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AARP Medicare Advantage Access from UHC WA-11 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Access from UHC WA-11 (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 Access from UHC WA-11 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Access from UHC WA-11 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Washington. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage Access from UHC WA-11 (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 Access from UHC WA-11 (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 Access from UHC WA-11 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $354.00. 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 $600.00 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 $3000.00 (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 $3000.00 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 Access from UHC WA-11 (PPO) plan offers an Enhanced Alternative drug benefit with a $600.00 annual prescription drug deductible. During the initial coverage phase, you will pay an $8.00 copay for Tier 1 preferred generic drugs at standard pharmacies. For other tiers at standard pharmacies, you will face a 19% coinsurance for standard generics, 44% coinsurance for preferred brands, and 26% coinsurance for non-preferred drugs. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase where you will pay nothing for Medicare Part D covered drugs. Additionally, beneficiaries who qualify for the low-income subsidy can reduce their Part D premium from $139.50 to $129.00.
Additional Benefits
The AARP Medicare Advantage Access from UHC WA-11 (PPO) plan offers highly comprehensive coverage with no copay and no coinsurance for most core medical services, including inpatient and outpatient hospital care, primary and specialist visits, emergency services, and home health care. Members will also pay no copay and no coinsurance for diagnostic tests, medical equipment, and skilled nursing facility stays up to 100 days. While prior authorization is required for several of these benefits, dialysis services are subject to a 20 percent coinsurance with no copay. For ancillary benefits, the plan covers routine vision and hearing exams with no copay and no coinsurance, as well as a $250 eyewear allowance every two years and affordable copays for hearing aids. Preventive and diagnostic dental care also features no copay and no coinsurance, while comprehensive dental services require a 50 percent coinsurance up to a $1,500 yearly maximum. However, certain services like routine transportation, cardiac rehabilitation, acupuncture, and over-the-counter items are not covered under this plan.
Inpatient Hospital See details
Inpatient hospital services are partially covered by AARP Medicare Advantage Access from UHC WA-11 (PPO) with no copay and no coinsurance for Medicare-covered acute and psychiatric stays. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional days for psychiatric care are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage Access from UHC WA-11 (PPO) with no copay and no coinsurance, including outpatient hospital, observation, ambulatory surgical center, outpatient substance abuse, and blood services. Prior authorization is required for most of these outpatient services.
Partial Hospitalization See details
AARP Medicare Advantage Access from UHC WA-11 (PPO) covers partial hospitalization benefits with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by AARP Medicare Advantage Access from UHC WA-11 (PPO), which offers ground and air ambulance services with no copay and no coinsurance. Transportation services, including rides to plan-approved or any health-related locations, are not covered under this plan.
Emergency Services See details
Emergency services, urgently needed services, and worldwide emergency coverage (including urgent care and emergency transportation) are covered under the AARP Medicare Advantage Access from UHC WA-11 (PPO) plan. Members will pay no copay and no coinsurance for these services, and there is no maximum limit on the worldwide benefit coverage.
Primary Care See details
Primary care benefits are covered by AARP Medicare Advantage Access from UHC WA-11 (PPO) with no copays and no coinsurance for primary care, specialist, therapy, and psychiatric services. Chiropractic services are partially covered, as routine chiropractic care is not covered.
Preventive Services See details
Preventive Services are partially covered by AARP Medicare Advantage Access from UHC WA-11 (PPO) with no copay and no coinsurance for covered options like annual physical exams, kidney disease education, and fitness benefits. Sub-services not covered under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs for hair loss, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, tobacco cessation, disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Access from UHC WA-11 (PPO), offering one annual routine hearing exam with no copay or coinsurance, though hearing aid fitting and evaluation services are not covered. Prescription hearing aids have a $199 to $1,249 copay and OTC hearing aids have a $199 to $829 copay with no coinsurance for up to two devices per year, 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 Access from UHC WA-11 (PPO), which features annual routine eye exams with no copay or coinsurance. Eyewear is covered up to $250 every two years with no coinsurance and a $0 copay for frames and contact lenses, though eyeglass lenses carry a $0 to $153 copay, and upgrades as well as combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage Access from UHC WA-11 (PPO), excluding implant services and orthodontics. Diagnostic and preventive services require no copay and no coinsurance, while covered comprehensive services have no copay and a 50% coinsurance, up to a $1,500 yearly maximum.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Access from UHC WA-11 (PPO), with prior authorization required. Medicare Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%, while chemotherapy and other Part B drugs have no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by the AARP Medicare Advantage Access from UHC WA-11 (PPO) plan with 20% coinsurance and no copay. Prior authorization is required for these services.
Medical Equipment See details
AARP Medicare Advantage Access from UHC WA-11 (PPO) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic supplies, with no copay and no coinsurance. Prior authorization is required for these covered benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage Access from UHC WA-11 (PPO) with no copay and no coinsurance. Prior authorization is required for these services, which include lab services, diagnostic procedures, therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
AARP Medicare Advantage Access from UHC WA-11 (PPO) covers home health services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage Access from UHC WA-11 (PPO) plan, as all sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered. Because there is no coverage for these services, there are no applicable copays or coinsurance under this plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by AARP Medicare Advantage Access from UHC WA-11 (PPO) with no copay and no coinsurance for days 1 through 100, though prior authorization is required. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by AARP Medicare Advantage Access from UHC WA-11 (PPO), which features a meal benefit for chronic illnesses with no copay and no coinsurance. However, acupuncture, over-the-counter (OTC) items, and dual-eligible SNPs are not covered under this plan.
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