AARP Medicare Advantage from UHC ME-0002 (PPO)

Inpatient Hospital See details

Inpatient Hospital benefits with AARP Medicare Advantage from UHC ME-0002 (PPO) include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you pay a $385 copay for days 1-4, and no copay for days 5-90, with additional days 91-999 having no copay, while Inpatient Hospital Psychiatric has a $385 copay for days 1-3 and no copay for days 4-90. However, Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.

Outpatient Services See details

Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services are covered. Outpatient hospital services have a copay between $0 and $385, observation services have a $385 copay per day, outpatient substance abuse individual sessions have a copay between $0 and $25, outpatient substance abuse group sessions have a $15 copay, and outpatient blood services have no copay.

Partial Hospitalization See details

Partial Hospitalization is covered, but requires prior authorization. You will pay a $55 copay for this service.

Ambulance and Transportation Services See details

Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground and air ambulance services have a copay of $290, and there is no coinsurance. 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 AARP Medicare Advantage from UHC ME-0002 (PPO). Emergency Services have a $110 copay, and Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.

Primary Care See details

The AARP Medicare Advantage from UHC ME-0002 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, and occupational therapy services with a copay between $0 and $20. Additionally, the plan covers physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services.

Preventive Services See details

The AARP Medicare Advantage from UHC ME-0002 (PPO) plan covers preventive services, including an annual physical exam with no copay. Other preventive services include glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, all with no copay. Additional preventive services like health education, in-home safety assessments, and others are not covered.

Hearing Services See details

Hearing Services include routine hearing exams with no copay, and prescription hearing aids with a copay between $199 and $1249. Fitting/evaluation for hearing aids, and prescription hearing aids - inner ear, outer ear, and over the ear, are not covered.

OTC hearing aids have a copay between $99 and $829.

Vision Services See details

The AARP Medicare Advantage from UHC ME-0002 (PPO) plan covers vision services, including eye exams with no copay, and eyewear with no copay for contact lenses and eyeglass frames. Eyeglass lenses have a copay of $0-$153, and a combined maximum benefit of $200 every two years for eyewear. Eyeglasses (lenses and frames) and upgrades are not covered.

Dental Services See details

Dental services are covered, but orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, removable, maxillofacial prosthetics, implant services, prosthodontics, fixed, oral and maxillofacial surgery, and orthodontics are not covered. For covered Medicare dental services, there is a 20% coinsurance.

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%.

Dialysis Services See details

Dialysis Services are covered by the AARP Medicare Advantage from UHC ME-0002 (PPO) plan. You will pay a 20% coinsurance for these services.

Medical Equipment See details

Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.

Diagnostic and Radiological Services See details

Diagnostic and Radiological Services, including diagnostic procedures and tests, are covered with a copay of $25.00, while lab services have no copay. Diagnostic radiological services have a maximum copay of $225.00, therapeutic radiological services have a minimum copay of $80.00, and outpatient X-ray services have a copay of $10.00.

Home Health Services See details

Home Health Services are covered by AARP Medicare Advantage from UHC ME-0002 (PPO) with no copay and no coinsurance. However, 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 Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required, and copay information is available in the plan details.

Skilled Nursing Facility (SNF) See details

Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage from UHC ME-0002 (PPO) plan, but require prior authorization. You will have no copay for days 1-20, and a $203 copay per day for days 21-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays are not covered.

Other Services See details

Other Services benefits are partially covered by AARP Medicare Advantage from UHC ME-0002 (PPO), with no copay for the Meal Benefit, which requires prior authorization. Acupuncture, Over-the-Counter (OTC) Items, 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.