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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 2025, 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 2025.
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 $39.00. 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 IN-0004 (PPO) plan has an enhanced alternative drug benefit. The plan has a $420 deductible for prescription drugs. During the initial coverage phase, after the deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you'll pay a $10 copay for preferred generic drugs at a standard pharmacy, and 28% coinsurance for non-preferred drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC IN-0004 (PPO) plan offers a range of benefits. This plan covers inpatient hospital stays with a copay, as well as outpatient services, and emergency services with a copay. The plan also offers coverage for primary care, preventive services, hearing, vision, and dental services, with varying copays and coinsurance. Additional benefits include coverage for ambulance services with a copay, and home health services with no copay. The plan also covers medical equipment, diagnostic and radiological services, and skilled nursing facility stays with a copay. Other services like over-the-counter items and meal benefits are also covered with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $370 copay for days 1-5, and no copay for days 6-90, and no copay for days 91-999. For Inpatient Hospital Psychiatric, you will pay a $370 copay for days 1-5, and no copay for days 6-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $370, observation services have a $370 copay, ambulatory surgical center services have no copay, individual outpatient substance abuse sessions have a copay between $0 and $25, group outpatient substance abuse sessions have a $15 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC IN-0004 (PPO) plan. Ground and Air Ambulance Services have a copay of $275.00, with no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered, with a $140 copay and no coinsurance. Urgently Needed Services have a copay between $0 and $65 and no coinsurance. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are covered with no coinsurance, and a $0 copay.
Primary Care See details
Primary Care Physician Services, Physician Specialist Services, and Additional Telehealth Benefits have no copay. Chiropractic Services have a $20 copay, and Occupational Therapy Services have a copay between $0 and $25. Mental Health Specialty Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, while Podiatry Services have a $35 copay. Other Health Care Professional and Psychiatric Services have a copay between $0 and $35 for individual sessions and a $15 copay for group sessions. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $25, and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and other preventive services are covered, but some services have a copay. Also covered are Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
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 with a copay between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/Evaluation for Hearing Aids, and Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered.
Vision Services See details
Vision services include routine eye exams and eyewear. Routine eye exams have no copay, and are limited to one every year. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $300 every two years. Eyeglass lenses have a copay between $0 and $153, while eyeglass frames and contact lenses have no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Other services, such as Oral Exams, Dental X-Rays, and Prophylaxis (Cleaning) have no copay. Other preventive services and restorative services have no copay, and the plan covers a maximum of $1250 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, with a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC IN-0004 (PPO) plan, but require prior authorization. You will pay 20% coinsurance for this service.
Medical Equipment See details
Medical Equipment is covered under this plan, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance for Medicare-covered items, and Diabetic Equipment with coinsurance for Medicare-covered Diabetic Supplies and a copay for Diabetic Therapeutic Shoes/Inserts. 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 and radiological services. Diagnostic Procedures/Tests have a $50 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $205, Therapeutic Radiological Services have up to 20% coinsurance, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC IN-0004 (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC IN-0004 (PPO) with a $0 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. Prior authorization is required.
Other Services See details
The AARP Medicare Advantage from UHC IN-0004 (PPO) plan covers Over-the-Counter (OTC) Items and Meal Benefit with no copay, while 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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