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AARP Medicare Advantage from UHC SC-0004 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC SC-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 SC-0004 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC SC-0004 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in South Carolina. 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 SC-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 SC-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 SC-0004 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $37.00. 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 $340.00 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 $6300.00 (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 $6300.00 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 SC-0004 (PPO) plan has a $340 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy you use. For example, you will pay no copay for preferred generic drugs at a standard pharmacy. For standard generic drugs at a standard pharmacy, the copay is $47. For preferred brand drugs, the copay is $100. 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 SC-0004 (PPO) plan offers a range of benefits with varying costs. You'll have a $325 copay for inpatient hospital stays (days 1-5), and no copay for many services like primary care, preventive services, vision exams, and home health. The plan also covers outpatient services, ambulance services, emergency services, and dental services, with copays and coinsurance depending on the specific service. There are also benefits for hearing, vision, and medical equipment.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care, with a $325 copay for days 1-5, and no copay for days 6-90, per admission or stay. Additional days for inpatient hospital-acute have no copay, while non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay between $0 and $325, observation services with a $325 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered with a copay between $0 and $25 for individual sessions, and a $15 copay for group sessions. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC SC-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 under the AARP Medicare Advantage from UHC SC-0004 (PPO) plan. Ground and Air Ambulance Services have a copay of $255, with no coinsurance, while transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by AARP Medicare Advantage from UHC SC-0004 (PPO). For Emergency Services, there is a $125 copay, and no coinsurance. Urgently Needed Services have a copay between $0 and $45, 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 SC-0004 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a copay between $0 and $30, and physician specialist services with a copay between $0 and $35. 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 are also covered, with varying copays. Routine chiropractic care is not covered.
Preventive Services See details
Preventive services include annual physical exams with no copay, and additional preventive services with a copay, as well as Fitness Benefit, Remote Access Technologies, and Home and Bathroom Safety Devices and Modifications with no copay. Other services like health education, in-home safety assessment, and others are not covered.
Hearing Services See details
Hearing exams are covered with no copay. Prescription hearing aids are partially covered; the plan covers Prescription Hearing Aids (all types) with a copay between $199 and $1249, but does not cover Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, or Prescription Hearing Aids - Over the Ear. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, while routine eye exams are covered once per year. Eyewear has no copay, but eyeglasses (lenses and frames) and upgrades are not covered. Contact lenses are covered with no copay, while eyeglass lenses are covered with a copay between $0 and $153. Eyeglass frames are covered with no copay and are available once every two years, with a combined maximum benefit of $300 for all eyewear every two years.
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 Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, and Oral and Maxillofacial Surgery with no copay, while Prosthodontics and fixed prosthodontics have a coinsurance of 0-50%; however, Implant Services and Orthodontics are not covered. The plan has a maximum benefit coverage of $2,000 per year for other dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC SC-0004 (PPO) plan. You will pay 20% coinsurance for this benefit, and prior authorization is required.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies (non-Medicare benefit), and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires authorization, while Prosthetic Devices and Medical Supplies have a 20% coinsurance and require authorization. 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 $25 copay, lab services with no copay, diagnostic radiological services with a copay up to $185, therapeutic radiological services with a $60 copay, 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 under the AARP Medicare Advantage from UHC SC-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 covered by AARP Medicare Advantage from UHC SC-0004 (PPO), but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. You will have no copay for days 1-20, and a $203 copay per day for days 21-100.
Other Services See details
The AARP Medicare Advantage from UHC SC-0004 (PPO) plan covers Over-the-Counter (OTC) Items with no copay, and a Meal Benefit with no copay and prior authorization required. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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