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AARP Medicare Advantage from UHC AR-0004 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC AR-0004 (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 AR-0004 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC AR-0004 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Arkansas. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC AR-0004 (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 AR-0004 (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 AR-0004 (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.
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 $520.00 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 AR-0004 (PPO) plan offers an Enhanced Alternative drug benefit with an annual prescription drug deductible of $520.00. During the initial coverage phase, standard pharmacy costs include a $12.00 copay for Tier 1 preferred generic drugs and a 17% coinsurance for Tier 2 standard generics. Tier 3 preferred brands and Tier 4 non-preferred drugs require a 32% and 27% coinsurance respectively through standard pharmacies or standard mail. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase where you pay nothing for covered Part D prescriptions. Additionally, individuals who qualify for the low-income subsidy will experience a premium reduction and have no copay for Part D.
Additional Benefits
The AARP Medicare Advantage from UHC AR-0004 (PPO) plan offers comprehensive medical coverage featuring no copay for primary care visits, telehealth, annual physicals, and home health services. Specialist visits and diagnostic tests are highly affordable with low copays, while inpatient hospital stays require a daily copay of $455 for the first six days before transitioning to no copay. Emergency care is covered with a $130 copay, which is waived upon admission, and ambulance services require a flat $275 copay with no coinsurance. For routine wellness, the plan provides annual eye and hearing exams with no copay, alongside allowances for eyewear and hearing aids. Preventive dental care also features no copay, while comprehensive dental services require a 50% coinsurance up to a $2,000 annual limit. Additionally, durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay, helping manage long-term health needs efficiently.
Inpatient Hospital See details
Inpatient Hospital benefits are partially covered by AARP Medicare Advantage from UHC AR-0004 (PPO), requiring a daily copay of $455 for days 1 to 6 of acute care (no copay for days 7 to 999) and days 1 to 5 of psychiatric care (no copay for days 6 to 90), with no coinsurance. Prior authorization is required, and 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 AR-0004 (PPO) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Copays for other outpatient services range from no copay to $25 for substance abuse sessions, and up to $455 for outpatient hospital and daily observation services.
Partial Hospitalization See details
AARP Medicare Advantage from UHC AR-0004 (PPO) covers partial hospitalization benefits with a $55 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by AARP Medicare Advantage from UHC AR-0004 (PPO), with ground and air ambulance services requiring a $275 copay and no coinsurance. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC AR-0004 (PPO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours. Urgently needed services feature a copay ranging from no copay to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary Care benefits are covered by AARP Medicare Advantage from UHC AR-0004 (PPO) with no copay and no coinsurance for primary care provider visits and telehealth services. Other services, including specialist visits, mental health sessions, and physical therapy, have copays ranging from $0 to $45 with no coinsurance, while chiropractic services are only partially covered because routine chiropractic care is not covered.
Preventive Services See details
Preventive services are covered under the AARP Medicare Advantage from UHC AR-0004 (PPO) plan with no copay and no coinsurance for annual physical exams, kidney disease education, and select screenings. Additional preventive services are partially covered, including fitness benefits and home safety devices, while sub-services such as health education, personal emergency response systems, and weight management programs are not covered.
Hearing Services See details
AARP Medicare Advantage from UHC AR-0004 (PPO) partially covers hearing services, providing one routine hearing exam per year with no copay or coinsurance, though fitting and evaluation exams are not covered. The plan also covers up to two prescription or OTC hearing aids annually with no coinsurance and copays ranging from $199.00 to $1,249.00, excluding inner ear, outer ear, and over-the-ear prescription models.
Vision Services See details
AARP Medicare Advantage from UHC AR-0004 (PPO) covers annual routine eye exams with no copay or coinsurance. Eyewear is partially covered up to a $150 limit every two years with no copay or coinsurance for contact lenses and frames, and a $0 to $153 copay and no coinsurance for lenses; however, 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 AR-0004 (PPO), excluding implant services and orthodontics. Covered preventive services feature no copay and no coinsurance, while Medicare dental requires a 20% coinsurance and no copay, and comprehensive services require a 50% coinsurance and no copay up to a $2,000 annual maximum.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by AARP Medicare Advantage from UHC AR-0004 (PPO), requiring prior authorization and step therapy. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by AARP Medicare Advantage from UHC AR-0004 (PPO) with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
AARP Medicare Advantage from UHC AR-0004 (PPO) covers durable medical equipment, prosthetics, and diabetic therapeutic shoes with a 20% coinsurance and no copay. Diabetic supplies are covered with no copay and no coinsurance, and prior authorization is required for most medical equipment benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC AR-0004 (PPO) covers diagnostic and radiological services, requiring prior authorization. Under these benefits, lab services have no copay or coinsurance, diagnostic tests cost a $50 copay and no coinsurance, outpatient x-rays cost a $30 copay and no coinsurance, diagnostic radiological services range from a $0 to $260 copay with no coinsurance, and therapeutic radiological services require 20% coinsurance and no copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC AR-0004 (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered under the AARP Medicare Advantage from UHC AR-0004 (PPO) plan, but in practice, no services are covered as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by AARP Medicare Advantage from UHC AR-0004 (PPO), which requires prior authorization and excludes coverage for additional days beyond the Medicare-covered limit. Under this plan, there is no copay and no coinsurance for days 1 through 20, followed by a $218 daily copay and no coinsurance for days 21 through 100.
Other Services See details
AARP Medicare Advantage from UHC AR-0004 (PPO) partially covers other services, offering over-the-counter (OTC) items and meal benefits with no copay and no coinsurance. Acupuncture and dual-eligible SNP highly integrated services are not covered, and the meal benefit requires prior authorization.
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