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AARP Medicare Advantage Giveback from UHC NM-7 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Giveback from UHC NM-7 (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 Giveback from UHC NM-7 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Giveback from UHC NM-7 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Albuquerque Metro Area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage Giveback from UHC NM-7 (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 Giveback from UHC NM-7 (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 Giveback from UHC NM-7 (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 $55.00. 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.
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:
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Drug Coverage
The AARP Medicare Advantage Giveback from UHC NM-7 (PPO) features an annual drug deductible of $600. For Tier 1 preferred generic and Tier 2 generic medications, members pay no copay for a 1-month or 3-month supply at standard pharmacies, as well as no copay for a 3-month supply through standard mail order. This makes managing common, everyday generic prescriptions highly affordable under this plan. For higher-tier medications, costs are structured as coinsurance rather than set copayments. Tier 3 preferred brand drugs require a 16% coinsurance for standard pharmacy and standard mail order fills. Meanwhile, Tier 4 non-preferred drugs carry a 36% coinsurance, and Tier 5 specialty drugs require a 26% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage Giveback from UHC NM-7 (PPO) offers comprehensive coverage for core medical needs, featuring no copay and no coinsurance for primary care visits, preventive care, and home health services. Specialist visits require a copay of up to $60 with no coinsurance, while emergency room visits carry a $130 copay that is waived upon hospital admission. For hospital stays, members pay a $550 daily copay for the first few days of inpatient care, and skilled nursing facility stays are covered with no copay for the first 20 days. For specialized care, the plan provides annual vision and hearing exams with no copay, plus coverage for hearing aids and a $150 eyewear allowance. While routine dental services, acupuncture, and over-the-counter items are not covered, Medicare-covered dental services, dialysis, and durable medical equipment are available with a 20% coinsurance. Diagnostic services like lab tests and diabetic supplies feature no copay, helping members manage their health with predictable out-of-pocket costs.
Inpatient Hospital See details
The AARP Medicare Advantage Giveback from UHC NM-7 (PPO) plan partially covers inpatient hospital services with no coinsurance, requiring a $550 copay for days 1 through 5 of acute stays (with no copay for days 6 and beyond) and a $550 copay for days 1 through 4 of psychiatric stays (with no copay for days 5 through 90). Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage Giveback from UHC NM-7 (PPO) covers outpatient services with no coinsurance, including outpatient hospital services with a copay of $0 to $550 and observation services with a $550 daily copay. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance. Outpatient substance abuse services also carry no coinsurance, with copays of $0 to $25 for individual sessions and a $15 copay for group sessions.
Partial Hospitalization See details
Partial hospitalization services are covered by the AARP Medicare Advantage Giveback from UHC NM-7 (PPO) with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Giveback from UHC NM-7 (PPO) covers Medicare-approved ground and air ambulance services with a $270 copay and no coinsurance, though prior authorization is required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage Giveback from UHC NM-7 (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 feature a copay ranging from no copay to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are fully covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage Giveback from UHC NM-7 (PPO) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $60 copay and no coinsurance. Other services like physical therapy require a $60 copay and no coinsurance, while chiropractic care is partially covered with a $15 copay and no coinsurance, with routine and other chiropractic services not covered.
Preventive Services See details
AARP Medicare Advantage Giveback from UHC NM-7 (PPO) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive services are partially covered, offering a fitness benefit with no copay, but excluding services such as health education, in-home safety assessments, nutritional benefits, and personal emergency response systems.
Hearing Services See details
AARP Medicare Advantage Giveback from UHC NM-7 (PPO) covers annual routine hearing exams with no copay or coinsurance, though fitting and evaluation services are not covered. The plan also covers up to two prescription hearing aids (with a $199 to $1,249 copay and no coinsurance) and up to two OTC hearing aids (with a $199 to $829 copay and no coinsurance) per year, though inner, outer, and over-the-ear prescription models are excluded.
Vision Services See details
Vision services are partially covered by the AARP Medicare Advantage Giveback from UHC NM-7 (PPO), featuring no copay and no coinsurance for annual routine eye exams, contact lenses, and eyeglass frames, subject to a $150 combined eyewear limit every two years. Eyeglass lenses require a $0 to $153 copay and no coinsurance, while other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services under the AARP Medicare Advantage Giveback from UHC NM-7 (PPO) are limited to Medicare-covered dental care, which is available with no copay and a 20% coinsurance. Routine preventive and comprehensive dental services, including cleanings, exams, x-rays, and restorative treatments, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by the AARP Medicare Advantage Giveback from UHC NM-7 (PPO) with no copay and no coinsurance, although prior authorization is required. Covered Medicare Part B chemotherapy and other drugs have coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the AARP Medicare Advantage Giveback from UHC NM-7 (PPO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by the AARP Medicare Advantage Giveback from UHC NM-7 (PPO) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
AARP Medicare Advantage Giveback from UHC NM-7 (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. There is no copay for lab services and diagnostic radiological services, while members pay a $5 copay for diagnostic tests, a $10 copay for outpatient X-rays, and a $60 copay for therapeutic radiological services.
Home Health Services See details
The AARP Medicare Advantage Giveback from UHC NM-7 (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the AARP Medicare Advantage Giveback from UHC NM-7 (PPO) with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by the AARP Medicare Advantage Giveback from UHC NM-7 (PPO) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. You will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though coverage does not extend to additional days beyond the standard Medicare limit.
Other Services See details
Other Services are not covered under the AARP Medicare Advantage Giveback from UHC NM-7 (PPO), with acupuncture, over-the-counter (OTC) items, and meal benefits all excluded from coverage. Since these benefits are not covered, members are responsible for all out-of-pocket costs and do not have plan copays or coinsurance for these services.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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