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AARP Medicare Advantage from UHC HI-0003 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC HI-0003 (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 HI-0003 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC HI-0003 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Kauai and Maui Counties. 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 HI-0003 (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 HI-0003 (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 HI-0003 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $19.00. 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 $340.00 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 HI-0003 (PPO) plan has an "Enhanced Alternative" drug benefit. The plan has a $340 deductible for prescription drugs. During the initial coverage phase, after the deductible is met, you will pay a copay for your prescriptions. For example, you will pay a $12 copay for preferred generic drugs at a standard pharmacy. After your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC HI-0003 (PPO) plan offers a range of benefits, including inpatient hospital stays with a copay, outpatient services, and coverage for emergency services. It also provides coverage for primary care with no copay, preventive services, and a range of hearing and vision services, often with no copay or low copays. Dental services are covered, with no copay for many services but with potential coinsurance. Additional benefits include coverage for ambulance services, partial hospitalization, and home health services. The plan also covers home infusion services and dialysis with coinsurance, and durable medical equipment with coinsurance. Additionally, the plan offers coverage for diagnostic and radiological services, skilled nursing facility stays, and other services like acupuncture and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with a $320 copay for days 1-4, and no copay for days 5-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while 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 $320, and observation services with a $320 copay. Ambulatory Surgical Center (ASC) services are covered with no copay, and outpatient blood services are covered with no copay. Outpatient substance abuse services are also covered, with individual sessions having a copay between $0 and $25, and group sessions having a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the AARP Medicare Advantage from UHC HI-0003 (PPO) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC HI-0003 (PPO) plan. Ground and Air Ambulance Services have a copay of $235, and there is no coinsurance. Transportation Services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the AARP Medicare Advantage from UHC HI-0003 (PPO) plan. Emergency Services have a $125 copay, Urgently Needed Services have a copay between $0 and $55, and Worldwide Emergency Services has a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage from UHC HI-0003 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $10 copay, occupational therapy services with a copay between $0 and $25, and physician specialist services with a copay between $0 and $35. The plan also covers mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services, all with varying copays.
Preventive Services See details
Preventive services include Medicare-covered preventive services, an annual physical exam with no copay, and additional services. Additional preventive services such as 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), Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered. The plan also covers Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with no copay.
Hearing Services See details
Hearing exams are covered with no copay, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with a copay between $199 and $1249 depending on the type, and OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
The AARP Medicare Advantage from UHC HI-0003 (PPO) plan covers vision services, including routine eye exams and eyewear. Eye exams and contact lenses have no copay, while eyeglass lenses have a copay between $0 and $153. Eyeglass frames also have no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
AARP Medicare Advantage from UHC HI-0003 (PPO) covers dental services, including a 20% coinsurance for Medicare Dental Services. Other Dental Services include coverage for Oral Exams, Dental X-Rays, and other diagnostic and preventive services with no copay. Restorative Services, and other services such as Prosthodontics and Oral Surgery are covered with no copay, but may have coinsurance of up to 50%. Implant and Orthodontic services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B insulin drugs with a $35 copay and coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC HI-0003 (PPO) plan, but require prior authorization. You will pay 20% coinsurance for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices with 20% coinsurance; however, Durable Medical Equipment for use outside the home is not covered. The plan also covers Medical Supplies with 20% coinsurance, and Diabetic Equipment including Diabetic Supplies with no copay and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a copay for diagnostic procedures/tests at $25, and no copay for lab services. Diagnostic Radiological Services have a copay up to $50, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a copay of $15.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC HI-0003 (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are generally covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. You will have no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
Other Services include acupuncture and a meal benefit. Acupuncture has a $10 copay for up to 12 treatments per year, while the meal benefit has no copay, but requires prior authorization.
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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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