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AARP Medicare Advantage from UHC NM-0006 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NM-0006 (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 NM-0006 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC NM-0006 (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 from UHC NM-0006 (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 NM-0006 (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 NM-0006 (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:
Sign up for AARP Medicare Advantage from UHC NM-0006 (PPO)
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Drug Coverage
The AARP Medicare Advantage from UHC NM-0006 (PPO) plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, members pay no copay for standard pharmacy fills and preferred or standard mail-order options. Tier 2 generic drugs cost a $12 copay for a one-month supply at standard pharmacies, but members can save with no copay for a three-month supply through preferred mail order. Higher-tier medications are subject to coinsurance rather than set copays under this plan. Tier 3 preferred brand drugs require 19% coinsurance for both standard pharmacies and mail-order fills. Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 28% and 26% coinsurance respectively for a one-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC NM-0006 (PPO) plan offers affordable access to essential medical care, featuring no copay and no coinsurance for primary care visits, telehealth services, and routine preventive care. Specialist visits and diagnostic tests are also highly accessible, with specialist copays ranging from no copay to $50 and lab services requiring no copay or coinsurance. For more intensive care, inpatient hospital stays require a $550 copay for the first few days with no coinsurance, while emergency room visits carry a $130 copay that is waived if you are admitted within 24 hours. This plan also includes valuable supplemental coverage, such as routine hearing and vision exams with no copay and no coinsurance, alongside a $300 eyewear allowance every two years. Preventive dental services like cleanings and X-rays are covered with no copay and no coinsurance, though comprehensive dental services are not covered under this plan. Additionally, members benefit from home health services, over-the-counter items, and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital care is covered by AARP Medicare Advantage from UHC NM-0006 (PPO) with no coinsurance, featuring a $550 copay for days 1 to 5 of acute stays and days 1 to 4 of psychiatric stays, with no copay for subsequent days. The benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC NM-0006 (PPO) with no coinsurance for all services, including ambulatory surgical and blood services which also feature no copays. Outpatient hospital services require a copay of $0 to $550, observation services carry a $550 daily copay, and outpatient substance abuse sessions have copays ranging from $0 to $25, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization is covered by AARP Medicare Advantage from UHC NM-0006 (PPO) with a $55.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered under the AARP Medicare Advantage from UHC NM-0006 (PPO). Ambulance services require prior authorization and have a $290.00 copay with no coinsurance for both ground and air transport, while transportation services are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC NM-0006 (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 copay of $0 to $50 and 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 NM-0006 (PPO) offers primary care and telehealth services with no copay and no coinsurance, and specialist visits with a $0 to $50 copay and no coinsurance. Physical, occupational, speech, and mental health therapies feature copays ranging from $0 to $45 with no coinsurance, while routine chiropractic care is not covered.
Preventive Services See details
Preventive Services are partially covered by AARP Medicare Advantage from UHC NM-0006 (PPO) with no copay and no coinsurance for covered options like annual physical exams, fitness benefits, and kidney disease education. Sub-services that are not covered under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC NM-0006 (PPO), offering one routine hearing exam per year with no copay, no coinsurance, and no deductible. Up to two prescription or OTC hearing aids are covered per year with no coinsurance and copays ranging from $199.00 to $1,249.00, though fitting evaluations and inner, outer, and over-the-ear prescription aids are not covered.
Vision Services See details
Vision Services are partially covered by AARP Medicare Advantage from UHC NM-0006 (PPO), offering routine eye exams with no copay and no coinsurance, and eyewear with no coinsurance and a $300 limit every two years. Covered eyewear includes contact lenses with no copay, eyeglass frames with no copay, and eyeglass lenses with a $0 to $153 copay, while other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered under AARP Medicare Advantage from UHC NM-0006 (PPO), which offers Medicare-covered dental care with no copay and a 20% coinsurance, alongside preventive services like cleanings, exams, and X-rays with no copay and no coinsurance. However, several comprehensive sub-services are not covered, including restorative, endodontics, periodontics, prosthodontics, oral surgery, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC NM-0006 (PPO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry no copay and 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC NM-0006 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
AARP Medicare Advantage from UHC NM-0006 (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are available with no copay, while diabetic therapeutic shoes or inserts require a 20% coinsurance, with prior authorization required for most equipment.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC NM-0006 (PPO) covers diagnostic and radiological services, offering lab services and diagnostic radiology with no copays and no coinsurance. Diagnostic tests require a $45 copay with no coinsurance, outpatient X-rays require a $30 copay, and therapeutic radiological services carry a 20% coinsurance, with prior authorization required.
Home Health Services See details
AARP Medicare Advantage from UHC NM-0006 (PPO) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC NM-0006 (PPO) does not cover Cardiac Rehabilitation Services, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC NM-0006 (PPO) with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required, additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
Other services are partially covered by AARP Medicare Advantage from UHC NM-0006 (PPO), offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit, and the meal benefit requires prior authorization.
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