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AARP Medicare Advantage from UHC VA-0003 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC VA-0003 (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 VA-0003 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC VA-0003 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Virginia. 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 VA-0003 (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 VA-0003 (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 VA-0003 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $21.00. 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 $1000.00 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 VA-0003 (PPO) prescription drug plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic drugs are available with a $14 copay for a 1-month standard pharmacy supply, or with no copay for a 3-month supply using preferred mail order. Higher-tier medications are subject to coinsurance rather than flat copayments under this plan. Tier 3 preferred brand drugs require a 19% coinsurance for both 1-month and 3-month supplies. Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 28% and 26% coinsurance respectively for a 1-month supply at standard pharmacies and mail order.
Additional Benefits
The AARP Medicare Advantage from UHC VA-0003 (PPO) plan offers comprehensive healthcare coverage with many essential services featuring no copays or coinsurance. Members benefit from no copays on primary care and telehealth visits, routine eye and hearing exams, preventive dental care, and home health services. Inpatient hospital stays require no coinsurance and feature a $245 daily copay for the first three days, followed by no copay for days four through 90. Specialized care and medical services under this plan are subject to affordable copays or standard coinsurance. Specialist visits range from no copay up to $40, emergency room services carry a $130 copay, and durable medical equipment requires a 20% coinsurance. While the plan includes a $200 eyewear allowance and hearing aid coverage, it does not cover comprehensive dental services like restorative work or implants.
Inpatient Hospital See details
AARP Medicare Advantage from UHC VA-0003 (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $245 daily copay for days 1 through 3 and no copay for days 4 through 90. Unlimited additional acute care days are covered at no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC VA-0003 (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital and observation services require a copay of $0 to $245, while outpatient substance abuse sessions have a copay ranging from $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC VA-0003 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by AARP Medicare Advantage from UHC VA-0003 (PPO), featuring ground and air ambulance services for a $150 copay and no coinsurance, subject to prior authorization. For transportation, some services are covered, but transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC VA-0003 (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 have 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 VA-0003 (PPO) offers primary care provider visits and telehealth services with no copay and no coinsurance. Other covered benefits require no coinsurance but have copays, including $0 to $40 for specialists, $30 for physical, occupational, and speech therapies, and up to $25 for individual mental health sessions, while chiropractic services are not covered in practice.
Preventive Services See details
Preventive Services are partially covered by AARP Medicare Advantage from UHC VA-0003 (PPO), offering Medicare-covered preventive services, annual physical exams, kidney disease education, and a fitness benefit with no copays and no coinsurance. However, several additional supplemental services, such as health education, in-home safety assessments, and nutritional therapy, are not covered.
Hearing Services See details
AARP Medicare Advantage from UHC VA-0003 (PPO) provides partially covered hearing services with no coinsurance, including one routine hearing exam per year with no copay, though fitting and evaluation exams are not covered. Up to two prescription hearing aids (with copays of $199.00 to $1,249.00) and two OTC hearing aids (with copays of $199.00 to $829.00) are covered annually with no coinsurance, but inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC VA-0003 (PPO) with no coinsurance and generally no copays, though eyeglass lenses carry a copay of $0 to $153. This benefit features one annual routine eye exam and a $200 eyewear allowance every two years, but excludes coverage for other eye exam services, eyeglasses (lenses and frames), and upgrades.
Dental Services See details
Dental services are partially covered under the AARP Medicare Advantage from UHC VA-0003 (PPO) plan, which offers Medicare-covered dental services with no copay and 20% coinsurance, as well as preventive dental services like exams, cleanings, fluoride, and x-rays with no copay and no coinsurance. Restorative services, endodontics, periodontics, prosthodontics, oral surgery, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC VA-0003 (PPO) with no copay, though prior authorization is required. Covered Part B chemotherapy and other drugs have no copay and 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC VA-0003 (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 VA-0003 (PPO) covers medical equipment, including durable medical equipment, prosthetics, and medical supplies, with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC VA-0003 (PPO) with no coinsurance, although prior authorization is required. There is no copay for lab services and diagnostic radiology, while diagnostic procedures and outpatient X-rays require a $5 copay, and therapeutic radiological services have a minimum copay of $80.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage from UHC VA-0003 (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage from UHC VA-0003 (PPO) with no copay, no coinsurance, and prior authorization requirements, though only some services are covered in practice. Specifically, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC VA-0003 (PPO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while the plan does not require a prior three-day hospital stay, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by AARP Medicare Advantage from UHC VA-0003 (PPO), featuring a meal benefit for chronic illnesses with no copay, no coinsurance, and required prior authorization. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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