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AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx SI-MA2 (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 Patriot No Rx SI-MA2 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2026 to people living in Select Counties in South Dakota and Nebraska. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage Patriot No Rx SI-MA2 (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 Patriot No Rx SI-MA2 (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. Additionally, this plan comes with a Part B Premium reduction of $130.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) offers robust coverage with no copay and no coinsurance for primary care, preventive services, annual physicals, and home health care. For specialized medical needs, patients will pay no coinsurance, though copays apply, including a $445 copay for the first days of inpatient hospital stays and up to a $50 copay for specialist visits. Emergency services carry a $130 copay, which is waived upon admission, while worldwide emergency care and outpatient ambulatory surgical services are available with no copay. Routine dental, vision, and hearing exams are highly accessible with no copays, though specific allowances and cost-sharing apply to hardware and comprehensive treatments. For instance, the plan features a $200 eyewear allowance and preventive dental coverage up to a $1,000 annual limit, while medical equipment and dialysis services require a 20% coinsurance with no copay. Additionally, skilled nursing facility care is covered with no copay for the first 20 days, followed by a daily copay of $218 for days 21 through 100.
Inpatient Hospital See details
Inpatient hospital care is partially covered by the AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) with no coinsurance, requiring a $445 copay for days 1-6 of acute stays and days 1-5 of psychiatric stays, and no copay for remaining covered days. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered under this plan.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) with no coinsurance, though prior authorization is required for most services. Patients will pay no copay for ambulatory surgical center and outpatient blood services, copays of $0 to $10 for outpatient substance abuse services, and copays ranging from $0 to $445 for outpatient hospital and observation services.
Partial Hospitalization See details
Partial hospitalization services are covered by the AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under the AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) plan, requiring a $290 copay and no coinsurance for both ground and air ambulance services. While some transportation services are covered, transportation to plan-approved locations or any health-related locations is not covered.
Emergency Services See details
AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay ranging from $0 to $50 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 Patriot No Rx SI-MA2 (PPO) covers primary care, telehealth, and opioid treatment with no copay and no coinsurance. Specialist visits, therapy, mental health, and podiatry services require copays ranging from $0 to $50 with no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by the AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) plan with no copay and no coinsurance for covered benefits such as annual physical exams, fitness benefits, and home safety modifications. However, several supplemental options are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management programs, and alternative therapies.
Hearing Services See details
Hearing services are partially covered by the AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO), which offers one annual routine hearing exam with no copay and no coinsurance, while fitting and evaluation exams are not covered. Up to two OTC hearing aids (copays of $199.00 to $829.00) and two prescription hearing aids (copays of $199.00 to $1,249.00) are covered annually with no coinsurance, though inner, outer, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by the AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) with no coinsurance, offering no copay for annual routine eye exams and eyeglass frames, and a copay ranging from $0 to $153 for eyeglass lenses. While a combined $200 maximum eyewear allowance is provided every two years, other eye exam services, upgrades, and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO), as implant services and orthodontics are not covered. Preventive services offer no copay and no coinsurance up to a $1,000 annual maximum, while Medicare-covered dental services have no copay and a 20% coinsurance, and comprehensive services require no copay and a 50% coinsurance.
Home Infusion bundled Services See details
The AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, require no coinsurance to 20% coinsurance, while Part B insulin drugs carry a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical Equipment covered by the AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) plan includes durable medical equipment, prosthetics, and medical supplies, all of which feature no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) plan with prior authorization required. Diagnostic tests require a $45 copay with no coinsurance, outpatient X-rays require a $30 copay, and therapeutic radiological services carry a 20% coinsurance, while lab services and diagnostic radiological services are covered with no copay and no coinsurance.
Home Health Services See details
AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) covers home health services with no copay and no coinsurance. Prior authorization is required to access these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no copay and no coinsurance under the AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO), though prior authorization is required. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by the AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and while a 3-day prior hospital stay is not required, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services under the AARP Medicare Advantage Patriot No Rx SI-MA2 (PPO) plan are partially covered, offering no copay and no coinsurance for over-the-counter items and chronic illness meal benefits, though acupuncture is not covered. The meal benefit requires prior authorization, and while the over-the-counter benefit includes nicotine replacement therapy and naloxone, it does not cover all drugs on the CMS OTC list.
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