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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 2025, 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 2025.
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 $73.00. 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 $495.00 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 $14000.00 (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 $14000.00 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 PA-12 (PPO) plan has a $495.00 deductible for prescription drugs. After you meet your deductible, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and the pharmacy you use. For example, you will pay a $14.00 copay for a preferred generic drug at a standard pharmacy. For preferred brand drugs, you will pay a $100.00 copay. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage Giveback from UHC PA-12 (PPO) plan offers coverage for a wide range of services with varying costs. You'll find no copays for primary care, preventive services, home health, and hearing and vision exams, while other services like inpatient hospital stays, outpatient services, and specialist visits have copays ranging from $15 to $475. This plan also covers essential services like ambulance, emergency, and dental with specific copays or coinsurance amounts. Additionally, the plan provides coverage for home infusion, dialysis, and medical equipment with some coinsurance requirements.
Inpatient Hospital See details
Inpatient Hospital services are covered, with a copay of $475 per admission for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute have no copay. Inpatient Hospital Psychiatric services have a copay of $475 for days 1-4, and no copay for days 5-90. Non-Medicare-covered stay and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $475, Observation Services with a $475 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and Outpatient Blood Services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage Giveback from UHC PA-12 (PPO) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage Giveback from UHC PA-12 (PPO) plan. Ground and Air Ambulance services have a $275 copay, with 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 Giveback from UHC PA-12 (PPO) plan. Emergency Services have a $110 copay with no coinsurance, Urgently Needed Services have a copay between $0 and $45 with no coinsurance, and Worldwide Emergency Services have no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Primary Care Physician Services have no copay, while Chiropractic Services have a $15 copay. Occupational Therapy Services have a copay between $0 and $20, and Physician Specialist Services have a copay between $0 and $50. Mental Health Specialty Services have a copay for individual sessions between $0 and $25, and a $15 copay for group sessions. Podiatry Services have a $40 copay, and Other Health Care Professional services have a copay between $0 and $50. Psychiatric Services have a copay for individual sessions between $0 and $25, and a $15 copay for group sessions. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $35, and Additional Telehealth Benefits have no copay. Opioid Treatment Program Services have no copay.
Preventive Services See details
The AARP Medicare Advantage Giveback from UHC PA-12 (PPO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, including Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, are covered with no copay. The plan does not cover Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, 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, Home and Bathroom Safety Devices and Modifications, or Counseling Services.
Hearing Services See details
Hearing exams have no copay, and routine hearing exams are covered once per year. Prescription hearing aids are covered, with a copay between $199 and $1249 for up to two hearing aids per year, but fitting/evaluation for hearing aids, and prescription hearing aids for inner, outer, and over-the-ear are not covered. OTC hearing aids have a copay between $99 and $829 for up to two hearing aids per year.
Vision Services See details
Vision services include eye exams with no copay, while routine eye exams are covered once per year with no copay. Eyewear benefits are covered, but contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare Dental Services. Oral exams, dental X-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. Orthodontic, restorative, adjunctive general, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, as well as Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires authorization, while Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic services, diagnostic procedures/tests with a $45 copay, lab services with no copay, and outpatient X-ray services with a $25 copay, are covered. Diagnostic Radiological Services have a copay of at most $200, and Therapeutic Radiological Services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Giveback from UHC PA-12 (PPO) plan with no copay and no coinsurance; however, 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 not covered by the AARP Medicare Advantage Giveback from UHC PA-12 (PPO) plan. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with prior authorization required. For days 1-20, there is no copay, and for days 21-100, the copay is $203.
Other Services See details
Other Services includes coverage for a meal benefit with no copay, but acupuncture, over-the-counter items, 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.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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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.
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