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AARP Medicare Advantage from UHC PA-0009 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC PA-0009 (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-0009 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC PA-0009 (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-0009 (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-0009 (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-0009 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $59.00. 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-0009 (PPO) plan has an "Enhanced Alternative" drug benefit. The plan has a deductible of $420.00. Once you meet your deductible, you will pay a $0 copay for standard generic drugs, a $47.00 copay for standard generic drugs, and a $100.00 copay for preferred brand drugs. Non-preferred drugs have a 28% coinsurance. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC PA-0009 (PPO) plan offers coverage for a wide range of services with varying cost-sharing arrangements. Inpatient hospital stays have a copay, with no copay for days 5-90. Outpatient services, including primary care, have no copay, and preventive services also have no copay. This plan also includes benefits for hearing, vision, and dental services, often with no copays. Emergency, ambulance, and transportation services have copays, and durable medical equipment and some other services are subject to coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered, but non-Medicare-covered stays and upgrades are not covered. For acute and psychiatric care, you will pay a $225 copay for days 1-4, and no copay for days 5-90, and additional days for acute care have no copay for days 91-999.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $395, Observation Services with a $395 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 with a $55 copay, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC PA-0009 (PPO) plan. Ground and Air Ambulance Services have a $275 copay, with no coinsurance. 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-0009 (PPO) plan. Emergency Services have a $125 copay and no coinsurance, Urgently Needed Services have a copay between $0 and $55 with no coinsurance, and Worldwide Emergency Services has a $0 copay and no coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage from UHC PA-0009 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, and occupational therapy services with a copay between $0 and $20. Physician specialist services have a copay between $0 and $30, while mental health specialty services, psychiatric services, and podiatry services have varying copays depending on the service. Physical therapy and speech-language pathology services have a copay between $0 and $20, and additional telehealth benefits have no copay. Opioid treatment program services also have no copay.
Preventive Services See details
Preventive Services include annual physical exams with no copay, and other preventive services with no copay. Other preventive services include Medicare-covered glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, all with no copay. Additional preventive services such as fitness benefits and home and bathroom safety devices and modifications are also covered with no copay. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, and counseling services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered for one visit per year with no copay. Prescription hearing aids are covered with a copay between $199 and $1249 for two hearing aids every year, but fitting and evaluation for hearing aids and hearing aids for inner ear, outer ear, and over the ear are not covered. OTC hearing aids are covered with a copay between $99 and $829 for two hearing aids every year.
Vision Services See details
The AARP Medicare Advantage from UHC PA-0009 (PPO) plan covers vision services, including eye exams with no copay and eyewear, including contact lenses, eyeglass lenses, and eyeglass frames with no copay, up to a combined maximum of $300 every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC PA-0009 (PPO) plan covers dental services, including oral exams, dental x-rays, other diagnostic services, cleaning, fluoride treatments, and other preventive services with no copay. Other services like Medicare dental services, restorative services, and orthodontics require prior authorization and may have a coinsurance of up to 50%. Some services, such as implant services and orthodontics, are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, you will pay a $35 copay, and the coinsurance is between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC PA-0009 (PPO) plan. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, while 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 all diagnostic and radiological services, but prior authorization is required. Diagnostic Procedures/Tests have a copay of $25, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $190, Therapeutic Radiological Services have a copay up to $80, and Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC PA-0009 (PPO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required, and copays apply; see the plan documents for more information.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization, and the copay is $0 for days 1-20 and $203 per day for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The AARP Medicare Advantage from UHC PA-0009 (PPO) plan covers Over-the-Counter (OTC) Items with no copay, and a Meal Benefit with no copay, but requires prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and a variety of other services are not covered.
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