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AARP Medicare Advantage Giveback from UHC NM-8 (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-8 (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-8 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Giveback from UHC NM-8 (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 Giveback from UHC NM-8 (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-8 (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-8 (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 $65.00. 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-8 (PPO) plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, there is no copay for standard pharmacy fills or mail-order deliveries. Tier 2 generic medications require a $12 copay for a 1-month supply at standard pharmacies, but you can avoid this cost entirely with no copay for a 3-month supply through preferred mail order. For brand-name and specialty medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require an 18% coinsurance for both standard pharmacy and mail-order options. Tier 4 non-preferred drugs carry a 28% coinsurance, while Tier 5 specialty tier drugs require a 26% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage Giveback from UHC NM-8 (PPO) offers comprehensive medical coverage with no copay for primary care visits, telehealth, and annual physical exams, while specialist visits require a copay of $0 to $60. For hospital stays, inpatient care features a $450 daily copay for the first five days and no copay for days six through 90, with no coinsurance. Emergency room visits carry a $130 copay, which is waived if you are admitted, while outpatient services range from no copay to a $450 copay with no coinsurance. Routine hearing and vision exams are covered with no copay, alongside allowances for eyewear and hearing aids, though routine dental services are not covered. Skilled nursing facility stays require no copay for the first 20 days, while medical equipment and dialysis services generally require a 20% coinsurance. Home health services are fully covered with no copay or coinsurance, helping to keep out-of-pocket costs predictable for essential healthcare needs.
Inpatient Hospital See details
AARP Medicare Advantage Giveback from UHC NM-8 (PPO) partially covers inpatient hospital care with no coinsurance, requiring a $450 copay for days 1 through 5 and no copay for days 6 through 90 for both acute and psychiatric stays. Prior authorization is required, and while unlimited additional acute days are covered at no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by the AARP Medicare Advantage Giveback from UHC NM-8 (PPO) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay ranging from no copay to $450, observation services carry a $450 daily copay, and outpatient substance abuse services require a $15 copay for group sessions and up to a $25 copay for individual sessions.
Partial Hospitalization See details
The AARP Medicare Advantage Giveback from UHC NM-8 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance services are covered by the AARP Medicare Advantage Giveback from UHC NM-8 (PPO) with a $145 copay and no coinsurance for ground and air transport, though prior authorization is required. For transportation, some services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
The AARP Medicare Advantage Giveback from UHC NM-8 (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 copays and no coinsurance.
Primary Care See details
Primary care benefits for the AARP Medicare Advantage Giveback from UHC NM-8 (PPO) feature no copay and no coinsurance for primary care and telehealth visits, while specialist visits range from a $0 to $60 copay with no coinsurance. Physical, occupational, and speech therapies require a $30 copay with no coinsurance, and while some chiropractic services are covered, routine and other chiropractic services are not covered. Other services like podiatry require a $45 copay, and mental health sessions range from a $0 to $25 copay, all with no coinsurance.
Preventive Services See details
Preventive Services are partially covered by the AARP Medicare Advantage Giveback from UHC NM-8 (PPO) with no copay and no coinsurance for covered services like annual physical exams, fitness benefits, kidney disease education, and various screenings. However, sub-services such as health education, in-home safety assessments, PERS, medical nutrition therapy, 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, smoking cessation, disease management, telemonitoring, remote access, home safety modifications, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by the AARP Medicare Advantage Giveback from UHC NM-8 (PPO), featuring no copay and no coinsurance for one routine hearing exam yearly, though fitting and evaluation services are not covered. Prescription hearing aids (copays of $199.00 to $1,249.00) and OTC hearing aids (copays of $199.00 to $829.00) are covered up to two per year with no coinsurance, but inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by the AARP Medicare Advantage Giveback from UHC NM-8 (PPO), offering annual routine eye exams and select eyewear with no coinsurance and no copay, although eyeglass lenses may require a copay of up to $153. A $150 combined allowance is provided every two years for eyewear, while other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage Giveback from UHC NM-8 (PPO) partially covers dental services, offering Medicare-covered dental care with no copay and a 20% coinsurance, subject to prior authorization. Routine preventive and comprehensive dental services, including oral exams, cleanings, x-rays, fluoride, restorative services, and implants, are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered with no copay under the AARP Medicare Advantage Giveback from UHC NM-8 (PPO), though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy and insulin, carry no coinsurance to 20% coinsurance, with insulin drugs also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Giveback from UHC NM-8 (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-8 (PPO), featuring no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies from specified manufacturers are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage Giveback from UHC NM-8 (PPO) with no coinsurance, though prior authorization is required. Under this coverage, lab services and diagnostic radiology services have no copay, diagnostic tests and outpatient X-rays require a $5 copay, and therapeutic radiological services have a copay starting at $50.
Home Health Services See details
The AARP Medicare Advantage Giveback from UHC NM-8 (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage Giveback from UHC NM-8 (PPO) does not cover Cardiac Rehabilitation Services, as all associated sub-services, including intensive cardiac, pulmonary, and SET for PAD rehabilitation, are excluded from coverage.
Skilled Nursing Facility (SNF) See details
The AARP Medicare Advantage Giveback from UHC NM-8 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and additional days beyond the standard Medicare-covered 100 days are not covered.
Other Services See details
Other Services are not covered under the AARP Medicare Advantage Giveback from UHC NM-8 (PPO), meaning there is no coverage, copay, or coinsurance for acupuncture, over-the-counter (OTC) items, and meal benefits.
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