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AARP Medicare Advantage from UHC NM-0001 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NM-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 NM-0001 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC NM-0001 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Albuquerque Metro Area. 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 NM-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 NM-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 NM-0001 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $27.00. 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 $6200.00 (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 $6200.00 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 NM-0001 (PPO) plan has a $420 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance for your prescriptions, depending on the drug tier and pharmacy. For example, standard generic drugs have a $8.00 copay, and preferred brand drugs have a $100 copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs. If you qualify for the low-income subsidy (LIS), your monthly premium may be reduced to $11.20. Please check the plan's formulary for specific drugs covered.
Additional Benefits
The AARP Medicare Advantage from UHC NM-0001 (PPO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services have copays that vary by service. Emergency and urgent care services have copays, and primary care, preventive services, and many mental health services are available with no copay. This plan covers hearing, vision, and dental services, with no copay for eye exams and eyewear, and a 20% coinsurance for dental services. The plan also includes coverage for ambulance, home health, and medical equipment with copays or coinsurance, plus additional benefits like OTC items and meal benefits, with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for acute and psychiatric care. For acute care, you'll pay a $295 copay for days 1-6, and no copay for days 7-90, with additional days 91-999 covered with no copay; non-Medicare-covered stays and upgrades are not covered. For psychiatric care, you'll pay a $295 copay for days 1-6, and no copay for days 7-90; additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services include outpatient hospital services with a copay between $0 and $295, observation services with a $295 copay, ambulatory surgical center services with no copay, and outpatient substance abuse services with a copay between $0 and $25 for individual sessions, and a $15 copay for group sessions. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC NM-0001 (PPO) plan, with a $275 copay for both ground and air ambulance services and 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. Emergency Services have a $140 copay, while Urgently Needed Services have a copay between $0 and $65. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The AARP Medicare Advantage from UHC NM-0001 (PPO) plan offers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $0 - $20 copay, and physician specialist services with a $0 - $20 copay. Mental health specialty services have a copay of $0 - $25 for individual sessions and $15 for group sessions, while podiatry services and other health care professional services have a $20 copay. Psychiatric services have a copay of $0 - $25 for individual sessions and $15 for group sessions, while physical therapy and speech-language pathology services have a $0 - $20 copay. Additional telehealth benefits have no copay, and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, and annual physical exams with no copay. Additional preventive services, including fitness benefits and home and bathroom safety devices, are covered with no copay, while services like health education, in-home safety assessments, and others are not covered.
Hearing Services See details
Hearing exams are covered with no copay, with routine hearing exams limited to one per year. Prescription hearing aids are partially covered, and OTC hearing aids have a copay between $99 and $829. Fitting/evaluation for hearing aids, and prescription hearing aids for inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear has no copay, a combined maximum benefit of $300 every two years, and includes contact lenses, eyeglass lenses, and eyeglass frames, but does not include eyeglasses (lenses and frames) or upgrades.
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, and other preventive dental services have no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC NM-0001 (PPO) plan. This benefit has a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetic Devices and Medical Supplies, both with a 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services with a copay for diagnostic procedures/tests, which has a copay of $50, and no copay for lab services. Radiological services include a copay for Medicare-covered diagnostic and therapeutic radiological services, and a 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC NM-0001 (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 the specific services of Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD are not covered. Prior authorization is required, and the copay information can be found below.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC NM-0001 (PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under "Other Services," this AARP plan covers over-the-counter (OTC) items and meal benefits with no copay, but acupuncture and other services are not covered. The plan provides OTC benefits, including nicotine replacement therapy and naloxone coverage, but does not cover all drugs on the CMS OTC list.
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