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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 2025, 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 out of 5 stars in 2025.
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 $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-0015 (PPO) plan has a $255 deductible for prescription drugs. After the deductible, you will pay the following costs for drugs in each tier. For preferred generic drugs at a standard pharmacy, there is no copay. Standard generic drugs have a $47 copay, while preferred brand drugs have a $100 copay. Non-preferred drugs have 30% coinsurance.
Additional Benefits
The AARP Medicare Advantage from UHC PA-0015 (PPO) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays depending on the service. The plan also covers a range of services such as primary care, preventive services, hearing, vision, and dental, often with no copay or low copays for many services. Emergency, ambulance, and home health services are covered, along with medical equipment and diagnostic services, while some services like certain dental procedures and long-term care are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $750 for a Medicare-covered stay, per admission or stay. Additional days for Inpatient Hospital-Acute have no copay, while Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute are not covered. Inpatient Hospital Psychiatric benefits are covered with a $750 copay for a Medicare-covered stay, but Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services and outpatient blood services, are covered by this plan. Outpatient hospital services have a copay between $0 and $450, and observation services have a $450 copay per day. Ambulatory Surgical Center (ASC) services have no copay, and individual outpatient substance abuse sessions have a copay between $0 and $25, while group sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services, each with a copay of $205 and no coinsurance. However, 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-0015 (PPO) plan. Emergency Services have a $125 copay with no coinsurance, while Urgently Needed Services have a copay between $0 and $55 with 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-0015 (PPO) plan covers Primary Care services, including Primary Care Physician Services with no copay and Chiropractic Services with a $20 copay. Occupational Therapy Services have a copay between $0 and $35. Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $40. Individual sessions for Mental Health and Psychiatric Specialty Services have a copay between $0 and $25. Group sessions for Mental Health and Psychiatric Specialty Services have a $15 copay. Podiatry Services and Other Health Care Professional services have a copay between $35 and $40, and Opioid Treatment Program Services has no copay. Additional Telehealth Benefits have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered zero dollar preventive services, annual physical exams with no copay, and additional preventive services like fitness benefits. Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are also covered with no copay. However, Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), and other services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered with no copay for one exam per year. Prescription hearing aids are covered with a copay between $199 and $1249 for two hearing aids every year, and OTC hearing aids are covered with a copay between $99 and $829 for two hearing aids per year. Fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
Vision Services include eye exams and eyewear. Routine eye exams and eyewear, including contact lenses and eyeglass frames, are covered with no copay, and eyeglass lenses are covered with a copay ranging from $0 to $153, while eyeglass lenses and upgrades are not covered.
Dental Services See details
Dental services with AARP Medicare Advantage from UHC PA-0015 (PPO) include a 20% coinsurance for Medicare dental services, with prior authorization required, and no copay for oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, prosthodontics, fixed, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC PA-0015 (PPO) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services includes coverage for all diagnostic services, with a copay of $5.00 for diagnostic procedures/tests. Lab services have no copay. Diagnostic radiological services have a copay of up to $100.00, therapeutic radiological services have a copay of at least $40.00, and outpatient X-ray services have a copay of $5.00.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage from UHC PA-0015 (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, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC PA-0015 (PPO), but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include a meal benefit with no copay, but acupuncture, over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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