A non-government entity
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 2026, 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 2026.
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 $29.00. 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:
Sign up for AARP Medicare Advantage from UHC HI-0003 (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The AARP Medicare Advantage from UHC HI-0003 (PPO) prescription drug plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, members enjoy no copay for 1-month and 3-month supplies at standard pharmacies and through mail order. 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 when using preferred mail order. For higher-tier medications, the plan transitions from flat copays to coinsurance. Tier 3 preferred brand drugs require a 16% coinsurance, while Tier 4 non-preferred drugs carry a 32% coinsurance for a 1-month supply. Tier 5 specialty drugs require a 26% coinsurance for a 1-month supply through standard pharmacies or mail order.
Additional Benefits
The AARP Medicare Advantage from UHC HI-0003 (PPO) plan offers robust coverage with no copay and no coinsurance for primary care visits, telehealth, home health services, and annual preventive exams. For hospital stays, members pay a $405 copay for days one through four of inpatient care, while outpatient hospital services range from no copay up to a $405 copay with zero coinsurance. Emergency care requires a $130 copay, which is waived if admitted, and worldwide emergency services are fully covered with no copays or coinsurance. Specialty services under this plan feature zero coinsurance, with specialist copays ranging from no copay up to $45 and routine vision and hearing exams requiring no copay. While preventive dental care is covered with no copay or coinsurance, other medical needs like durable medical equipment and dialysis carry a 20% coinsurance with no copay. Skilled nursing facility stays are also covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
Inpatient Hospital services are partially covered by AARP Medicare Advantage from UHC HI-0003 (PPO) with no coinsurance, requiring a $405 copay for days 1 to 4 and no copay for days 5 through 90. Room upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC HI-0003 (PPO) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $405, observation services carry a $405 daily copay, and outpatient substance abuse sessions range from a $0 to $25 copay, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization services are covered by AARP Medicare Advantage from UHC HI-0003 (PPO) with a $55.00 copayment and no coinsurance. Prior authorization is required to access these covered services.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC HI-0003 (PPO) covers ground and air ambulance services with a $275 copay and no coinsurance, 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 HI-0003 (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 a copay of $0 to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC HI-0003 (PPO) covers primary care provider visits and telehealth services with no copay and no coinsurance. Other covered services, such as specialist visits, therapy, and mental health services, feature no coinsurance and copays ranging from $0 to $45, though chiropractic care is only partially covered as other chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC HI-0003 (PPO) offers preventive services with no copay and no coinsurance, covering annual physical exams, kidney disease education, and a fitness benefit. However, additional preventive services are only partially covered, excluding options such as health education, nutritional/dietary benefits, in-home safety assessments, and personal emergency response systems.
Hearing Services See details
AARP Medicare Advantage from UHC HI-0003 (PPO) partially covers hearing services, offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Up to two prescription hearing aids (with copays of $199.00 to $1,249.00) and two OTC hearing aids (with copays of $199.00 to $829.00) are covered annually with no coinsurance, but inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC HI-0003 (PPO), featuring no coinsurance and no copay for annual routine eye exams and eyeglass frames. Covered eyewear is subject to a $300 combined limit every two years with copays ranging from $0 to $153 for lenses, though other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC HI-0003 (PPO) partially covers dental services, offering medicare-covered dental care with no copay and a 20% coinsurance, as well as preventive services like cleanings and exams with no copay and no coinsurance. However, comprehensive services such as restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC HI-0003 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry no copay and no coinsurance to 20% coinsurance, while Part B insulin drugs have a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC HI-0003 (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 HI-0003 (PPO) covers medical equipment, including 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 require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC HI-0003 (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Members pay no copay for lab services and certain diagnostic radiology services, while diagnostic tests require a $5 copay, outpatient X-rays cost $30, and therapeutic radiological services have a copay starting at $60.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage from UHC HI-0003 (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC HI-0003 (PPO) covers Cardiac Rehabilitation Services with no coinsurance and either no copay or a $15 copay, but only some services are covered because standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC HI-0003 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required and no prior three-day hospital stay is needed, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by AARP Medicare Advantage from UHC HI-0003 (PPO), which includes acupuncture for a $10 copay and no coinsurance (limited to 12 treatments per year) and chronic illness meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this plan, and prior authorization is required for the meal benefit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved