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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 2025, 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 3.5 out of 5 stars in 2025.
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 $420.00 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 has a $420 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For the initial coverage phase, you will pay $12 for preferred generic drugs, $47 for standard generic drugs, and $100 for preferred brand drugs at the standard pharmacy. Non-preferred drugs have a 28% coinsurance. Once your total drug costs reach $2000, you enter the next coverage phase where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC AR-0004 (PPO) plan offers comprehensive coverage with varying cost-sharing amounts. This plan includes coverage for inpatient hospital stays with a copay, outpatient services with copays, and emergency services with copays. It also covers primary care, preventive services, hearing, vision, and dental services with various copays and coinsurance amounts. Additional benefits include ambulance services, home health services, and skilled nursing facility stays with specific cost-sharing structures. Diagnostic and radiological services, medical equipment, and home infusion services are also covered, with costs depending on the specific service. This plan also provides coverage for over-the-counter items and a meal benefit.
Inpatient Hospital See details
Inpatient hospital stays, including acute and psychiatric, are covered under this plan. For days 1-5 of an inpatient hospital stay, there is a $295 copay, and days 6-90 have no copay.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $295, observation services with a $295 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. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services, each with a $250 copay and no coinsurance. However, 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 by the AARP Medicare Advantage from UHC AR-0004 (PPO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55; both have no coinsurance. Worldwide Emergency Services has no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage from UHC AR-0004 (PPO) plan covers Primary Care services, including Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a copay between $0 and $30, Physician Specialist Services with a copay between $0 and $35, and Mental Health Specialty Services with copays varying by service. The plan also covers Podiatry Services with a $35 copay, Other Health Care Professional services with a copay between $0 and $35, Psychiatric Services with copays varying by service, Physical Therapy and Speech-Language Pathology Services with a copay between $0 and $30, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
Preventive services include no copay for an annual physical exam, and additional preventive services including Fitness Benefit, Remote Access Technologies, and Home and Bathroom Safety Devices and Modifications. Other preventive services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Counseling Services, and Glaucoma Screening are not covered.
Hearing Services See details
Hearing exams are covered with no copay, with routine hearing exams covered once per year. Prescription hearing aids are covered with a copay between $199 and $1249 for all types, and are available twice per year. Over-the-counter hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear, which includes contact lenses, eyeglass lenses, and eyeglass frames, has no copay for contact lenses and eyeglass frames, and a copay of $0.00 - $153.00 for eyeglass lenses; contact lenses are unlimited, while eyeglass lenses and eyeglass frames are limited to one pair every two years, with a combined maximum benefit of $300 for both in-network and out-of-network services. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with 20% coinsurance, and other dental services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay. Restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery all have no copay. Prosthodontics, removable and fixed, have a coinsurance of 0% to 50%. Orthodontic services are not covered. Implant Services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay, and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC AR-0004 (PPO) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance. Diabetic Equipment is also covered, with specific costs depending on the service, including no copay for Diabetic Supplies and a 20% coinsurance for Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay of $15, lab services with no copay, diagnostic radiological services with a copay up to $195, therapeutic radiological services with a copay up to $50, and outpatient X-ray services with a $5 copay. Prior authorization is required for all services.
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. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC AR-0004 (PPO). There is no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
The AARP Medicare Advantage from UHC AR-0004 (PPO) plan covers Over-the-Counter (OTC) items with no copay, and a meal benefit with no copay, but requires prior authorization. Acupuncture, Dual Eligible SNPs, and several other services are not covered.
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