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AARP Medicare Advantage from UHC ME-0005 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC ME-0005 (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 ME-0005 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC ME-0005 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Maine. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC ME-0005 (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 ME-0005 (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 ME-0005 (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 has a $1250.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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:
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Drug Coverage
The AARP Medicare Advantage from UHC ME-0005 (PPO) plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and through mail-order services. Tier 2 generic drugs cost a $12 copay for a 1-month supply at standard pharmacies, but you can save with no copay for a 3-month supply when using preferred mail order. For higher-tier medications, costs transition to coinsurance, starting with a 15% coinsurance for Tier 3 preferred brand drugs. Tier 4 non-preferred drugs require a 41% coinsurance for a 1-month supply through standard pharmacies or mail order. Specialty Tier 5 medications carry a 26% coinsurance for a 1-month supply, ensuring you only pay a percentage of the drug's cost.
Additional Benefits
The AARP Medicare Advantage from UHC ME-0005 (PPO) plan offers robust coverage with no copay for primary care visits, telehealth services, and annual preventive care, including routine hearing and eye exams. Members also benefit from no copay on preventive dental care, while specialist visits range from no copay to a $45 copay. Additionally, the plan provides up to $300 every two years for eyewear and covers prescription hearing aids with predictable copayments. For major medical needs, inpatient hospital stays require a $270 daily copay for the first three days and no copay thereafter, while skilled nursing facilities offer no copay for the first 20 days. Emergency room visits carry a $130 copay, which is waived if admitted, and outpatient surgery centers require no copay. Most services under this plan feature no coinsurance, though a 20% coinsurance applies to select services such as dialysis, durable medical equipment, and Medicare-covered dental care.
Inpatient Hospital See details
Inpatient hospital care under AARP Medicare Advantage from UHC ME-0005 (PPO) is covered with no coinsurance, requiring a $270 daily copay for days 1-3 and no copay for days 4-90 for both acute and psychiatric stays. Unlimited additional acute days are covered at no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC ME-0005 (PPO) with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $270 (with a $270 daily copay for observation services), and outpatient substance abuse services have copays ranging from $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC ME-0005 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC ME-0005 (PPO) covers ground and air ambulance services with a $275 copay per service and no coinsurance, subject to prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services under the AARP Medicare Advantage from UHC ME-0005 (PPO) plan are covered with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay of $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 ME-0005 (PPO) offers primary care and telehealth services with no copay and no coinsurance, while specialist visits range from a $0 to $45 copay with no coinsurance. Physical and occupational therapies require a $35 copay with no coinsurance, though chiropractic services are not covered in practice under this plan.
Preventive Services See details
Preventive Services are partially covered by AARP Medicare Advantage from UHC ME-0005 (PPO) with no copay and no coinsurance for covered care, including annual physical exams, kidney disease education, and fitness benefits. Multiple supplemental services are not covered, including health education, weight management, nutritional/dietary benefits, alternative therapies, therapeutic massage, in-home safety assessments, and personal emergency response systems. Other excluded services include post-discharge medication reconciliation, caregiver support, telemonitoring, and home safety modifications.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC ME-0005 (PPO), featuring one annual routine hearing exam with no copay, no coinsurance, and no deductible. Up to two prescription hearing aids per year are covered with a $199 to $1,249 copay and no coinsurance, and OTC hearing aids are covered with a $199 to $829 copay and no coinsurance. Fitting and evaluation for hearing aids, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are covered by AARP Medicare Advantage from UHC ME-0005 (PPO) with no coinsurance, featuring one routine eye exam annually with no copay, although other eye exams are not covered. Eyewear is covered up to a $300 combined limit every two years with no coinsurance, including contacts and frames with no copay and lenses with a $0 to $153 copay, while 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 ME-0005 (PPO), offering Medicare-covered dental services with no copay and a 20% coinsurance, as well as preventive dental care with no copay and no coinsurance. Comprehensive services, including restorative treatment, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC ME-0005 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC ME-0005 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
AARP Medicare Advantage from UHC ME-0005 (PPO) covers durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, subject to manufacturer limitations, and prior authorization is required for medical equipment benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC ME-0005 (PPO) covers diagnostic and radiological services, offering lab services with no copay and no coinsurance, and diagnostic tests with a $50 copay and no coinsurance. Diagnostic radiological services feature no minimum copay, outpatient X-rays require a $30 copay, and therapeutic radiological services carry a minimum 20% coinsurance, with prior authorization required.
Home Health Services See details
The AARP Medicare Advantage from UHC ME-0005 (PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage from UHC ME-0005 (PPO) with no coinsurance and require prior authorization, although only some services are covered in practice. Specifically, Cardiac Rehabilitation and Intensive Cardiac Rehabilitation are not covered (with no copay), while Pulmonary Rehabilitation and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) are not covered (with a $15 copay).
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC ME-0005 (PPO) with no coinsurance and do not require a prior three-day hospital stay. There is no copay for days 1 through 20, while days 21 through 100 require a $218 daily copay, and additional days beyond the Medicare limit are not covered.
Other Services See details
Other services are partially covered by the AARP Medicare Advantage from UHC ME-0005 (PPO), featuring a meal benefit for chronic illness with no copay and no coinsurance, though prior authorization is required. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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