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AARP Medicare Advantage from UHC VA-0005 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC VA-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 VA-0005 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC VA-0005 (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-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 VA-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 VA-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. Additionally, this plan comes with a Part B Premium reduction of $10.00. You must continue to pay paying your reduced 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 $440.00 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 $13900.00 (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 $13900.00 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-0005 (PPO) plan has an annual prescription drug deductible of $440. Tier 1 preferred generic drugs feature no copay for a 1-month or 3-month supply at standard pharmacies, and no copay for a 3-month supply through mail order. Tier 2 generic drugs cost an $8 copay for a 1-month supply at standard pharmacies, but you can avoid a copay entirely by choosing a 3-month supply through preferred mail order. For higher-tier medications, the plan transitions to a coinsurance structure. Tier 3 preferred brand drugs require a 17% coinsurance for both standard pharmacy fills and mail-order options. Tier 4 non-preferred drugs carry a 40% coinsurance, while Tier 5 specialty medications require a 28% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC VA-0005 (PPO) plan offers robust coverage with no coinsurance and no copay for primary care visits, telehealth, and routine preventive services. For more intensive care, members pay a $395 copay for the first few days of inpatient hospital stays and a $115 copay for emergency room visits, which is waived if admitted. Outpatient services and specialist visits are highly accessible, featuring no coinsurance and low-to-moderate copays ranging up to $55 for specialists. This plan also includes essential support for daily wellness, providing routine dental cleanings, annual hearing exams, and routine eye exams with no copay. While comprehensive dental and eyewear are not covered, prescription hearing aids are available with copays starting at $199. Additionally, home health care and cardiac rehabilitation feature no copays, while medical equipment and dialysis services generally require a twenty percent coinsurance.
Inpatient Hospital See details
Inpatient hospital care is partially covered by AARP Medicare Advantage from UHC VA-0005 (PPO) with no coinsurance, requiring a $395 copay for days 1 to 6 of acute stays and days 1 to 5 of psychiatric stays, with no copay for remaining covered days. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered by the plan.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC VA-0005 (PPO) with no coinsurance across all services and no copay for ambulatory surgical center and blood services. Covered outpatient hospital services require a copay of no copay to $395, observation services cost a $395 daily copay, and outpatient substance abuse sessions require copays up to $25.
Partial Hospitalization See details
Partial hospitalization is covered under the AARP Medicare Advantage from UHC VA-0005 (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC VA-0005 (PPO) covers ground and air ambulance services with a $240 copay and no coinsurance per service. For transportation benefits, some services are covered, but transportation to plan-approved health-related locations and any other health-related locations is not covered.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage from UHC VA-0005 (PPO) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a $0 to $40 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC VA-0005 (PPO) covers primary care physician services and telehealth visits with no copay and no coinsurance, though chiropractic services are not covered. Other services feature no coinsurance, with copays ranging from $0 to $55 for specialists, $35 for therapy services, and up to $45 for podiatry, psychiatric, and mental health care.
Preventive Services See details
AARP Medicare Advantage from UHC VA-0005 (PPO) offers preventive services with no copay and no coinsurance for covered benefits, including annual physical exams, fitness benefits, kidney disease education, diabetes self-management, glaucoma screenings, digital rectal exams, and EKGs. However, this benefit is only partially covered, as excluded services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access, home safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC VA-0005 (PPO), featuring one annual routine hearing exam with no copay and no coinsurance, while hearing aid fittings and evaluations are not covered. Prescription and OTC hearing aids are covered up to two per year with no coinsurance and copays ranging from $199 to $1,249 and $199 to $829 respectively, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by the AARP Medicare Advantage from UHC VA-0005 (PPO) plan, featuring one routine eye exam per year with no copay, no coinsurance, and no deductible, subject to prior authorization. Other eye exams and all eyewear options, including contact lenses, eyeglasses, and upgrades, are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC VA-0005 (PPO), offering preventive care like exams, cleanings, and fluoride with no copay and no coinsurance. Medicare-covered dental services are available with no copay and a 20% coinsurance, but comprehensive services such as restorative, endodontics, periodontics, prosthodontics, implants, orthodontics, and oral surgery are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC VA-0005 (PPO) covers home infusion bundled services with no copay, though prior authorization and step therapy may apply. Covered Medicare Part B drugs, including chemotherapy, radiation, and insulin, require no coinsurance to 20% coinsurance, with insulin also having a $35 copay.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC VA-0005 (PPO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC VA-0005 (PPO), with durable medical equipment, prosthetics, and medical supplies requiring a 20% coinsurance and no copay. Diabetic supplies are covered with no copay, and diabetic therapeutic shoes and inserts carry a 20% coinsurance, with prior authorization required for most items.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC VA-0005 (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Members will pay no copay for lab services and diagnostic radiology, a $5 copay for diagnostic tests, a $10 copay for outpatient X-rays, and a minimum $80 copay for therapeutic radiological services.
Home Health Services See details
The AARP Medicare Advantage from UHC VA-0005 (PPO) plan 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 with no copay and no coinsurance under the AARP Medicare Advantage from UHC VA-0005 (PPO) plan, though only some services are covered as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC VA-0005 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance and no prior three-day hospital stay required. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC VA-0005 (PPO) offers other services that are partially covered, featuring a limited-duration meal benefit for chronic illnesses 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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