A non-government entity
AARP Medicare Advantage Giveback from UHC PA-12 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Giveback from UHC PA-12 (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 PA-12 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Giveback from UHC PA-12 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Pennsylvania. 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 PA-12 (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 PA-12 (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 PA-12 (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 $60.00. 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 $13900.00 (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 $13900.00 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 Giveback from UHC PA-12 (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The AARP Medicare Advantage Giveback from UHC PA-12 (PPO) features a $600 drug deductible. For Tier 1 preferred generic drugs, you will pay no copay for 1-month and 3-month supplies at standard pharmacies and through mail order. Tier 2 generic drugs carry a $14 copay for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay through preferred mail order. For Tier 3 preferred brand drugs, the plan charges a 16% coinsurance for 1-month and 3-month supplies. Tier 4 non-preferred drugs require a 33% coinsurance, and Tier 5 specialty drugs require a 26% coinsurance for a 1-month supply. These coinsurance rates apply to both standard pharmacy and mail order options.
Additional Benefits
The AARP Medicare Advantage Giveback from UHC PA-12 (PPO) offers affordable coverage for everyday healthcare needs, featuring no copays or coinsurance for primary care visits, preventive dental cleanings, annual eye exams, and routine hearing tests. For specialized care, specialist visits and physical therapy require low copays ranging from $0 to $55, while diagnostic lab services and home health care are available with no copay. If you require inpatient hospital stays, the plan features a $555 daily copay for the first few days, after which there is no copay. Emergency medical care is accessible with a $115 copay, which is waived upon hospital admission, while ambulance services carry a $270 copay. For durable medical equipment, dialysis, and Medicare Part B drugs, members generally pay a 20% coinsurance with no copay, though Part B insulin is capped at a $35 copay. Skilled nursing facility stays are also covered with no copay for the first 20 days, followed by a daily copay of $218 for days 21 through 100.
Inpatient Hospital See details
AARP Medicare Advantage Giveback from UHC PA-12 (PPO) partially covers inpatient hospital services with no coinsurance, excluding upgrades, non-Medicare-covered stays, and additional psychiatric days. Acute stays require a $555 daily copay for days 1-4 and no copay for days 5 and beyond, while psychiatric stays require a $555 daily copay for days 1-3 and no copay for days 4-90.
Outpatient Services See details
AARP Medicare Advantage Giveback from UHC PA-12 (PPO) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital and observation services require a copay of $0 to $555, while outpatient substance abuse services have a copay ranging from $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage Giveback from UHC PA-12 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services under the AARP Medicare Advantage Giveback from UHC PA-12 (PPO) feature a $270 copay and no coinsurance for both ground and air ambulance services, which require prior authorization. Routine transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage Giveback from UHC PA-12 (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay to a $40 copay 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 Giveback from UHC PA-12 (PPO) provides primary care and telehealth services with no copay and no coinsurance, while chiropractic services are not covered. Specialist visits, physical therapy, mental health, and podiatry services are covered with no coinsurance and copays ranging from $0 to $55.
Preventive Services See details
Preventive services are partially covered under the AARP Medicare Advantage Giveback from UHC PA-12 (PPO) with no copay and no coinsurance for covered options like annual physical exams, kidney disease education, and fitness benefits. However, several additional preventive services are not covered, including health education, in-home safety assessments, personal emergency response systems, 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.
Hearing Services See details
Hearing services are partially covered by the AARP Medicare Advantage Giveback from UHC PA-12 (PPO), featuring one annual routine hearing exam with no copay or coinsurance, though fitting and evaluation exams are not covered. Up to two prescription and OTC hearing aids are covered per year with no coinsurance and copays ranging from $199 to $1,249, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision Services under the AARP Medicare Advantage Giveback from UHC PA-12 (PPO) are partially covered, offering one routine eye exam every year with no deductible, no copay, and no coinsurance, though prior authorization is required. Other eye exam services and all eyewear, including contact lenses and eyeglasses, are not covered.
Dental Services See details
Dental Services are partially covered by the AARP Medicare Advantage Giveback from UHC PA-12 (PPO), offering preventive care such as cleanings, exams, and x-rays with no copay and no coinsurance, while Medicare-covered dental services have no copay and a 20% coinsurance. Comprehensive services like restorative care, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the AARP Medicare Advantage Giveback from UHC PA-12 (PPO) with no copay and no coinsurance, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the AARP Medicare Advantage Giveback from UHC PA-12 (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
AARP Medicare Advantage Giveback from UHC PA-12 (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic services, with prior authorization required. Most of these benefits feature no copay and a 20% coinsurance, while diabetic supplies are covered with no copay.
Diagnostic and Radiological Services See details
AARP Medicare Advantage Giveback from UHC PA-12 (PPO) covers diagnostic and radiological services, featuring no copay and no coinsurance for lab services and diagnostic radiology. Diagnostic procedures and tests require a $45 copay with no coinsurance, outpatient x-rays have a $30 copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
AARP Medicare Advantage Giveback from UHC PA-12 (PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no copay and no coinsurance under the AARP Medicare Advantage Giveback from UHC PA-12 (PPO), with prior authorization required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
The AARP Medicare Advantage Giveback from UHC PA-12 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by the AARP Medicare Advantage Giveback from UHC PA-12 (PPO), which includes a meal benefit for chronic illnesses with no copay and no coinsurance, subject to prior authorization. Acupuncture and Over-the-Counter (OTC) items are not covered under this benefit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved