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AARP Medicare Advantage from UHC DE-0001 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC DE-0001 (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 DE-0001 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC DE-0001 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Delaware. 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 DE-0001 (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 DE-0001 (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 DE-0001 (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 $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 DE-0001 (PPO) plan features a $600 annual drug deductible and offers significant savings on generic medications. Under this plan, Tier 1 preferred generics have no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generics cost a $10 copay for a 1-month supply at standard pharmacies, but you can secure a 3-month supply with no copay when using preferred mail order. For brand-name and specialty prescriptions, the plan utilizes coinsurance rather than flat copayments. Tier 3 preferred brands require a 15% coinsurance for both 1-month and 3-month supplies. Tier 4 non-preferred drugs require a 41% coinsurance, while Tier 5 specialty medications carry a 26% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC DE-0001 (PPO) plan offers robust coverage for essential medical services, featuring no copay and no coinsurance for primary care visits, telehealth, and annual physical exams. Specialist visits range from a $0 to $45 copay, while emergency room visits carry a $130 copay that is waived if you are admitted. Inpatient hospital stays require a $455 daily copay for the first few days with no coinsurance, and home health services are available with no copay and no coinsurance. For routine care, members enjoy preventive dental, annual hearing, and vision exams with no copay and no coinsurance, alongside allowances for prescription eyewear and hearing aids. Skilled nursing facility stays have no copay for the first 20 days, while medical equipment and dialysis services generally require a 20% coinsurance with no copay. Note that certain specialized services like cardiac rehabilitation, acupuncture, and routine transportation are not covered under this plan.
Inpatient Hospital See details
Inpatient hospital care is partially covered by AARP Medicare Advantage from UHC DE-0001 (PPO) with no coinsurance, requiring prior authorization. For acute stays, you will pay a $455 daily copay for days 1 to 6 and no copay for days 7 and beyond, while psychiatric stays require a $455 daily copay for days 1 to 5 and no copay for days 6 to 90. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC DE-0001 (PPO) covers outpatient hospital services with no coinsurance and copays from $0 to $455, and observation services with a $455 daily copay and no coinsurance. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services have no coinsurance and copays ranging from no copay to $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC DE-0001 (PPO) covers partial hospitalization benefits with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC DE-0001 (PPO) covers ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. Some transportation services are covered, but trips to plan-approved health-related locations and any other health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC DE-0001 (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 $0 to $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits for the AARP Medicare Advantage from UHC DE-0001 (PPO) plan offer no copay and no coinsurance for primary care visits and telehealth services. Specialist visits range from a $0 to $45 copay, therapy services require a $30 copay, and podiatry visits have a $40 copay, all with no coinsurance, though routine and other chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC DE-0001 (PPO) provides coverage for several preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, glaucoma screenings, diabetes self-management training, and a fitness benefit. However, additional preventive services are only partially covered, excluding benefits such as health education, in-home safety assessments, personal emergency response systems, nutritional/dietary benefits, and weight management programs.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC DE-0001 (PPO), which offers one annual routine hearing exam with no copay, no coinsurance, and no deductible, though fitting and evaluation exams are not covered. Up to two prescription hearing aids (with copays of $199.00 to $1,249.00) and OTC hearing aids (with copays of $199.00 to $829.00) are covered yearly with no coinsurance, but inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC DE-0001 (PPO), offering one routine eye exam annually and select eyewear with no coinsurance and no copay, except for eyeglass lenses which carry a $0 to $153 copay. A combined $300 maximum benefit is available every two years for contact lenses, lenses, and frames, while upgrades, other eye exams, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC DE-0001 (PPO), offering preventive care such as oral exams, cleanings, fluoride, and x-rays with no copay and no coinsurance. Medicare-covered dental services require no copay and a 20% coinsurance, whereas restorative services, endodontics, periodontics, prosthodontics, implants, orthodontics, and oral surgery are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the AARP Medicare Advantage from UHC DE-0001 (PPO) plan with no copay, though prior authorization and step therapy are required. Covered Medicare Part B chemotherapy, radiation, and other infusion drugs carry no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by AARP Medicare Advantage from UHC DE-0001 (PPO) with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
Medical equipment covered by AARP Medicare Advantage from UHC DE-0001 (PPO) features no copay and a 20% coinsurance for durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay and no coinsurance, though prior authorization is required for most equipment and manufacturer limits apply to diabetic supplies.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the AARP Medicare Advantage from UHC DE-0001 (PPO) plan, requiring prior authorization. Members pay no copay or coinsurance for lab services, a $55 copay with no coinsurance for diagnostic tests, copays starting at $0 for diagnostic radiology, a $30 copay plus coinsurance for outpatient X-rays, and a copay plus a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
AARP Medicare Advantage from UHC DE-0001 (PPO) covers home health services with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage from UHC DE-0001 (PPO) plan. This lack of coverage applies to all sub-services, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC DE-0001 (PPO) with no coinsurance and no required 3-day prior hospital stay, though prior authorization is required. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with no coverage provided for additional days beyond the Medicare limit.
Other Services See details
AARP Medicare Advantage from UHC DE-0001 (PPO) partially covers other services, offering a meal benefit for chronic illnesses with no copay and no coinsurance, though prior authorization is required. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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