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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 2025, 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 State of Alabama. 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 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 $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 AL-0004 (PPO) plan has a $420 deductible for prescription drugs. In the initial coverage phase, you will pay a copay for your prescriptions, such as $0 for standard generic drugs, $47 for standard generic drugs, and $100 for preferred brand drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for your Part D covered drugs. If you qualify for low-income subsidy (LIS), you may have your premium reduced, and pay $0 for Part D drugs.
Additional Benefits
The AARP Medicare Advantage from UHC AL-0004 (PPO) plan offers comprehensive coverage with a variety of benefits. This plan includes inpatient hospital stays, with a copay of $385 for the first six days, and no copay for days 7-90. Outpatient services, primary care, and preventive services, like annual physical exams, have no copay. The plan also covers ambulance services, emergency services, hearing and vision services, and dental services. Diagnostic and radiological services, home health services, and skilled nursing facilities are covered with varying copays or coinsurance. The plan offers additional benefits such as OTC items and a meal benefit, both with no copay.
Inpatient Hospital See details
The AARP Medicare Advantage from UHC AL-0004 (PPO) plan covers inpatient hospital stays, including services not usually covered by Medicare, with a copay of $385 for days 1-6 and no copay for days 7-90. Additional days for inpatient hospital-acute have no copay, while non-Medicare-covered stays and upgrades are not covered. Inpatient Hospital Psychiatric stays have a copay of $385 for days 1-4 and no copay for days 5-90, with additional days and non-Medicare-covered stays not covered.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services, with a copay ranging from $0 to $385, and observation services with a copay of $385 per day. The plan also covers ambulatory surgical center services and outpatient blood services with no copay, as well as outpatient substance abuse services, with individual sessions having a copay between $0 and $25, and group sessions having a copay of $15.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan, but prior authorization is required. The plan has a $55 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC AL-0004 (PPO) plan. Ground and air ambulance services have a $290 copay, with no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by AARP Medicare Advantage from UHC AL-0004 (PPO) with a $125 copay, and no coinsurance. Urgently Needed Services have a copay between $0 and $55, and no coinsurance. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are covered with no copay, and no coinsurance.
Primary Care See details
Under the AARP Medicare Advantage from UHC AL-0004 (PPO) plan, primary care physician services have no copay, and chiropractic services have a $20 copay. Occupational therapy services have a $0 - $25 copay, physician specialist services have a $0 - $25 copay, and mental health specialty services have a $0 - $25 copay for individual sessions and a $15 copay for group sessions. Podiatry services and other health care professional services have a $25 copay, while physical therapy and speech-language pathology services have a $0 - $25 copay. Additional telehealth benefits and opioid treatment program services have no copay.
Preventive Services See details
Preventive services include annual physical exams with no copay, and other preventive services which are covered with a $0 copay for glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. The plan does not cover health education, in-home safety assessment, personal emergency response systems, 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 benefits, 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, or counseling services. The plan also covers fitness benefits, remote access technologies (including web/phone-based technologies and nursing hotline), home and bathroom safety devices and modifications, and kidney disease education services, all with a $0 copay.
Hearing Services See details
Hearing exams are covered with no copay, and prescription hearing aids are covered with a copay between $199 and $1249. OTC hearing aids are covered with a copay between $99 and $829. Fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
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 is covered, with no copay for contact lenses and eyeglass frames, while eyeglass lenses have a copay of $0 - $153; the plan covers one pair of lenses and frames every two years, up to a combined maximum 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 are covered, with 20% coinsurance for Medicare Dental Services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay, and coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered with prior authorization, and require 20% coinsurance.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. Diagnostic Procedures/Tests have a $20 copay, Lab Services have no copay, Diagnostic Radiological Services have a copay of at most $220, Therapeutic Radiological Services have a copay of at most $80, and Outpatient X-Ray Services have a $20 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC AL-0004 (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the AARP Medicare Advantage from UHC AL-0004 (PPO) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC AL-0004 (PPO) plan. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and Non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items with no copay, and Meal Benefit 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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