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AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx NM-MA01 (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 Patriot No Rx NM-MA01 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select counties in New Mexico. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage Patriot No Rx NM-MA01 (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 Patriot No Rx NM-MA01 (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. Additionally, this plan comes with a Part B Premium reduction of $50.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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 Patriot No Rx NM-MA01 (PPO)
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Drug Coverage
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan offers comprehensive coverage with no copay or coinsurance for primary care visits, telehealth, and annual preventive services. For hospital care, members pay a $550 daily copay for the first five days of inpatient stays, with no copay for additional days, while outpatient hospital services feature copays ranging from no copay up to $550. Emergency care is accessible with a $130 copay, which is waived upon hospital admission, and worldwide emergency services are covered with no copay. Ancillary benefits include routine hearing and vision exams with no copay, alongside dental coverage up to a $1,000 annual limit where preventive services require no copay or coinsurance. Skilled nursing facility stays feature no copay for the first 20 days, while durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay. Additionally, home health services and select over-the-counter items are fully covered with no copay or coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) covers inpatient acute hospital stays with no coinsurance and a $550 copay for days 1 through 5, followed by no copay for additional days. Inpatient psychiatric care is also covered with no coinsurance, requiring a $550 copay for days 1 through 4 and no copay for days 5 through 90, though upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by the AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) with no coinsurance, though prior authorization is required. You will pay no copay for ambulatory surgical center and blood services, a $0 to $550 copay for outpatient hospital services, a $550 daily copay for observation services, and copays between $0 and $25 for outpatient substance abuse sessions.
Partial Hospitalization See details
AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this covered benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) with a $290 copay and no coinsurance for both ground and air transportation, which require prior authorization. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services carry a copay ranging from $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
Primary care services are covered by AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) with no copay and no coinsurance, which also applies to telehealth and opioid treatment. Specialist visits, physical and occupational therapy, mental health, and podiatry require no coinsurance and copays ranging from $0 to $60, though some chiropractic services are covered but routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) covers preventive services, including annual physicals, kidney disease education, and diabetes self-management training, with no copay and no coinsurance. While fitness benefits and home safety modifications are covered with no copay, several other supplemental services such as health education, nutritional therapy, and in-home support are not covered.
Hearing Services See details
AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) partially covers hearing services, offering one annual routine hearing exam with no copay and no coinsurance, while fitting and evaluation exams are not covered. The plan also covers up to two prescription hearing aids (with copays ranging from $199.00 to $1,249.00) and up to two OTC hearing aids (with copays ranging from $199.00 to $829.00) per year with no coinsurance, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by the AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan, featuring routine eye exams with no copay and no coinsurance, and eyewear with no coinsurance and copays ranging from no copay to $153 up to a $200 combined limit every two years. Other eye exam services, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) offers partially covered dental services with a $1,000 annual maximum, though implant services and orthodontics are not covered. Preventive care has no copay and no coinsurance, Medicare-covered dental services require no copay and 20% coinsurance, and covered comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by the AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan with no copay, though prior authorization is required. Associated Medicare Part B drugs, such as chemotherapy, carry no coinsurance to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) covers 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 carry a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) covers diagnostic and radiological services, with prior authorization required for both. Lab services and diagnostic radiological services feature no copay and no coinsurance, while diagnostic tests require a $50 copay with no coinsurance, outpatient X-rays require a $30 copay with coinsurance, and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all not covered. Although the plan technically indicates some services are covered with no copay and no coinsurance subject to prior authorization, none of these key sub-services are actually covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Patriot No Rx NM-MA01 (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, a prior three-day hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) partially covers other services, offering over-the-counter (OTC) items and a chronic illness meal benefit with no copay and no coinsurance. Acupuncture is not covered, 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
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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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