A non-government entity
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 2025, 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 2025.
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)
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
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 a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services have copays that vary by service. Emergency services have a copay, and primary care visits, preventive services, vision exams, and eyewear have no copay. The plan also includes coverage for hearing exams, dental services with coinsurance, and home health services with no copay. Medical equipment and dialysis services have coinsurance, while skilled nursing facilities have a copay after the initial 20 days. Additionally, the plan covers over-the-counter items and a meal benefit with no copay, and the plan offers $0 copays for many other services.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care, with a $425 copay for days 1-7 and days 1-5, respectively, and no copay for the remaining days. Additional days for inpatient hospital acute are covered with no copay, while non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $425, observation services have a $425 copay, ambulatory surgical center services have no copay, individual outpatient substance abuse sessions have a copay between $0 and $25, group outpatient substance abuse sessions have a $15 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground and air ambulance services have a $290 copay, with no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan. Emergency services have a $125 copay, and no coinsurance. Urgently Needed Services have a copay between $0 and $55, with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have no copay. Chiropractic Services has a $20 copay, while Physician Specialist Services have a copay between $0 and $55. Mental Health Specialty Services have a $0-$25 copay for individual sessions and a $15 copay for group sessions. Podiatry Services and Other Health Care Professional services have a $45 copay, with Routine Foot Care covered. Psychiatric Services have a $0-$25 copay for individual sessions and a $15 copay for group sessions. Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other preventive services, including Medicare-covered glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit, all with no copay. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, 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, counseling services, are not covered. The plan also covers a fitness benefit, with no copay, and home and bathroom safety devices and modifications, also with no copay.
Hearing Services See details
Hearing services include hearing exams with no copay, routine hearing exams with no copay, and OTC hearing aids with a copay between $99 and $829. Prescription hearing aids are partially covered, but the fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear is covered with no copay, and contact lenses are unlimited, while eyeglass lenses are covered once every two years with a copay between $0 and $153, and eyeglass frames are covered once every two years with no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay, while Prosthodontics (removable and fixed) have a coinsurance between 0% and 50%. Orthodontic Services are covered under Diagnostic and Preventive Dental, while implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and 0-20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment. DME has a 20% coinsurance, while medical supplies and prosthetic devices have a 20% coinsurance, and diabetic supplies have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $50 copay, and lab services with no copay. Radiological services are covered, including a copay for Medicare-covered diagnostic and therapeutic radiological services, and coinsurance for Medicare-covered X-ray services with a minimum of 20% coinsurance. Outpatient X-ray services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan with no copay and no coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) plan's "Other Services" benefit covers over-the-counter items with no copay, and a meal benefit with no copay, but requires prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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