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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 2026, 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 in Pennsylvania. 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 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 $42.00. 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. 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) prescription drug plan has an annual drug deductible of $520. Fortunately, there is no copay for Tier 1 preferred generic and Tier 2 generic drugs when filled as a 1-month or 3-month supply at a standard pharmacy, or as a 3-month supply through standard mail order. This makes everyday generic medications highly accessible and affordable for members. Brand-name and specialty medications are subject to coinsurance under this plan. You will pay an 18% coinsurance for Tier 3 preferred brand drugs, a 41% coinsurance for Tier 4 non-preferred drugs, and a 27% coinsurance for Tier 5 specialty drugs. These coinsurance rates apply to standard pharmacy and standard mail order options as specified in the plan details.
Additional Benefits
The AARP Medicare Advantage from UHC PA-0007 (PPO) plan offers covered services with no copay and no coinsurance for primary care, telehealth, and routine preventive care. For inpatient hospital admissions, members pay a $395 copay per stay with no coinsurance, while specialist office visits range from no copay to a $35 copay. Emergency room visits require a $130 copay, which is waived if admitted within 24 hours, and outpatient hospital services range from no copay to a $395 copay. This plan also features dental, vision, and hearing benefits, including no copay for preventive dental services up to a $2,000 annual limit, routine eye exams, and routine hearing exams. Prescription hearing aids require a copay of $199 to $1,249, while durable medical equipment and dialysis services require no copay and a 20% coinsurance. Skilled nursing facility care is covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
AARP Medicare Advantage from UHC PA-0007 (PPO) partially covers inpatient hospital services, requiring a $395 copay per stay and no coinsurance for both acute and psychiatric admissions. While unlimited additional acute care days are covered with no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC PA-0007 (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copay and no coinsurance. Outpatient hospital services require a copay of $0 to $395, observation services have a $395 daily copay, and outpatient substance abuse sessions have no coinsurance and copays ranging from $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC PA-0007 (PPO) covers partial hospitalization services with a $55 copay and no coinsurance. Prior authorization is required to receive this care.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC PA-0007 (PPO) covers ground and air ambulance services with a $275 copay and no coinsurance, although prior authorization is required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage from UHC PA-0007 (PPO) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay ranging from no copay 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 PA-0007 (PPO) covers primary care and telehealth services with no copay and no coinsurance. Specialist visits range from a $0 to $35 copay, therapy services require a $35 copay, and mental health services have copays up to $25, all with no coinsurance, though routine chiropractic care is not covered.
Preventive Services See details
AARP Medicare Advantage from UHC PA-0007 (PPO) partially covers preventive services with no copay and no coinsurance for covered benefits like annual physical exams, fitness benefits, home safety devices, and kidney disease education. Excluded sub-services that are not covered under this benefit include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
AARP Medicare Advantage from UHC PA-0007 (PPO) provides partially covered hearing services, offering one annual routine hearing exam with no copay and no coinsurance, while fitting and evaluation exams are not covered. Up to two prescription hearing aids per year are covered with a copay of $199.00 to $1,249.00 and no coinsurance, and up to two OTC hearing aids are covered with a copay of $199.00 to $829.00 and no coinsurance. Specific prescription types, including inner ear, outer ear, and over-the-ear hearing aids, are not covered under this benefit.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC PA-0007 (PPO), featuring one routine eye exam per year and eyeglass frames or contact lenses with no copay and no coinsurance. Covered eyewear is subject to a combined $300 maximum benefit every two years with a $0 to $153 copay and no coinsurance for eyeglass lenses, while other eye exams, combined eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC PA-0007 (PPO), as implant services and orthodontics are not covered. Preventive and diagnostic services feature no copay and no coinsurance up to a $2,000 yearly maximum, while Medicare-covered dental services require no copay and 20% coinsurance, and covered comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC PA-0007 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other infusion drugs have no copay and a coinsurance of no coinsurance to 20%, while Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the AARP Medicare Advantage from UHC PA-0007 (PPO) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage from UHC PA-0007 (PPO) covers durable medical equipment, prosthetics, and medical supplies with 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 services.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC PA-0007 (PPO) covers diagnostic and radiological services, with prior authorization required for these benefits. Diagnostic tests require a $30 copay with no coinsurance, lab services and diagnostic radiology have no copay, outpatient X-rays have a $25 copay, and therapeutic radiology services require a 20% coinsurance.
Home Health Services See details
AARP Medicare Advantage from UHC PA-0007 (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under AARP Medicare Advantage from UHC PA-0007 (PPO) with no copay and no coinsurance, though prior authorization is required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy for symptomatic peripheral artery disease services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC PA-0007 (PPO) with no coinsurance and no prior three-day hospital stay required, though prior authorization is necessary. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage for additional days beyond the Medicare limit.
Other Services See details
AARP Medicare Advantage from UHC PA-0007 (PPO) partially covers other services, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and other miscellaneous services under this benefit are not covered, and prior authorization is required for the meal benefit.
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