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AARP Medicare Advantage from UHC WA-17 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC WA-17 (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 WA-17 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC WA-17 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Spokane County. 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 WA-17 (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 WA-17 (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 WA-17 (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 $520.00 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:
Sign up for AARP Medicare Advantage from UHC WA-17 (PPO)
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Drug Coverage
The AARP Medicare Advantage from UHC WA-17 (PPO) plan features an annual prescription drug deductible of $520. For Tier 1 preferred generic drugs, members pay no copay for standard pharmacy fills or mail-order services. Tier 2 generic medications cost a $10 copay for a one-month supply at standard pharmacies, though you can receive a three-month supply with no copay through preferred mail order. For higher-tier medications, cost sharing shifts to coinsurance percentages. Tier 3 preferred brand drugs require a 16% coinsurance, while Tier 4 non-preferred drugs have a 41% coinsurance. Tier 5 specialty drugs carry a 27% coinsurance for a one-month supply across standard pharmacies and mail-order options.
Additional Benefits
The AARP Medicare Advantage from UHC WA-17 (PPO) plan offers robust coverage for essential medical needs, featuring no copay and no coinsurance for primary care visits, routine preventive services, and home health care. For inpatient hospital stays, members pay a $485 daily copay for the first five days and no copay for subsequent days. Emergency room visits require a $130 copay, which is waived upon admission, while urgent care services range from no copay to a $50 copay. Specialist visits and mental health services carry a copay of $0 to $50, while diagnostic lab work and routine vision and hearing exams are available with no copay. Preventive dental services, including cleanings and exams, also require no copay, though Medicare-covered dental services and durable medical equipment are subject to a 20% coinsurance. Prescription hearing aids are covered with copays ranging from $199 to $1,249 depending on the model.
Inpatient Hospital See details
AARP Medicare Advantage from UHC WA-17 (PPO) covers inpatient hospital services with no coinsurance, requiring prior authorization. For acute care, you pay a $485 daily copay for days 1 to 5 and no copay for days 6 and beyond, while psychiatric stays require a $485 daily copay for days 1 to 4 and no copay for days 5 to 90. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC WA-17 (PPO) covers outpatient services with no coinsurance, offering ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital and observation services have a copay ranging from $0.00 to $485.00, while outpatient substance abuse services require a copay of $0.00 to $25.00.
Partial Hospitalization See details
AARP Medicare Advantage from UHC WA-17 (PPO) covers partial hospitalization services with a $55 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance services are covered by AARP Medicare Advantage from UHC WA-17 (PPO) with a $290 copay for ground and air trips and no coinsurance, requiring prior authorization. Routine transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Emergency services under the AARP Medicare Advantage from UHC WA-17 (PPO) are covered with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $0 to $50 copay 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 WA-17 (PPO) offers primary care and telehealth services with no copay and no coinsurance, while specialist, mental health, and therapy services require copays ranging from $0 to $50 and no coinsurance. Chiropractic services are partially covered, featuring a $10 copay and no coinsurance for routine care, while other chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC WA-17 (PPO) offers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, glaucoma screenings, diabetes self-management, and fitness benefits. However, the plan's preventive benefits are only partially covered, as they do not include health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, extra smoking cessation, disease management, telemonitoring, remote access, home modifications, or counseling.
Hearing Services See details
AARP Medicare Advantage from UHC WA-17 (PPO) provides partially covered hearing services, including one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Up to two prescription hearing aids (with copays of $199 to $1,249) and two OTC hearing aids (with copays of $199 to $829) are covered per year with no coinsurance, but inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision Services are partially covered by AARP Medicare Advantage from UHC WA-17 (PPO), with no coverage for other eye exam services, combined eyeglasses (lenses and frames), and upgrades. Covered routine exams and eyewear have no deductible, no coinsurance, and no copay, except for eyeglass lenses which carry a copay of up to $153, all subject to a $300 combined limit every two years.
Dental Services See details
AARP Medicare Advantage from UHC WA-17 (PPO) partially covers dental services, offering Medicare-covered dental with no copay and a 20% coinsurance. Preventive services like exams, cleanings, and x-rays are covered with no copay and no coinsurance, while restorative, endodontic, periodontic, prosthodontic, oral surgery, orthodontic, and implant services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC WA-17 (PPO) with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the AARP Medicare Advantage from UHC WA-17 (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC WA-17 (PPO), featuring no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes or inserts require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC WA-17 (PPO), with prior authorization required. Lab services and diagnostic radiological services have no copay and no coinsurance, while diagnostic tests require a $45 copay with no coinsurance, outpatient X-rays require a $15 copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC WA-17 (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the AARP Medicare Advantage from UHC WA-17 (PPO) with no copay, no coinsurance, and required prior authorization, though only some services are covered. In practice, specific sub-services including Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC WA-17 (PPO) covers Skilled Nursing Facility (SNF) care with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
Other services are partially covered by AARP Medicare Advantage from UHC WA-17 (PPO), featuring acupuncture with a $10.00 copay and no coinsurance for up to 12 treatments per year, and chronic illness meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items and other supplemental services are not covered.
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