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AARP Medicare Advantage from UHC IN-0004 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC IN-0004 (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 IN-0004 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC IN-0004 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Indiana. 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 IN-0004 (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 IN-0004 (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 IN-0004 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $49.00. 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 $600.00 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 IN-0004 (PPO) plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and mail-order services. Tier 2 generic drugs cost a $12 copay for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay through preferred mail order. For higher-tier medications, the plan charges coinsurance instead of flat copays. Tier 3 preferred brand drugs require a 15% coinsurance for both 1-month and 3-month supplies at standard pharmacies and mail-order services. Tier 4 non-preferred drugs carry a 40% coinsurance for a 1-month supply, while Tier 5 specialty drugs require a 26% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC IN-0004 (PPO) plan offers affordable coverage for core medical needs, featuring no copay and no coinsurance for primary care visits and routine preventive services. Specialist visits range from no copay up to a $50 copay, while emergency care carries a $130 copay that is waived upon hospital admission. For inpatient hospital stays, members pay no coinsurance but are responsible for a $550 daily copay for the first few days of acute or psychiatric care. Members also benefit from no copay on routine vision and hearing exams, as well as preventive dental care, though Medicare-covered dental services and durable medical equipment require a 20% coinsurance. Home health services are fully covered with no copay or coinsurance, and skilled nursing facility stays have no copay for the first 20 days. However, certain benefits like cardiac rehabilitation, major dental treatments, and routine chiropractic care are not covered by this plan.
Inpatient Hospital See details
AARP Medicare Advantage from UHC IN-0004 (PPO) covers inpatient hospital services with no coinsurance, requiring a $550 daily copay for days 1-5 of acute stays (no copay for days 6 and beyond) and a $550 daily copay for days 1-4 of psychiatric stays (no copay for days 5-90). This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC IN-0004 (PPO) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $550, while outpatient substance abuse services carry a copay of $0 to $25 for individual sessions and $15 for group sessions with no coinsurance.
Partial Hospitalization See details
AARP Medicare Advantage from UHC IN-0004 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC IN-0004 (PPO) covers ground and air ambulance services with a $255 copay and no coinsurance, though prior authorization is required. While some transportation services are covered, transportation to plan-approved health-related locations and any other health-related locations is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC IN-0004 (PPO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a copay of up to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care services are covered by AARP Medicare Advantage from UHC IN-0004 (PPO) with no copay and no coinsurance, while specialist visits range from a $0 to $50 copay with no coinsurance. Additional services like physical therapy require a $25 copay and podiatry requires a $45 copay with no coinsurance, though chiropractic benefits are only partially covered as routine and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by AARP Medicare Advantage from UHC IN-0004 (PPO) with no copay and no coinsurance for covered services like annual physical exams, fitness benefits, kidney disease education, and select screenings. However, the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC IN-0004 (PPO), featuring no copay and no coinsurance for one routine annual hearing exam, while fitting/evaluation for hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered. Covered prescription hearing aids carry a $199 to $1,249 copay and OTC hearing aids carry a $199 to $829 copay, both with no coinsurance and a limit of two devices per year.
Vision Services See details
AARP Medicare Advantage from UHC IN-0004 (PPO) offers partially covered vision services with no coinsurance, featuring no copays for yearly routine eye exams, contact lenses, and eyeglass frames. Eyeglass lenses are covered with no coinsurance and a copay of $0 to $153, but other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by the AARP Medicare Advantage from UHC IN-0004 (PPO), which features no copay and a 20% coinsurance for Medicare-covered dental services, and no copay and no coinsurance for preventive care like cleanings, exams, and X-rays. Major dental treatments, including restorative services, endodontics, periodontics, prosthodontics, implants, and oral surgery, are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC IN-0004 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and insulin (which has a $35 copay), have a coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis services are covered under the AARP Medicare Advantage from UHC IN-0004 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
AARP Medicare Advantage from UHC IN-0004 (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts carry a 20% coinsurance.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC IN-0004 (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Under this plan, diagnostic tests require a $10 copay, outpatient X-rays require a $5 copay, therapeutic radiology requires a $60 copay, and lab services and diagnostic radiology are covered with no copay.
Home Health Services See details
Home Health Services are fully covered under the AARP Medicare Advantage from UHC IN-0004 (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under AARP Medicare Advantage from UHC IN-0004 (PPO), as all associated sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, are not covered by the plan.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC IN-0004 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC IN-0004 (PPO) partially covers other services, offering a meal benefit for chronic illnesses with no copay and no coinsurance, although prior authorization is required. Acupuncture and over-the-counter (OTC) items are not covered.
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