewear. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames with no copay, as well as a combined maximum benefit of $250 every two years; however, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Other Dental Services, Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Maxillofacial Prosthetics, and Oral and Maxillofacial Surgery are covered with no copay, and Orthodontic Services and Prosthodontics (removable and fixed) are covered, with a coinsurance between 0% and 50%. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan. You will pay 20% coinsurance for these services, and prior authorization is required.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance, as well as Diabetic Equipment with coinsurance and copay information available. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services includes coverage for diagnostic procedures and tests with a copay of $50, lab services with no copay, and diagnostic radiological services with a copay up to $250. Therapeutic Radiological Services have a 20% coinsurance. Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization, and have no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
The AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) plan covers Over-the-Counter (OTC) Items and Meal Benefits with no copay. 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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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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