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AARP Medicare Advantage from UHC ID-0011 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC ID-0011 (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 ID-0011 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC ID-0011 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Idaho. 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 ID-0011 (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 ID-0011 (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 ID-0011 (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. 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 from UHC ID-0011 (PPO) plan has a $420 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For generic drugs at a standard pharmacy, you will pay a $10 or $47 copay. For preferred brand drugs, the copay is $100. Non-preferred drugs have a 28% coinsurance. After your total drug costs reach $2000, you will enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC ID-0011 (PPO) plan offers a range of benefits, including inpatient hospital care with a $295 copay for the first few days, and outpatient services with copays ranging from $0 to $295. You'll also find coverage for primary care with no copay, along with specialist services, vision, and dental coverage. Additional benefits include ambulance services with a $275 copay, emergency services with a $125 copay, and preventive services with no copay. Hearing exams and hearing aids are also covered with varying copays, and home health services are available with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered. For acute care, you'll pay a $295 copay for days 1-5, and no copay for days 6-90, with additional days covered at no copay; non-Medicare-covered stays and upgrades are not covered. Inpatient Hospital Psychiatric care has a $295 copay for days 1-4 and no copay for days 5-90, with additional days and non-Medicare-covered stays not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by this plan, with copays ranging from $0 to $295. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Outpatient Substance Abuse Services are covered with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC ID-0011 (PPO) plan with a $55 copay, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by AARP Medicare Advantage from UHC ID-0011 (PPO). Ground and Air Ambulance Services have a $275 copay, and there is no coinsurance; however, Transportation Services to a plan-approved or 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 from UHC ID-0011 (PPO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55, and Worldwide Emergency Services have a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage from UHC ID-0011 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, and occupational therapy services with a copay between $0 and $25. The plan also covers physician specialist services with a copay between $0 and $40, mental health specialty services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and podiatry services with a $40 copay. Other benefits include other health care professional services with a copay between $0 and $40, psychiatric services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, physical therapy and speech-language pathology services with a copay between $0 and $25, additional telehealth benefits with no copay, and opioid treatment program services with no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services with no copay, and an annual physical exam with no copay. Additional preventive services, including Fitness Benefit and Remote Access Technologies, have no copay. Some services, such as Health Education, are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered for one visit per year with no copay. Prescription hearing aids are covered, with a copay between $199 and $1249 for all types, up to two per year, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are covered with a copay between $99 and $829, up to two per year. Fitting/evaluation for hearing aids is not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear has no copay, and contact lenses are covered, while eyeglasses (lenses and frames) and upgrades are not covered; eyeglass lenses are covered with a copay between $0 and $153, and eyeglass frames are covered once every two years.
Dental Services See details
Dental services include coverage for Medicare dental services with 20% coinsurance, oral exams with no copay, dental X-rays with no copay, prophylaxis (cleaning) with no copay, fluoride treatment with no copay, and other preventive dental services with no copay. Orthodontic, restorative, adjunctive general, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by AARP Medicare Advantage from UHC ID-0011 (PPO) and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay with 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 by the AARP Medicare Advantage from UHC ID-0011 (PPO) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment, Prosthetics, Medical Supplies, and Diabetic Equipment, is covered by AARP Medicare Advantage from UHC ID-0011 (PPO). Durable Medical Equipment has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a 20% coinsurance for Medicare-covered items, and Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered, including diagnostic procedures and tests with a $50 copay, and lab services with no copay. Diagnostic radiological services have a copay of at most $165, while therapeutic radiological services have a coinsurance of at least 20%, and outpatient X-rays have a $25 copay.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC ID-0011 (PPO) 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 cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required, and there is a copay for some services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC ID-0011 (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include 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.
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