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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 2025, 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 2025.
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 $420.00 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 NM-0006 (PPO) plan has a $420.00 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy you use. For example, you'll pay a $12.00 copay for preferred generic drugs at a standard pharmacy, and $100.00 copay for preferred brand drugs. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC NM-0006 (PPO) plan offers a range of benefits, including inpatient hospital stays with a copay, and outpatient services with varying copays. Emergency and primary care services have copays, and preventive services are available at no cost. This plan also includes coverage for hearing, vision, and dental services, with copays or coinsurance applying to certain services. Additional benefits such as ambulance, home health, and skilled nursing facility services are covered with copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $325 for days 1-6, and no copay for days 7-90 for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Additional days for Inpatient Hospital-Acute have no copay, while Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with copays ranging from $0 to $325, observation services with a $325 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services include individual sessions with copays from $0 to $25 and group sessions with a $15 copay, and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by AARP Medicare Advantage from UHC NM-0006 (PPO). This benefit has a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC NM-0006 (PPO) plan. Ground and Air Ambulance Services have a $290 copay, and there is no coinsurance; however, transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a copay between $0 and $40, Physician Specialist Services with a copay between $0 and $40, and Mental Health Specialty Services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Podiatry Services and Other Health Care Professional services have a copay between $40 and $40. Psychiatric Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $40, Additional Telehealth Benefits have no copay, and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional preventive services with no copay for glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit. 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, and counseling services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and prescription hearing aids are covered with a copay between $199 and $1249. OTC hearing aids are covered with a copay between $99 and $829, while fitting/evaluation for hearing aids, and prescription hearing aids for inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include eye exams, eyewear, contact lenses, and eyeglass lenses. Routine eye exams, eyewear, and contact lenses have no copay, while eyeglass lenses have a copay between $0 and $153. Eyeglass frames are covered with no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC NM-0006 (PPO) plan covers dental services, with a 20% coinsurance for Medicare Dental Services, and no copay for oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, prosthodontics, fixed, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC NM-0006 (PPO) plan, but require prior authorization. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics, Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance, while Prosthetic Devices, Medical Supplies, and Diabetic Therapeutic Shoes/Inserts also have a 20% coinsurance; Diabetic Supplies have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for diagnostic procedures/tests with a copay of $50, lab services with no copay, and outpatient x-ray services with a $25 copay. Diagnostic radiological services have a maximum copay of $100, and therapeutic radiological services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC NM-0006 (PPO) with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the AARP Medicare Advantage from UHC NM-0006 (PPO) plan, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage from UHC NM-0006 (PPO) plan. There is no copay for days 1-20, but there is a $203 copay for days 21-100.
Other Services See details
Under the "Other Services" benefit, 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. Over-the-Counter (OTC) Items and Meal Benefit are covered with no copay; the meal benefit requires prior authorization.
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