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AARP Medicare Advantage from UHC PA-0014 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC PA-0014 (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 PA-0014 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC PA-0014 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Pennsylvania. 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 PA-0014 (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 PA-0014 (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 PA-0014 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.00. 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:
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Drug Coverage
The AARP Medicare Advantage from UHC PA-0014 (PPO) plan has a $255 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you'll pay no copay for preferred generic drugs at a standard pharmacy. For standard generic drugs at a standard pharmacy, the copay is $47. Preferred brand drugs have a $100 copay, regardless of the pharmacy. Non-preferred drugs have a 30% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for your prescriptions.
Additional Benefits
The AARP Medicare Advantage from UHC PA-0014 (PPO) plan offers a range of benefits with varying costs. You'll pay a $390 copay for inpatient hospital stays, while outpatient services have copays ranging from $0 to $390. Emergency services have a $125 copay, and primary care visits have no copay. Preventive services, including annual physical exams, are covered with no copay. Hearing and vision services include no copay for exams, and eyewear. Dental services have a 20% coinsurance for Medicare Dental Services. Diagnostic and radiological services range from no copay to a $195 copay, and home health services have no copay.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you pay a $390 copay per admission or stay, and additional days have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered. For Inpatient Hospital Psychiatric, you also pay a $390 copay per admission or stay, and additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered. Outpatient Hospital Services have a copay between $0 and $390, Observation Services have a $390 copay, Ambulatory Surgical Center (ASC) Services have no copay, and Outpatient Blood Services have no copay. Individual sessions for Outpatient Substance Abuse have a copay between $0 and $25, and Group Sessions for Outpatient Substance Abuse have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC PA-0014 (PPO) plan. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC PA-0014 (PPO) plan. Ground and Air Ambulance Services have a $275 copay with no coinsurance, while 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 the AARP Medicare Advantage from UHC PA-0014 (PPO) plan. Emergency Services have a $125 copay, and no coinsurance, while Urgently Needed Services have a copay between $0 and $55, and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
The AARP Medicare Advantage from UHC PA-0014 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, and occupational therapy services with a copay between $0 and $30. Physician specialist services have a copay between $0 and $35, while mental health specialty services have copays of $0-$25 for individual sessions and $15 for group sessions. Podiatry services and other health care professional visits have a $35 copay, psychiatric services have a $0-$25 copay for individual sessions and a $15 copay for group sessions, and physical therapy and speech-language pathology services have a copay between $0 and $30. Additional telehealth benefits and opioid treatment program services have no copay.
Preventive Services See details
Preventive Services, including annual physical exams, are covered by the AARP Medicare Advantage from UHC PA-0014 (PPO) plan with no copay. Additional preventive services, such as fitness benefits and home and bathroom safety devices and modifications, are covered with a $0 copay. Other services like health education, in-home safety assessments, and others are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year. Prescription hearing aids are covered, with a copay between $199 and $1249, up to two per year, but fitting/evaluation for hearing aids, and prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are covered with a copay between $99 and $829, up to two per year.
Vision Services See details
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, all with no copay. Eyeglass lenses are covered once every two years, and eyeglass frames are covered once every two years. The plan does not cover eyeglass frames or upgrades.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay. Other services like orthodontics, restorative services, and more are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC PA-0014 (PPO) plan. The plan requires prior authorization and has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires prior authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a 20% coinsurance, while Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a $25 copay, lab services with no copay, diagnostic radiological services with a copay up to $195, therapeutic radiological services with a copay of $80 or more, and outpatient X-ray services with a $10 copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC PA-0014 (PPO) with no copay and no coinsurance, but 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 PA-0014 (PPO) plan. The plan does not cover Cardiac Rehabilitation Services, 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 with prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and Meal Benefits, with no copay for either. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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