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AARP Medicare Advantage from UHC FL-0016 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC FL-0016 (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 FL-0016 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC FL-0016 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Florida. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC FL-0016 (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 FL-0016 (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 FL-0016 (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 $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 $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 FL-0016 (PPO) prescription drug plan has an annual drug deductible of $600. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies, or for a 3-month supply via mail order. Tier 2 generic drugs cost a $12 copay for a 1-month standard pharmacy supply, but have no copay for a 3-month supply when using preferred mail order. Higher tier medications under this plan utilize coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 16% coinsurance for both standard pharmacies and mail order services. Tier 4 non-preferred drugs carry a 42% coinsurance, while Tier 5 specialty drugs require a 26% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC FL-0016 (PPO) plan offers robust medical coverage with no copays and no coinsurance for primary care doctor visits, telehealth services, home health care, and annual preventive exams. For specialized care, members benefit from no coinsurance, though copays apply, including no copay to a $60 copay for specialist visits, a $130 copay for emergency room visits, and a $495 daily copay for the first few days of inpatient hospital stays. Diagnostic services, outpatient surgeries, and lab tests are also covered with no coinsurance, requiring no copay for basic labs and diagnostic radiology. This plan also features routine dental, vision, and hearing care, offering annual routine exams and preventive dental cleanings with no copay and no coinsurance. While major restorative dental procedures are not covered, members pay no coinsurance for eyewear and hearing aids, though copays apply, including no copay to a $153 copay for eyeglass lenses and fixed copays for prescription and over-the-counter hearing aids. Furthermore, dialysis services, diabetic supplies, and durable medical equipment are covered, typically requiring no copay and a 20% coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC FL-0016 (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute care, you pay a $495 daily copay for days 1-5 and no copay for days 6 and beyond, while psychiatric care requires a $495 daily copay for days 1-4 and no copay for days 5-90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC FL-0016 (PPO) covers outpatient services with no coinsurance across all categories. You will pay no copay for ambulatory surgical center and blood services, while outpatient hospital services carry a $0 to $495 copay, observation services require a $495 daily copay, and substance abuse services have a copay of $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC FL-0016 (PPO) covers partial hospitalization with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC FL-0016 (PPO) covers ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. While transportation services are technically listed as covered, trips to plan-approved or other health-related locations are not covered in practice.
Emergency Services See details
AARP Medicare Advantage from UHC FL-0016 (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 $0 to $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Primary Care benefits under the AARP Medicare Advantage from UHC FL-0016 (PPO) feature no copay and no coinsurance for primary care doctor visits and telehealth. Specialized care is available with no coinsurance, including specialist visits for a $0 to $60 copay, physical and occupational therapy for a $30 copay, and mental health services ranging from a $0 to $25 copay. Chiropractic services are partially covered, though routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage from UHC FL-0016 (PPO) with no copay and no coinsurance for annual exams, kidney disease education, glaucoma screenings, diabetes training, and fitness benefits. Additional preventive services are only partially covered, as health education, in-home safety assessments, personal emergency response systems, 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, smoking cessation, disease management, telemonitoring, remote access, safety devices, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC FL-0016 (PPO), featuring one routine hearing exam per year with no copay and no coinsurance, though fitting and evaluation exams are not covered. The plan covers up to two prescription hearing aids (copays from $199 to $1,249) and two OTC hearing aids (copays from $199 to $829) annually with no coinsurance, but inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
AARP Medicare Advantage from UHC FL-0016 (PPO) provides partially covered vision services with no coinsurance, featuring one routine eye exam per year with no copay. Covered eyewear benefits include contact lenses and eyeglass frames with no copay, and eyeglass lenses with a $0 to $153 copay, up to a $300 combined maximum every two years; however, upgrades, packaged eyeglasses, and other eye exams are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC FL-0016 (PPO), offering preventive care like cleanings, exams, fluoride, and X-rays with no copay and no coinsurance. Medicare-covered dental services require a 20% coinsurance and no copay, but restorative, endodontic, periodontic, prosthodontic, orthodontic, implant, oral surgery, and other diagnostic services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC FL-0016 (PPO) with no copay, though prior authorization and step therapy are required. Associated Medicare Part B drugs, including chemotherapy and radiation, require 0% to 20% coinsurance, while covered Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the AARP Medicare Advantage from UHC FL-0016 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
Medical equipment covered by AARP Medicare Advantage from UHC FL-0016 (PPO) includes durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the AARP Medicare Advantage from UHC FL-0016 (PPO) plan with no coinsurance, though prior authorization is required. There is no copay for lab services and diagnostic radiology, while diagnostic tests require a $50 copay, outpatient X-rays require a $30 copay, and therapeutic radiology services have a copay starting at $80.
Home Health Services See details
AARP Medicare Advantage from UHC FL-0016 (PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by AARP Medicare Advantage from UHC FL-0016 (PPO) with no copay and no coinsurance, but require prior authorization. While some services are covered, 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 FL-0016 (PPO) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring no prior three-day inpatient hospital stay, though prior authorization is needed. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC FL-0016 (PPO) partially covers other services, which includes a meal benefit for chronic illnesses with no copay and no coinsurance, subject to prior authorization. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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