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AARP Medicare Advantage from UHC PA-0011 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC PA-0011 (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 PA-0011 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC PA-0011 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Pennsylvania. 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 PA-0011 (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 PA-0011 (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 PA-0011 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $520.00 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 PA-0011 (PPO) plan features an annual prescription drug deductible of $520. For Tier 1 preferred generic and Tier 2 generic drugs, members enjoy no copay for 1-month and 3-month supplies at standard pharmacies, as well as no copay for 3-month supplies through standard mail order. This makes managing common, everyday prescriptions highly affordable under this plan. For brand-name and specialty medications, costs are structured around coinsurance percentages rather than flat fees. Tier 3 preferred brand drugs require a 19% coinsurance for standard pharmacy and standard mail order fills. Tier 4 non-preferred drugs carry a 41% coinsurance, while Tier 5 specialty drugs require a 27% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC PA-0011 (PPO) plan offers comprehensive coverage for essential medical services, featuring no copay and no coinsurance for primary care, telehealth, home health, and preventive care. For hospital stays, patients pay no coinsurance, though inpatient services require a $375 daily copay for the first six days, and outpatient hospital copays range up to $375. Emergency care carries a $130 copay that is waived if admitted, while worldwide emergency and urgent care are available with no copay or coinsurance. Routine dental, vision, and hearing exams are covered with no copays or coinsurance, alongside allowances for eyewear and hearing aids. Skilled nursing facility stays require no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100. Diagnostic lab tests and diabetic supplies are also covered with no copay, while durable medical equipment and dialysis services require a 20% coinsurance with no copay.
Inpatient Hospital See details
AARP Medicare Advantage from UHC PA-0011 (PPO) covers inpatient acute and psychiatric hospital services with no coinsurance, requiring a $375 daily copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional acute days are covered at no copay, but additional psychiatric days, hospital upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC PA-0011 (PPO) with no coinsurance across all services, although prior authorization is required. Patients will pay no copay for ambulatory surgical center and blood services, while outpatient hospital copays range from $0 to $375 (with $375 per day for observation services) and outpatient substance abuse sessions carry a copay of up to $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC PA-0011 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC PA-0011 (PPO) plan, which features a $275 copay and no coinsurance for both ground and air ambulance services. Prior authorization is required for ambulance services, and routine transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage from UHC PA-0011 (PPO) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC PA-0011 (PPO) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits range from a $0 to $45 copay with no coinsurance. Physical, occupational, and speech therapies require a $45 copay with no coinsurance, whereas chiropractic services are only partially covered because routine chiropractic care is excluded.
Preventive Services See details
Preventive Services are covered by AARP Medicare Advantage from UHC PA-0011 (PPO) with no copay and no coinsurance for key services like annual physical exams, kidney disease education, and glaucoma screenings. Additional preventive services are partially covered, offering fitness benefits and home safety devices with no copay, while sub-services such as health education, personal emergency response systems, and weight management programs are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC PA-0011 (PPO), featuring one annual routine hearing exam with no copay and no coinsurance, while fitting and evaluation exams are not covered. Up to two prescription or OTC hearing aids are covered per year with no coinsurance and copays ranging from $199 to $1,249, though inner, outer, and over-the-ear prescription aid types are excluded.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC PA-0011 (PPO) with no deductible, offering one routine eye exam per year with no copay and no coinsurance, while other eye exams are not covered. Eyewear is also partially covered up to a $200 limit every two years with no coinsurance, featuring no copay for contact lenses and frames and a $0 to $153 copay for lenses, though upgrades and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC PA-0011 (PPO), featuring Medicare-covered dental services with no copay and a 20% coinsurance, and preventive services like cleanings, exams, and fluoride with no copay and no coinsurance. Restorative, endodontic, periodontic, prosthodontic, orthodontic, adjunctive general, maxillofacial prosthetic, implant, and oral and maxillofacial surgery services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC PA-0011 (PPO) with no copay, though prior authorization is required. Covered Part B chemotherapy and other drugs have no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by AARP Medicare Advantage from UHC PA-0011 (PPO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage from UHC PA-0011 (PPO) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes, with no copay and 20% coinsurance. Diabetic supplies are covered with no copay and no coinsurance, though prior authorization is required and manufacturer limitations apply.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC PA-0011 (PPO) covers diagnostic and radiological services, though prior authorization is required. Diagnostic tests have a $50 copay and lab services have no copay (both with no coinsurance), while diagnostic radiological services start at no copay, outpatient X-rays require a $30 copay, and therapeutic radiological services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage from UHC PA-0011 (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC PA-0011 (PPO) covers some Cardiac Rehabilitation Services with no copay and no coinsurance, though prior authorization is required. Under this plan, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC PA-0011 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. This benefit is partially covered as additional days beyond the Medicare-covered limit are not covered, and prior authorization is required.
Other Services See details
AARP Medicare Advantage from UHC PA-0011 (PPO) partially covers other services, offering over-the-counter (OTC) items and a meal benefit for chronic illnesses with no copay and no coinsurance. Acupuncture is not covered under this plan.
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