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AARP Medicare Advantage from UHC PA-0015 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC PA-0015 (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-0015 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC PA-0015 (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 4.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC PA-0015 (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-0015 (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-0015 (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 has a $500.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 $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-0015 (PPO) plan features an annual drug deductible of $440. Under this plan, you will enjoy no copay for Tier 1 preferred generic and Tier 2 generic drugs at standard pharmacies for both 1-month and 3-month supplies, as well as for 3-month standard mail orders. This helps keep the cost of common, everyday medications highly affordable. For brand-name and specialty medications, your out-of-pocket costs are determined by coinsurance percentages during the initial coverage phase. Tier 3 preferred brand drugs require a 20% coinsurance for standard pharmacy and mail order fills, while Tier 4 non-preferred drugs carry a 44% coinsurance. Specialty medications in Tier 5 require a 28% coinsurance for 1-month fills at standard pharmacies and through standard mail order.
Additional Benefits
The AARP Medicare Advantage from UHC PA-0015 (PPO) plan offers comprehensive medical coverage with no copay or coinsurance for primary care visits, telehealth, and preventive services. Specialist visits feature a low copay ranging from $0 to $45, while inpatient hospital stays require a $750 copay per stay with no coinsurance. Emergency room visits carry a $130 copay, which is waived if you are admitted within 24 hours, and worldwide emergency services are covered with no copay. For routine personal care, members enjoy no copay for annual eye and hearing exams, alongside a $150 eyewear allowance and predictable copays for prescription hearing aids. Preventive dental care has no copay or coinsurance, while Medicare-covered dental services and durable medical equipment require a 20% coinsurance. Additionally, home health services and the first 20 days of skilled nursing facility care are covered with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital care is partially covered by AARP Medicare Advantage from UHC PA-0015 (PPO), requiring a $750 copay per stay and no coinsurance for Medicare-covered acute and psychiatric admissions. Unlimited additional acute care days are covered with no copay, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under the AARP Medicare Advantage from UHC PA-0015 (PPO) are covered with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $450 (with a $450 daily copay for observation services), and outpatient substance abuse sessions have a copay of $0 to $25, with prior authorization required for most services.
Partial Hospitalization See details
AARP Medicare Advantage from UHC PA-0015 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC PA-0015 (PPO) covers ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage from UHC PA-0015 (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours. Urgently needed services have no coinsurance and a copay ranging from $0 to $50, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care services under the AARP Medicare Advantage from UHC PA-0015 (PPO) feature no copay and no coinsurance for primary care provider visits and telehealth. Other covered benefits, including specialist visits, physical and occupational therapies, and mental health services, have copays ranging from $0 to $45 and no coinsurance, though chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC PA-0015 (PPO) offers partially covered preventive services with no copay and no coinsurance for covered benefits like annual physical exams, fitness benefits, home safety devices, kidney disease education, glaucoma screenings, diabetes training, digital rectal exams, and post-welcome visit EKGs. Sub-services that are not covered include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for chemotherapy-related hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional or dietary benefits, home-based palliative care, in-home support services, caregiver support, additional smoking and tobacco cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling services.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC PA-0015 (PPO) with no deductible and no coinsurance, featuring no copay for routine exams, a $199.00 to $1,249.00 copay for prescription hearing aids, and a $199.00 to $829.00 copay for OTC hearing aids. However, hearing aid fitting and evaluation, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC PA-0015 (PPO) with no coinsurance or deductibles, offering no copay for annual routine eye exams, contact lenses, and eyeglass frames, alongside eyeglass lenses with a copay of up to $153. While a combined $150 eyewear allowance is provided every two years, other eye exam services, upgrades, and bundled eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC PA-0015 (PPO) offers partially covered dental services, featuring no copay and 20% coinsurance for Medicare-covered dental, alongside preventive care with no copay and no coinsurance. Non-covered sub-services include restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC PA-0015 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Part B chemotherapy, radiation, and other drugs have no copay and 0% (no coinsurance) to 20% coinsurance, while Part B insulin has a $35 copay and 0% (no coinsurance) to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC PA-0015 (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
AARP Medicare Advantage from UHC PA-0015 (PPO) covers medical equipment, offering durable medical equipment, prosthetic devices, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes or inserts carry a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the AARP Medicare Advantage from UHC PA-0015 (PPO) plan, with prior authorization required. Lab services have no copay and no coinsurance, diagnostic procedures require a $50 copay with no coinsurance, diagnostic radiological services have no copay, outpatient X-rays require a $30 copay with coinsurance, and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
The AARP Medicare Advantage from UHC PA-0015 (PPO) plan 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 PA-0015 (PPO) indicates some services are covered for Cardiac Rehabilitation Services, but in practice, cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered. This benefit requires prior authorization and features no copay and no coinsurance.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC PA-0015 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, admission does not require a prior three-day inpatient hospital stay, and additional days beyond the standard 100 days are not covered.
Other Services See details
AARP Medicare Advantage from UHC PA-0015 (PPO) provides partial coverage for other services, offering over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance. Acupuncture is not covered under this benefit, and prior authorization is required for the meal benefit.
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