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AARP Medicare Advantage Patriot No Rx NM-MA02 (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-MA02 (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-MA02 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx NM-MA02 (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-MA02 (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-MA02 (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-MA02 (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 $115.00. 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:
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Drug Coverage
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx NM-MA02 (PPO).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx NM-MA02 (PPO) plan offers a range of benefits, including coverage for inpatient hospital stays, outpatient services, and emergency services with varying copays. Primary care, preventive services, vision, and dental services are also covered. Many of these services have no copay or a coinsurance, such as primary care, preventive services, and vision exams. Additional benefits include hearing services, with no copay for routine exams and copays for hearing aids. Home health services, medical equipment, and dialysis services are covered with no copay or coinsurance. However, some services, such as skilled nursing facilities, have copays.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered. For days 1-6, the copay is $315, and there is no copay for days 7-90, and additional days 91-999. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. For outpatient hospital services, the copay ranges from $0 to $315. Observation services have a copay of $315 per day, and ambulatory surgical center services have no copay. Individual sessions for outpatient substance abuse have a copay between $0 and $25, and group sessions have a copay of $15. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage Patriot No Rx NM-MA02 (PPO) plan with a $55 copay, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage Patriot No Rx NM-MA02 (PPO) plan, with a $290 copay for both ground and air ambulance services and no coinsurance. 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-MA02 (PPO) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, have no copay.
Primary Care See details
The AARP Medicare Advantage Patriot No Rx NM-MA02 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a copay between $0 and $45, and physician specialist services with a copay between $0 and $55. Mental health services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services are also covered with varying copays. Routine chiropractic care is not covered.
Preventive Services See details
The AARP Medicare Advantage Patriot No Rx NM-MA02 (PPO) plan covers preventive services, including an annual physical exam with no copay. Other preventive services, such as fitness benefits and home/bathroom safety devices, are also covered with no copay.
Hearing Services See details
Hearing Services include routine hearing exams with no copay, and prescription hearing aids with a copay between $199 and $1249 depending on the type of hearing aid, and OTC hearing aids with a copay between $99 and $829. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
The AARP Medicare Advantage Patriot No Rx NM-MA02 (PPO) plan covers vision services including eye exams with no copay, and eyewear. Eyewear coverage includes contact lenses, eyeglass lenses, and eyeglass frames, each with no copay; however, eyeglass lenses have a copay between $0.00 and $153.00. 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. Other services like 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 have no copay, but have limited visits. Prosthodontics, removable and fixed, have a coinsurance between 0% and 50%. Orthodontic Services and Implant Services 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 coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
The AARP Medicare Advantage Patriot No Rx NM-MA02 (PPO) plan covers Durable Medical Equipment (DME) with no copay and 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices are covered with 20% coinsurance, and Medical Supplies are covered with a 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic services, diagnostic procedures/tests, and outpatient X-ray services, are covered, with a $50 copay for diagnostic procedures/tests, a $25 copay for outpatient X-ray services, and a copay of up to $250 for diagnostic radiological services. Lab services have no copay, and therapeutic radiological services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered 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 covered, but the plan does not cover the following sub-services: Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required, and more copay information is available.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under "Other Services", 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 have no copay, and the plan offers a Meal Benefit with no copay and requires prior authorization.
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