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AARP Medicare Advantage Patriot No Rx DC-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 DC-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 DC-MA01 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx DC-MA01 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Maryland and Washington, DC. 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 DC-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 DC-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 DC-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 $14000.00 (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 $14000.00 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
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx DC-MA01 (PPO).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx DC-MA01 (PPO) plan offers comprehensive coverage with varying costs depending on the service. Many services have a $0 copay, including primary care visits, preventive services, hearing exams, vision exams, and home health services. However, some services like inpatient hospital stays, outpatient services, specialist visits, and dental services have copays ranging from $15 to $450. This plan also includes coverage for emergency services, ambulance services, and various therapies with copays. Diagnostic and radiological services, as well as medical equipment, are covered with copays or coinsurance. The plan also offers additional benefits like a meal benefit.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with a copay of $450 for days 1-5 and days 1-4, respectively, and no copay for days 6-90 and days 5-90. Additional Days for Inpatient Hospital-Acute are covered with no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the AARP Medicare Advantage Patriot No Rx DC-MA01 (PPO) plan, including Outpatient Hospital Services with a copay between $0 and $450, Observation Services with a $450 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and Outpatient Blood Services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered under the AARP Medicare Advantage Patriot No Rx DC-MA01 (PPO) plan. You will pay a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage Patriot No Rx DC-MA01 (PPO) plan. Ground and Air Ambulance Services have a $275 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. Emergency Services have a $110 copay, and Urgently Needed Services have a copay between $0 and $45; there is no coinsurance for either. Worldwide Emergency Services include Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, all of which have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services, and Additional Telehealth Benefits have no copay. Chiropractic Services have a $15 copay, while Occupational Therapy Services have a copay between $0 and $35. Physician Specialist Services have a copay between $0 and $55. Mental Health Specialty Services have a copay between $0 and $25 for individual sessions and $15 for group sessions. Podiatry Services have a $45 copay. Other Health Care Professional and Psychiatric Services have a copay between $0 and $55 for individual sessions and $15 for group sessions. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $50. Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, as well as annual physical exams with no copay. Additional preventive services, like fitness benefits, are covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered for one visit per year with no copay. Prescription hearing aids are partially covered, with a copay between $199 and $1249 for all types and 2 visits per year, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are covered with a copay between $99 and $829, and a quantity of 2 per year.
Vision Services See details
Vision Services include eye exams with no copay, and eyewear benefits. Eyewear benefits have a combined maximum of $200 every two years, and include contact lenses with no copay, and eyeglass lenses with a copay between $0 and $153. Eyeglass frames are also covered with no copay. Eyeglasses and upgrades are not covered.
Dental Services See details
Dental services through the AARP Medicare Advantage Patriot No Rx DC-MA01 (PPO) plan include coverage for oral exams, dental X-rays, prophylaxis (cleaning), fluoride treatments, and other preventive services with no copay, but Medicare Dental Services have a 20% coinsurance. Orthodontic, restorative, adjunctive general, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay, and the coinsurance is between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage Patriot No Rx DC-MA01 (PPO) plan. You will pay 20% coinsurance for these services. Prior authorization is required.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance with no copay, while Prosthetic Devices and Medical Supplies have a 20% coinsurance with no copay. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services includes coverage for diagnostic procedures and tests with a $50 copay, lab services with no copay, and diagnostic radiological services with a copay up to $250. Therapeutic radiological services have a coinsurance of at least 20%, and 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 DC-MA01 (PPO) plan with no copay and no coinsurance. 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 DC-MA01 (PPO) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Patriot No Rx DC-MA01 (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203 per day; there is no coinsurance. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes a meal benefit with no copay. However, acupuncture, over-the-counter items, 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.
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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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