A non-government entity
AARP Medicare Advantage from UHC AL-0004 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC AL-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 AL-0004 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC AL-0004 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties of Alabama. 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 AL-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 AL-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 AL-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 $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:
Sign up for AARP Medicare Advantage from UHC AL-0004 (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The AARP Medicare Advantage from UHC AL-0004 (PPO) plan offers an Enhanced Alternative drug benefit with a $600 prescription drug deductible. After meeting this deductible, you will pay a $12 copay for Tier 1 preferred generic drugs and a 16% coinsurance for Tier 2 standard generic drugs at standard pharmacies. Tier 3 preferred brands and Tier 4 non-preferred drugs require a 39% and 26% coinsurance respectively at standard pharmacies and through mail order. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and will pay nothing for covered Part D prescription drugs. Additionally, beneficiaries who qualify for the low-income subsidy will benefit from no premium costs for their Part D coverage.
Additional Benefits
The AARP Medicare Advantage from UHC AL-0004 (PPO) plan offers strong coverage for routine care, featuring no copays and no coinsurance for primary care visits, preventive services, and home health care. For more intensive medical needs, inpatient hospital stays require a $550 copay for the first few days with no copay thereafter, while emergency room visits incur a $130 copay. Specialist visits and diagnostic services are also highly accessible, with specialist copays capped at $50 and lab services offered with no copay. This plan also includes essential supplemental benefits, providing no copay for routine vision exams and preventive dental care like cleanings and x-rays. For prescription hearing aids and specialized eyewear, members can expect predictable copays with no coinsurance, though certain services like dental implants and cardiac rehabilitation are not covered. Additionally, treatments like dialysis and durable medical equipment are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by AARP Medicare Advantage from UHC AL-0004 (PPO), with no coverage for upgrades, non-Medicare-covered stays, or additional days for psychiatric care. For acute care, you pay a $550 copay for days 1-5 and no copay for days 6-999, while psychiatric stays require a $550 copay for days 1-4 and no copay for days 5-90, both with no coinsurance.
Outpatient Services See details
AARP Medicare Advantage from UHC AL-0004 (PPO) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services, alongside a $550 daily copay for observation services. Outpatient hospital copays range from no copay to $550, while outpatient substance abuse sessions range from no copay to a $25 copay, with prior authorization required for most services.
Partial Hospitalization See details
AARP Medicare Advantage from UHC AL-0004 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access these covered benefits.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by AARP Medicare Advantage from UHC AL-0004 (PPO), as transportation to plan-approved or any health-related locations is not covered. Covered ground and air ambulance services require prior authorization and incur a $290 copay with no coinsurance.
Emergency Services See details
AARP Medicare Advantage from UHC AL-0004 (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 ranging from $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
AARP Medicare Advantage from UHC AL-0004 (PPO) offers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a copay of up to $50 with no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, though routine chiropractic care is not covered. Other covered benefits, including physical therapy, mental health, and podiatry, range from no copay to a $45 copay with no coinsurance.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage from UHC AL-0004 (PPO) with no copay and no coinsurance for covered services like annual physicals, kidney disease education, and fitness benefits. However, several supplemental services, including health education, in-home safety assessments, personal emergency response systems, and weight management programs, are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC AL-0004 (PPO), which offers one annual routine hearing exam with no copay or coinsurance, though fitting/evaluation exams and inner-ear, outer-ear, and over-the-ear prescription hearing aids are not covered. Covered prescription hearing aids require a copay of $199.00 to $1,249.00, and OTC hearing aids have a copay of $199.00 to $829.00, with no coinsurance required for either benefit.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC AL-0004 (PPO), though upgrades and combined eyeglasses (lenses and frames) are not covered. Routine eye exams, contact lenses, and eyeglass frames have no copay and no coinsurance, while eyeglass lenses have a $0 to $153 copay and no coinsurance, up to a combined $300 eyewear limit every two years.
Dental Services See details
AARP Medicare Advantage from UHC AL-0004 (PPO) partially covers dental services, offering preventive care like cleanings, exams, and x-rays with no copay and no coinsurance. Medicare-covered dental services require a 20% coinsurance and no copay, while restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by AARP Medicare Advantage from UHC AL-0004 (PPO) with prior authorization. Covered chemotherapy, radiation, and other Part B drugs require no copay and no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC AL-0004 (PPO) covers Dialysis Services with a 20% coinsurance and no copay. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
AARP Medicare Advantage from UHC AL-0004 (PPO) covers medical equipment, requiring a 20% coinsurance and no copay for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay and no coinsurance, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC AL-0004 (PPO) covers diagnostic and radiological services with prior authorization, offering lab services with no copay or coinsurance, outpatient X-rays with a $30 copay and no coinsurance, and diagnostic procedures with a $55 copay and no coinsurance. Diagnostic radiological services range from no copay up to a $220 copay with no coinsurance, while therapeutic radiological services require a 20% coinsurance and no copay.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC AL-0004 (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 from UHC AL-0004 (PPO) plan. None of the associated sub-services, including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation, are covered by this plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by AARP Medicare Advantage from UHC AL-0004 (PPO), featuring no copay or coinsurance for days 1 through 20 and a $218 daily copay with no coinsurance for days 21 through 100. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC AL-0004 (PPO) partially covers Other Services, providing a chronic illness meal benefit with no copay and no coinsurance, subject to prior authorization. Acupuncture, Over-the-Counter (OTC) items, and Dual Eligible SNPs with Highly Integrated Services are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved