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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 2026, 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 2026.
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 $33.00. 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 NM-0001 (PPO) plan features a yearly drug deductible of $520. For Tier 1 preferred generic medications, there is no copay for a 1-month or 3-month supply at standard pharmacies or via 3-month mail order. Tier 2 generic drugs have an $8 copay for a 1-month standard pharmacy supply, while a 3-month supply through preferred mail order has no copay. For brand-name and specialty medications, costs are based on coinsurance percentages rather than flat copays. Tier 3 preferred brand drugs require a 17% coinsurance for standard pharmacy and mail order prescriptions. Tier 4 non-preferred drugs carry a 31% coinsurance, while Tier 5 specialty tier drugs require a 27% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC NM-0001 (PPO) plan offers robust medical coverage, featuring no copay for primary care visits, telehealth services, and routine preventive care. For hospital services, members face a $395 daily copay for the first few days of inpatient stays and up to a $395 copay for outpatient hospital services, both with no coinsurance. Emergency care is accessible with a $130 copay, which is waived if you are admitted, and there is no copay for worldwide emergency services. This plan also includes valuable supplemental benefits, including routine dental, vision, and hearing exams with no copay. Comprehensive dental services are covered up to a $1,500 annual limit with a 50% coinsurance, while prescription hearing aids and eyewear are available with varying copays. Additionally, diagnostic labs and home health services require no copay, while durable medical equipment and dialysis services carry a 20% coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC NM-0001 (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. You will pay a $395 daily copay for days 1 to 6 of acute stays (no copay for days 7 and beyond) and days 1 to 5 of psychiatric stays (no copay for days 6 to 90), while upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC NM-0001 (PPO) covers outpatient services with no coinsurance, though prior authorization is required. Under this plan, there is no copay for ambulatory surgical center and blood services, while outpatient hospital and observation services have copays up to $395, and outpatient substance abuse sessions require copays between $0 and $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC NM-0001 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this covered benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC NM-0001 (PPO) covers ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC NM-0001 (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay ranging from $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC NM-0001 (PPO) offers primary care and telehealth visits with no copay and no coinsurance, while specialist visits range from no copay to a $35 copay with no coinsurance. Physical, occupational, and speech therapies require a $30 copay, mental health sessions range from no copay to a $25 copay, and podiatry costs a $35 copay, all with no coinsurance. Some chiropractic services are covered, but routine and other chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC NM-0001 (PPO) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive services are partially covered, offering fitness benefits and home safety devices with no copay and no coinsurance, but excluding health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing Services are partially covered by AARP Medicare Advantage from UHC NM-0001 (PPO), which offers one routine hearing exam annually with no copay and no coinsurance, but does not cover fitting and evaluation exams. Up to two prescription hearing aids (with a $199 to $1,249 copay and no coinsurance) and up to two OTC hearing aids (with a $199 to $829 copay and no coinsurance) are covered per year, 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 NM-0001 (PPO), with other eye exam services, combined eyeglasses (lenses and frames), and upgrades not covered. Routine eye exams have no copay and no coinsurance, while covered eyewear has no coinsurance and copays ranging from $0 to $153, subject to a $200 combined maximum limit every two years.
Dental Services See details
Dental services are covered by AARP Medicare Advantage from UHC NM-0001 (PPO) with no copay and no coinsurance for preventive care, and no copay with a 20% coinsurance for Medicare-covered dental. Comprehensive dental services are partially covered up to a $1,500 annual maximum with 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 NM-0001 (PPO) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, range from no coinsurance to 20% coinsurance, with insulin carrying a $35 copay.
Dialysis Services See details
AARP Medicare Advantage from UHC NM-0001 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
AARP Medicare Advantage from UHC NM-0001 (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are also 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 NM-0001 (PPO) with no coinsurance, though prior authorization is required. Members pay no copay for lab services and diagnostic radiology, a $25 copay for outpatient X-rays and diagnostic tests, and a $50 copay for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC NM-0001 (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered with no copay and no coinsurance under the AARP Medicare Advantage from UHC NM-0001 (PPO) plan; however, while some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC NM-0001 (PPO) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a daily copay of $218 for days 21 through 100, and additional days beyond the standard Medicare-covered period are not covered.
Other Services See details
Other Services are partially covered by AARP Medicare Advantage from UHC NM-0001 (PPO), providing Over-the-Counter (OTC) items and chronic-illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit, and prior authorization is required for the meal benefit.
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