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AARP Medicare Advantage from UHC NM-0002 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NM-0002 (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-0002 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC NM-0002 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in New Mexico. 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-0002 (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-0002 (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-0002 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.00. 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-0002 (PPO) prescription drug plan features an annual drug deductible of $520. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply at standard pharmacies, or for 3-month mail-order supplies. Tier 2 generic drugs have an $8 copay for a 1-month standard pharmacy supply, but you can receive a 3-month supply with no copay through preferred mail order. For Tier 3 preferred brand drugs, you will pay a 16% coinsurance for both standard pharmacies and mail-order options. Tier 4 non-preferred drugs require a 37% coinsurance for a 1-month supply, whether filled at standard pharmacies or through mail order. Finally, Tier 5 specialty drugs carry a 27% coinsurance for a 1-month supply at standard pharmacies and mail-order services.
Additional Benefits
The AARP Medicare Advantage from UHC NM-0002 (PPO) plan features no copay and no coinsurance for primary care, preventive services, and home health care. Specialist visits range from no copay to a $45 copay, while inpatient hospital stays require a daily copay of $425 for the first five to six days with no copay for subsequent days. Emergency room visits carry a $130 copay, which is waived upon admission, and urgent care ranges from no copay to $50. Routine annual hearing and vision exams are covered with no copay, alongside allowances for eyewear and hearing aids. Preventive dental services also feature no copay up to a $1,000 annual limit, while comprehensive dental care requires a 50% coinsurance. Durable medical equipment, diabetic supplies, and dialysis are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by AARP Medicare Advantage from UHC NM-0002 (PPO) with no coinsurance, requiring a daily copay of $425 for days 1-6 of acute stays and days 1-5 of psychiatric stays, with no copay for subsequent days. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC NM-0002 (PPO) covers outpatient services with no coinsurance, although prior authorization is required. Ambulatory surgical and outpatient blood services feature no copay, while outpatient hospital copays range from $0 to $425, observation services cost $425 daily, and outpatient substance abuse sessions require a copay of $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC NM-0002 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
Ambulance services under the AARP Medicare Advantage from UHC NM-0002 (PPO) require a $150 copay and no coinsurance for both ground and air transport, with prior authorization required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage from UHC NM-0002 (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 require no copay to a $50 copay 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 NM-0002 (PPO) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits range from a $0 to $45 copay with no coinsurance. Physical, occupational, and speech therapy services require a $15 copay and no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by AARP Medicare Advantage from UHC NM-0002 (PPO) with no copay and no coinsurance for covered options like annual physicals, fitness benefits, and safety devices. Non-covered sub-services include health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation counseling, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC NM-0002 (PPO), offering annual routine hearing exams with no copay and no coinsurance, though fitting and evaluation exams are not covered. Up to two prescription and OTC hearing aids are covered per year with no coinsurance and copays ranging from $199 to $1,249 for prescription and $199 to $829 for OTC, while 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-0002 (PPO) with no deductible and no coinsurance, offering one routine eye exam per year with no copay, while other eye exam services are not covered. Eyewear is also partially covered up to a $150 combined limit every two years with no copay for contact lenses and frames, and a $0 to $153 copay for lenses, though upgrades and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered under the AARP Medicare Advantage from UHC NM-0002 (PPO) plan, with implant services and orthodontics being excluded from coverage. Preventive services feature no copay and no coinsurance up to a $1,000 yearly limit, while Medicare-covered services require a 20% coinsurance and comprehensive services require a 50% coinsurance, both with no copay.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC NM-0002 (PPO) covers Home Infusion bundled Services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require between no coinsurance and 20% coinsurance, while Part B insulin is covered with a $35 copay and up to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC NM-0002 (PPO) covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage from UHC NM-0002 (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and medical supplies, with no copay and 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts are covered with a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC NM-0002 (PPO) with no coinsurance, though prior authorization is required. Under this plan, there is no copay for lab services and diagnostic radiology, a $5 copay for diagnostic procedures and outpatient X-rays, and a $25 copay for therapeutic radiology.
Home Health Services See details
Home health services are covered by AARP Medicare Advantage from UHC NM-0002 (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice under the AARP Medicare Advantage from UHC NM-0002 (PPO) plan, as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC NM-0002 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC NM-0002 (PPO) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and other miscellaneous services are not covered, and prior authorization is required for the meal benefit.
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