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AARP Medicare Advantage from UHC VA-0007 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC VA-0007 (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-0007 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC VA-0007 (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-0007 (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-0007 (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-0007 (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 $355.00 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-0007 (PPO) plan features an annual drug deductible of $355. Beneficiaries enjoy no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs for 1-month and 3-month supplies filled at standard pharmacies or through standard mail order. This plan provides highly cost-effective access to common generic medications. For brand-name and specialty medications, costs are based on coinsurance during the initial coverage phase. Tier 3 (Preferred Brand) drugs require a 20% coinsurance at standard pharmacies and through standard mail order. Tier 4 (Non-Preferred) drugs carry a 42% coinsurance, while Tier 5 (Specialty) medications require a 29% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC VA-0007 (PPO) plan offers robust coverage with no copays or coinsurance for primary care visits, telehealth, and preventive services. For specialized medical needs, specialist visits require a copay of up to $45, while inpatient hospital stays feature a $450 daily copay for the first few days and no copay thereafter. Emergency services are covered with a $115 copay, which is waived if you are admitted, while worldwide emergency services feature no copay. This plan also includes key supplemental benefits, such as preventive dental care with no copay up to a $3,000 annual limit and routine vision exams with no copay plus a $300 eyewear allowance. Members also benefit from no copay or coinsurance for annual hearing exams, home health services, and over-the-counter items. While some services like dialysis and medical equipment require a 20% coinsurance, the plan generally minimizes out-of-pocket costs for daily healthcare needs.
Inpatient Hospital See details
AARP Medicare Advantage from UHC VA-0007 (PPO) covers inpatient hospital services with no coinsurance, requiring a $450 daily copay for days 1 to 5 of acute stays and days 1 to 4 of psychiatric stays, with no copay for subsequent days. While unlimited additional acute days are covered with no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC VA-0007 (PPO) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $450 for outpatient hospital services and $450 per day for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services range from a $0 to $25 copay with no coinsurance.
Partial Hospitalization See details
AARP Medicare Advantage from UHC VA-0007 (PPO) covers partial hospitalization services with a $55 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC VA-0007 (PPO) covers ground and air ambulance services with a $265 copay and no coinsurance, requiring prior authorization. While some transportation services are covered, trips to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC VA-0007 (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a copay of $0 to $40 and 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-0007 (PPO) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $45 copay and no coinsurance. Other services like physical, occupational, mental health, and podiatry therapies require no coinsurance and copays ranging from $0 to $45, though routine and other chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC VA-0007 (PPO) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive benefits are partially covered with no copay and no coinsurance for fitness programs and home safety devices, while services like health education, personal emergency response systems, and nutritional therapy are not covered.
Hearing Services See details
AARP Medicare Advantage from UHC VA-0007 (PPO) partially covers hearing services, offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. The plan also covers up to two OTC hearing aids (copays of $199 to $829, no coinsurance) and up to two prescription hearing aids (copays of $199 to $1,249, no coinsurance) per year, but prescription inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
AARP Medicare Advantage from UHC VA-0007 (PPO) covers vision services with no coinsurance, featuring no copay for annual routine eye exams and a $300 combined limit every two years for eyewear. Covered eyewear includes contact lenses and eyeglass frames with no copay, as well as eyeglass lenses with a $0 to $153 copay, though upgrades, other eye exams, and combined eyeglasses packages are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC VA-0007 (PPO), with implant services and orthodontics not being covered. Preventive and diagnostic services require no copay and no coinsurance up to a $3,000 annual maximum, while covered comprehensive services have no copay and a 50% coinsurance, and Medicare-covered dental services require no copay and a 20% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC VA-0007 (PPO) with no copay, though prior authorization and step therapy are required. Under this plan, covered Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while covered Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the AARP Medicare Advantage from UHC VA-0007 (PPO) plan 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-0007 (PPO) with no copays, though a 20% coinsurance applies to durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC VA-0007 (PPO) with prior authorization required. There is no copay or coinsurance for lab services and diagnostic radiology, while diagnostic tests require a $15 copay, outpatient X-rays have a $5 copay, and therapeutic radiology services require a minimum 20% coinsurance.
Home Health Services See details
AARP Medicare Advantage from UHC VA-0007 (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC VA-0007 (PPO) covers Cardiac Rehabilitation Services with no copay and no coinsurance, although prior authorization is required. While some services are covered, standard Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC VA-0007 (PPO) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not needed, and additional days beyond the standard 100 days are not covered.
Other Services See details
AARP Medicare Advantage from UHC VA-0007 (PPO) partially covers other services, offering over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance. Acupuncture is not covered under this benefit, and prior authorization is required to access the meal benefit.
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