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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 2025, 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 2025.
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 $20.00. 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-0002 (PPO) plan has an enhanced alternative drug benefit. The plan has a $420 deductible. In the initial coverage phase, you will pay a copay or coinsurance for your prescriptions depending on the tier and pharmacy. For preferred generic drugs, you will pay an $8 copay at a standard pharmacy. For standard generic drugs, you will pay a $47 copay at a standard pharmacy. For preferred brand drugs, you will pay a $100 copay at any pharmacy. For non-preferred drugs, you will pay 28% coinsurance at any pharmacy.
Additional Benefits
The AARP Medicare Advantage from UHC NM-0002 (PPO) plan offers comprehensive coverage with varying costs. Inpatient hospital stays have a copay, while outpatient services, including primary care and many therapies, often have no copay or a low copay. This plan also covers emergency services, ambulance services, and offers benefits for hearing, vision, and dental care. Additional benefits include preventive services with no copay, and coverage for medical equipment, diagnostic services, and home health services.
Inpatient Hospital See details
Inpatient hospital services are covered, with a copay of $355 for days 1-6 and no copay for days 7-90 for acute care, and a copay of $355 for days 1-5 and no copay for days 6-90 for psychiatric care. Additional days for inpatient hospital-acute are covered with no copay, but non-Medicare-covered stays and upgrades for inpatient hospital-acute are not covered, and additional days and non-Medicare-covered stays for inpatient hospital psychiatric are not covered.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services, with a copay between $0 and $355, observation services with a $355 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered, with individual sessions having a copay between $0 and $25, and group sessions with a $15 copay. Outpatient blood services are also covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC NM-0002 (PPO) plan. The plan has a $55 copay for this benefit, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the AARP Medicare Advantage from UHC NM-0002 (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 by the AARP Medicare Advantage from UHC NM-0002 (PPO) plan. Emergency Services have a $140 copay, while Urgently Needed Services have a copay between $0 and $65; Worldwide Emergency Services have a copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, all with a $0 copay.
Primary Care See details
The AARP Medicare Advantage from UHC NM-0002 (PPO) plan covers primary care physician services with no copay, and covers chiropractic services with a $20 copay. The plan also covers occupational therapy services with a copay between $0 and $30, physician specialist services with a copay between $0 and $35, and physical therapy and speech-language pathology services with a copay between $0 and $30. Mental health specialty services, psychiatric services, and other health care professional services are covered with varying copays, and podiatry services are covered with a $35 copay. Additional telehealth benefits have no copay, and opioid treatment program services have no copay.
Preventive Services See details
AARP Medicare Advantage from UHC NM-0002 (PPO) covers preventive services, including an annual physical exam with no copay. This plan also covers additional preventive services, including Fitness Benefit and Home and Bathroom Safety Devices and Modifications, with no copay. This plan does not cover Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, 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 (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services.
Hearing Services See details
Hearing exams are covered with no copay, routine hearing exams are covered once per year with no copay, and fitting/evaluation for hearing aids are not covered. Prescription hearing aids are partially covered, with a copay between $199 and $1249 for all types of hearing aids, but not for inner ear, outer ear, or over the ear aids. OTC hearing aids are covered with a copay between $99 and $829.
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 is covered with a combined maximum of $300 every two years, and includes contact lenses, eyeglass lenses, and eyeglass frames with no copay, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, including Medicare dental services with a 20% coinsurance and other dental services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay, while prosthodontics (removable) and prosthodontics (fixed) have a 0% - 50% coinsurance. Orthodontics are not covered, and there is a $1,000 maximum plan benefit for other dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the AARP Medicare Advantage from UHC NM-0002 (PPO) plan. The plan covers Medicare Part B Insulin Drugs with a $35 copay and coinsurance between 0% and 20%, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC NM-0002 (PPO) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and the plan does not cover DME for use outside the home. Prosthetic devices and medical supplies have a 20% coinsurance, and Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $50 copay, and lab services with no copay. Radiological services are covered, including diagnostic services with a maximum copay of $250, therapeutic services with at least 20% coinsurance, and outpatient X-ray services with a $25 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC NM-0002 (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 not covered by the AARP Medicare Advantage from UHC NM-0002 (PPO) plan. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC NM-0002 (PPO) plan. 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
The AARP Medicare Advantage from UHC NM-0002 (PPO) plan covers Over-the-Counter (OTC) Items and Meal Benefits. OTC items have no copay, while meal benefits also have no copay and require prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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