A non-government entity
AARP Medicare Advantage from UHC VA-0004 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC VA-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 VA-0004 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC VA-0004 (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 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC VA-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 VA-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 VA-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 $255.00 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 VA-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 VA-0004 (PPO) plan has a $255 deductible for prescription drugs. After the deductible is met, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you'll pay a $5 copay for preferred generic drugs at a standard pharmacy, and a $47 copay for standard generic drugs at a standard pharmacy. For preferred brand drugs, you'll pay a $100 copay, and for non-preferred drugs, you'll pay 30% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC VA-0004 (PPO) plan offers comprehensive coverage with varying cost-sharing. You'll pay a copay for inpatient hospital stays, outpatient services, emergency services, and specialist visits, with no copay for primary care, preventive services, and home health services. This plan includes benefits for hearing, vision, and dental, with no copay for hearing exams and eye exams. The plan also covers ambulance services, diagnostic services, and home infusion, with some services requiring prior authorization and/or coinsurance.
Inpatient Hospital See details
Inpatient hospital stays, including acute and psychiatric, are covered with a $345 copay for days 1-4, and no copay for days 5-90. Additional days for acute inpatient hospital stays are covered with no copay, while non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $345, and observation services with a $345 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, while Outpatient Substance Abuse Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC VA-0004 (PPO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by AARP Medicare Advantage from UHC VA-0004 (PPO). Ground and air ambulance services have a $90 copay, with no coinsurance, but 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. For Emergency Services, there is a $50 copay, but no coinsurance. Urgently Needed Services have a copay between $0 and $30, with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, and Additional Telehealth Benefits have no copay. Chiropractic Services have a $20 copay, while Physician Specialist Services have a copay between $0 and $30. Podiatry Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, and Opioid Treatment Program Services have varying copays. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $20.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and the other services are covered with no copay. Additional preventive services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, 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, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline) and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year with no copay; however, fitting/evaluation for hearing aids is not covered. Prescription hearing aids (all types) are covered with a copay between $199 and $1249, up to two per year, while inner ear, outer ear, and over the ear prescription hearing aids are not covered. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Under the AARP Medicare Advantage from UHC VA-0004 (PPO) plan, vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear includes contact lenses, eyeglass lenses and eyeglass frames, with a combined maximum benefit of $250 every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with 20% coinsurance. Other Dental Services include oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventative dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery, all with no copay. This plan does not cover implant services or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay, with coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is no copay, with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC VA-0004 (PPO) plan. You will pay 20% coinsurance for these services, and prior authorization is required.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics, and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires prior authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for diagnostic procedures and tests with a copay of $15, lab services with no copay, diagnostic radiological services with a copay up to $205, therapeutic radiological services with a copay up to $50, and outpatient X-ray services with a $5 copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC VA-0004 (PPO) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the AARP Medicare Advantage from UHC VA-0004 (PPO) plan. The plan also does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC VA-0004 (PPO) plan, with prior authorization required. There is no copay for days 1-20, but there is a $203 copay for days 21-100, and there is no coinsurance. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
The AARP Medicare Advantage from UHC VA-0004 (PPO) plan covers Over-the-Counter (OTC) Items and Meal Benefits, with no copay for either. 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.
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