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AARP Medicare Advantage from UHC PA-0007 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC PA-0007 (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 PA-0007 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC PA-0007 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties of Pennsylvania. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC PA-0007 (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 PA-0007 (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 PA-0007 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $35.00. 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 $420.00 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 PA-0007 (PPO) plan has a $420 deductible for prescription drugs. After the deductible, you will pay the following costs for drugs. For preferred generic drugs at a standard pharmacy, there is no copay, while standard generic drugs have a $47 copay. Preferred brand drugs have a $100 copay, regardless of whether you go to a preferred or standard pharmacy, or use mail order. Non-preferred drugs have a 28% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC PA-0007 (PPO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a $365 copay per admission, while outpatient services may have copays ranging from $0 to $365. Emergency services have a $125 copay, and primary care and many other services have no copay. This plan includes coverage for hearing and vision services, with no copay for hearing exams and eye exams. Dental services are covered with varying coinsurance. The plan also covers home health services, and other services with varying cost-sharing.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered. For Medicare-covered stays, there is a $365 copay per admission or stay, and for additional days for Inpatient Hospital-Acute, there is no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services includes coverage for Outpatient Hospital Services with a copay between $0 and $365, Observation Services with a $365 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and Outpatient Blood Services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by AARP Medicare Advantage from UHC PA-0007 (PPO). Ground and air ambulance services have a $275 copay, with no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the AARP Medicare Advantage from UHC PA-0007 (PPO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Services include Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, all with no copay.
Primary Care See details
Primary Care Physician Services, Physician Specialist Services, and Additional Telehealth Benefits have no copay. Chiropractic Services have a $20 copay, and Occupational Therapy Services have a copay between $0 and $20. Podiatry Services, Other Health Care Professional, Psychiatric Services, and Opioid Treatment Program Services have varying copays. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $20. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional preventive services, which may have a copay. Other services like Health Education, In-Home Safety Assessment, and others are not covered.
Hearing Services See details
Hearing exams are covered with no copay, with Routine Hearing Exams covered once per year. Prescription hearing aids are covered, with a copay between $199 and $1249 for all types and a limit of 2 per year. OTC hearing aids are covered with a copay between $99 and $829, with a limit of 2 per year. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Vision Services include eye exams with no copay, and eyewear benefits, including contact lenses, eyeglass lenses, and eyeglass frames. Eyeglass lenses may have a copay between $0 and $153, and eyeglass frames have no copay. Eyeglasses (lenses and frames) and upgrades are not covered. The plan offers a combined maximum benefit of $300 for eyewear every two years.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare dental services. Oral exams, dental X-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay. Prosthodontics, removable and prosthodontics, fixed services have 0% - 50% coinsurance. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, and for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC PA-0007 (PPO) plan. There is a coinsurance of 20% for dialysis services, and prior authorization is required.
Medical Equipment See details
Medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, is covered. DME has a 20% coinsurance and requires authorization, while prosthetic devices and medical supplies have a 20% coinsurance. Diabetic supplies have no copay, and diabetic therapeutic shoes/inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a $20 copay, lab services with no copay, diagnostic radiological services with a copay up to $200, therapeutic radiological services with a copay up to $80, and outpatient X-ray services with a $25 copay. Prior authorization is required for all services.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC PA-0007 (PPO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage from UHC PA-0007 (PPO), but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization, with a $0 copay for days 1-20 and a $203 copay per day for days 21-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
The AARP Medicare Advantage from UHC PA-0007 (PPO) plan covers Over-the-Counter (OTC) Items with no copay, and also covers meal benefits with no copay and prior authorization required. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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