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AARP Medicare Advantage from UHC OR-0001 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC OR-0001 (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 OR-0001 (PPO) in 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
AARP Medicare Advantage from UHC OR-0001 (PPO) is a PPO plan offered by Care Improvement Plus South Central Insurance Co. available for the 2026 plan year to people living in Select Counties in Oregon. 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 OR-0001 (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 OR-0001 (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 OR-0001 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $74.00. 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 that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5700.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $5700.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $10100.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $10100.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
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 OR-0001 (PPO) plan features an annual prescription drug deductible of $520. For Tier 1 preferred generic drugs, there is no copay for a one-month or three-month supply at standard pharmacies, as well as no copay for three-month mail-order options. Tier 2 generic medications cost a $10 copay for a one-month supply at standard pharmacies, but you can get a three-month supply with no copay through preferred mail order. Higher-tier medications under this plan transition to coinsurance, starting with a 15% coinsurance for Tier 3 preferred brand drugs at standard pharmacies and mail-order services. Tier 4 non-preferred drugs require a 37% coinsurance for a one-month supply, while Tier 5 specialty drugs carry a 27% coinsurance. These structured costs help you plan your healthcare budget based on your specific prescription needs.
Additional Benefits
The AARP Medicare Advantage from UHC OR-0001 (PPO) plan provides robust coverage for essential medical services, often with no coinsurance. Members enjoy no copay for primary care visits, annual physicals, preventive care, and home health services. For other medical needs, costs are structured around fixed copays, including $0 to $40 for specialist visits, $130 for emergency care, and daily copays for inpatient hospital stays. Additional benefits like dental, vision, and hearing services are also covered to help minimize out-of-pocket expenses. Dental care features no copay and up to a 50% coinsurance with a $1,000 annual limit, while routine vision and hearing exams are available with no copay. Additionally, diagnostic lab tests, cardiac rehabilitation, and chronic condition meal benefits are covered with no copay, though certain medical equipment and dialysis require a 20% coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC OR-0001 (PPO) partially covers inpatient hospital services with no coinsurance, requiring prior authorization and a daily copay of $455 for days 1 through 6 for acute stays and days 1 through 5 for psychiatric stays, followed by no copay for remaining covered days. Non-Medicare-covered stays, upgrades for acute care, and additional days for psychiatric care are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC OR-0001 (PPO) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services. Outpatient hospital and observation services require copays ranging from $0 to $455, while outpatient substance abuse sessions feature copays between $0 and $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC OR-0001 (PPO) covers partial hospitalization services with a $55 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Ambulance services covered by AARP Medicare Advantage from UHC OR-0001 (PPO) require prior authorization and have a $290 copay with no coinsurance for both ground and air transport, while transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage from UHC OR-0001 (PPO) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay ranging from $0 to $50 with 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 OR-0001 (PPO) covers primary care physician visits, telehealth, and opioid treatment with no copay and no coinsurance. Other services like specialist visits, mental health, and physical therapy require copays ranging from $0 to $40 with no coinsurance, while chiropractic benefits are only partially covered because other chiropractic services are excluded.
Preventive Services See details
AARP Medicare Advantage from UHC OR-0001 (PPO) partially covers preventive services with no copay and no coinsurance for covered benefits such as annual physical exams, fitness benefits, and kidney disease education. However, multiple supplemental services are not covered, including health education, in-home safety assessments, nutritional therapy, and personal emergency response systems.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC OR-0001 (PPO), offering one annual routine exam with no copay and no coinsurance, while fitting and evaluation exams are not covered. Up to two prescription hearing aids (with a $199 to $1,249 copay) and two OTC hearing aids (with a $199 to $829 copay) are covered yearly with no coinsurance, though 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 OR-0001 (PPO), offering no coinsurance and no copay for one routine eye exam per year, contact lenses, and frames. Eyewear benefits include a $300 combined limit every two years with a $0 to $153 copay for lenses, while other eye exams, package eyeglasses, and upgrades are not covered.
Dental Services See details
Dental Services are partially covered by AARP Medicare Advantage from UHC OR-0001 (PPO), offering up to a $1,000 annual maximum benefit for combined in-network and out-of-network care. Preventive services feature no copay and no coinsurance, Medicare-covered services carry no copay and a 20% coinsurance, and covered comprehensive services have no copay and a 50% coinsurance, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC OR-0001 (PPO) with no copay, although prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other Part B drugs have no copay and up to 20% coinsurance, while Part B insulin drugs require a $35 copay and up to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC OR-0001 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC OR-0001 (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 and inserts carry 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 OR-0001 (PPO) with no copay for lab services and diagnostic radiology, and a $50 copay with no coinsurance for diagnostic tests. Outpatient x-rays require a $30 copay, therapeutic radiology involves a 20% coinsurance, and prior authorization is required for these services.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC OR-0001 (PPO) 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 OR-0001 (PPO) with no copay and no coinsurance, although prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and Supervised Exercise Therapy (SET) for Peripheral Artery Disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC OR-0001 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered period are not covered.
Other Services See details
AARP Medicare Advantage from UHC OR-0001 (PPO) provides other services including acupuncture with a $10 copay and no coinsurance for up to 12 treatments per year, and a meal benefit for chronic illness with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under these benefits.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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