A non-government entity
AARP Medicare Advantage from UHC PA-0013 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC PA-0013 (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 from UHC PA-0013 (PPO) in 2025, please refer to our full plan details page.
This summary reflects 2025 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
AARP Medicare Advantage from UHC PA-0013 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for the 2025 plan year to people living in Select Counties in Pennsylvania. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC PA-0013 (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 from UHC PA-0013 (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 from UHC PA-0013 (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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $420.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6900.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $6900.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $14000.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $14000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
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 from UHC PA-0013 (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
Drug Coverage
The AARP Medicare Advantage from UHC PA-0013 (PPO) plan has a $420 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you'll pay a $10 copay for preferred generic drugs at a standard pharmacy, and a $100 copay for preferred brand drugs at a standard pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC PA-0013 (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $250 copay for the first six days, but no copay for the following days. Outpatient services, primary care, preventive services, hearing exams, and vision services such as eye exams and contact lenses, often have no copay. Emergency services, ambulance services, and home health services also have copays. Dental services include 20% coinsurance for Medicare dental services, while the plan covers other dental services with no copay. The plan also provides coverage for services like partial hospitalization, dialysis, and medical equipment, with varying copays and coinsurance, as well as home infusion and skilled nursing facility services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Acute and Psychiatric care; for days 1-6 there is a $250 copay, and for days 7-90 there is no copay. Additional days for Inpatient Hospital-Acute have no copay, while Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and Additional days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $250, and observation services with a $250 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, while Outpatient Substance Abuse Services cover individual sessions with a copay between $0 and $25, and group sessions with a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the AARP Medicare Advantage from UHC PA-0013 (PPO) plan, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground and Air Ambulance Services have a $195 copay with no coinsurance, while transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services from AARP Medicare Advantage from UHC PA-0013 (PPO) includes emergency services with a $110 copay and no coinsurance. Urgently needed services have a copay between $0 and $45, with no coinsurance. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are covered with no coinsurance and no copay.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Additional Telehealth Benefits, and Opioid Treatment Program Services have no copay. Chiropractic Services have a $15 copay, while Physician Specialist Services have a copay between $0 and $35. Mental Health Specialty Services have a copay between $0 and $25 for individual sessions and $15 for group sessions. Podiatry Services and Other Health Care Professional have a copay between $35.00 and $35.00. Psychiatric Services have a copay between $0 and $25 for individual sessions and $15 for group sessions. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $25.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional preventive services, kidney disease education services, and other preventive services; however, additional preventive services, and other preventive services have a copay, and various services such as Health Education, In-Home Safety Assessment, and others are not covered. The plan covers Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with no copay.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are limited to one per year. Prescription hearing aids are covered with a copay between $199 and $1249, limited to two per year, while OTC hearing aids have a copay between $99 and $829, with a limit of two per year. Fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
Vision services include eye exams, eyewear, contact lenses, eyeglass lenses, and eyeglass frames. Eye exams and routine eye exams have no copay. Contact lenses and eyeglass frames have no copay. Eyeglasses (lenses and frames) and upgrades are not covered. Eyeglass lenses have a copay of $0 to $153.
Dental Services See details
The AARP Medicare Advantage from UHC PA-0013 (PPO) plan covers Medicare Dental Services with 20% coinsurance, and other dental services with no copay for oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services. This plan does not cover orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a 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
Medical Equipment benefits are covered, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services and radiological services. Diagnostic Procedures/Tests have a $25 copay, while Lab Services have no copay, and outpatient X-Ray services have a $15 copay. Diagnostic Radiological Services have a maximum copay of $150, and Therapeutic Radiological Services have a minimum coinsurance of 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 provide specific cost information, and prior authorization is required. 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. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes 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.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
SMID: MULTIPLAN_HCIHNMEDADVRX27_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 or 1-800-MEDICARE 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.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
© 2026 Dog Media Solutions LLC. All rights reserved