AARP Medicare Advantage Extras from UHC SC-8 (PPO)

Inpatient Hospital See details

Inpatient Hospital benefits include Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $395 copay for days 1-5, and no copay for days 6-90, with no coinsurance; additional days (91-999) have no copay. For Inpatient Hospital Psychiatric, you will pay a $395 copay for days 1-4, and no copay for days 5-90, with no coinsurance.

Outpatient Services See details

Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $395, Observation Services with a $395 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and Outpatient Blood Services with no copay. Prior authorization is required for all services.

Partial Hospitalization See details

Partial Hospitalization is covered with a $55 copay, and prior authorization is required.

Ambulance and Transportation Services See details

Ambulance and Transportation Services are covered under the AARP Medicare Advantage Extras from UHC SC-8 (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 Extras from UHC SC-8 (PPO) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $55; both have no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.

Primary Care See details

Under the AARP Medicare Advantage Extras from UHC SC-8 (PPO) plan, primary care physician services have no copay, chiropractic services have a $20 copay, and occupational therapy services have a copay between $0 and $45. Physician specialist services have a copay between $0 and $45, and mental health specialty services have a copay between $0 and $25 for individual sessions and $15 for group sessions. Podiatry services have a $40 copay, other health care professional services have a copay between $0 and $45, and psychiatric services have a copay between $0 and $25 for individual sessions and $15 for group sessions. Physical therapy and speech-language pathology services have a copay between $0 and $50, additional telehealth benefits have no copay, and Opioid Treatment Program Services have no copay.

Preventive Services See details

The AARP Medicare Advantage Extras from UHC SC-8 (PPO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, as well as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, are covered with no copay.

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 for all types, with a limit of two hearing aids per year. OTC hearing aids are covered with a copay between $99 and $829, with a limit of 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 includes coverage for eye exams with no copay, and eyewear. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, with no copay for contact lenses and eyeglass frames, and a copay between $0 and $153 for eyeglass lenses. Eyeglasses (lenses and frames) and upgrades are not covered.

Dental Services See details

Dental Services are covered, including Medicare Dental Services with a 20% coinsurance. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay.

Restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery have no copay, while prosthodontics (removable and fixed) have a 0-50% coinsurance. Implant services and orthodontics are not covered.

Home Infusion bundled Services See details

Home Infusion bundled Services are covered, with prior authorization required. 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 Extras from UHC SC-8 (PPO) plan, with a coinsurance between 20% and 20%. Prior authorization is required for this benefit.

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 authorization, while 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 include coverage for Diagnostic Procedures/Tests with a $40 copay, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $215, Therapeutic Radiological Services with a coinsurance of at least 20%, and Outpatient X-Ray Services with a $25 copay. All services require prior authorization.

Home Health Services See details

Home Health Services are covered by the AARP Medicare Advantage Extras from UHC SC-8 (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 Extras from UHC SC-8 (PPO), but the plan does not cover any of the sub-services, including 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 under this plan, but require prior authorization. There is no copay for days 1-20, but there is a $203 copay for days 21-100.

Other Services See details

Other Services includes coverage for Over-the-Counter (OTC) Items and Meal Benefits with no copay, and Acupuncture is not covered. This plan also does not cover 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.