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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 2026, 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 2026.
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 $19.00. 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 $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 from UHC ID-0011 (PPO) plan features an annual prescription drug deductible of $600. For Tier 1 preferred generic drugs, members pay no copay for standard pharmacy fills or three-month mail-order options. Tier 2 generic drugs require a $10 copay for a one-month supply at standard pharmacies, though you can enjoy no copay with a three-month preferred mail-order prescription. For higher-tier medications, cost-sharing is structured as coinsurance instead of flat copays. Tier 3 preferred brand drugs require a 15% coinsurance for both standard pharmacy and mail-order fills. Tier 4 non-preferred drugs carry a 43% coinsurance, while Tier 5 specialty drugs require a 26% coinsurance for a one-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC ID-0011 (PPO) plan offers robust coverage for essential medical services with predictable out-of-pocket costs and no coinsurance for many benefits. You will pay no copay for primary care visits, telehealth, outpatient lab services, and diagnostic radiology, while specialist visits require a copay of $0 to $55. Emergency services carry a $130 copay, which is waived if you are admitted, and inpatient hospital stays feature a $520 daily copay for the first few days followed by no copay. Everyday health services like routine eye exams, preventive dental cleanings, and routine hearing tests are covered with no copay and no coinsurance. For specialized care, durable medical equipment and dialysis services require a 20% coinsurance, while prescription hearing aids and eyeglass lenses are covered with variable copays. Home health care and cardiac rehabilitation services are also accessible with no copay and no coinsurance, ensuring affordable ongoing recovery.
Inpatient Hospital See details
AARP Medicare Advantage from UHC ID-0011 (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, though prior authorization is required. For acute stays, there is a $520 copay for days 1-5 and no copay for days 6 and beyond, while psychiatric stays require a $520 copay for days 1-4 and no copay for days 5-90, with upgrades, non-Medicare-covered stays, and additional psychiatric days not covered.
Outpatient Services See details
Outpatient services under the AARP Medicare Advantage from UHC ID-0011 (PPO) feature no coinsurance, though prior authorization is required for most services. There is no copay for ambulatory surgical center and outpatient blood services, while outpatient hospital copays range from $0 to $520, observation services cost $520 per day, and outpatient substance abuse sessions require a $0 to $25 copay.
Partial Hospitalization See details
Partial hospitalization is covered under the AARP Medicare Advantage from UHC ID-0011 (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC ID-0011 (PPO) covers ground and air ambulance services with a $125 copay and no coinsurance, though prior authorization is required. For transportation benefits, some services are covered but transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC ID-0011 (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC ID-0011 (PPO) covers primary care and telehealth visits with no copay and no coinsurance, and specialist visits with a $0 to $55 copay and no coinsurance. Physical therapy requires a $35 copay and occupational therapy requires a $25 copay (both with no coinsurance), while some chiropractic services are covered but routine and other chiropractic services are not.
Preventive Services See details
AARP Medicare Advantage from UHC ID-0011 (PPO) offers partially covered preventive services with no copay and no coinsurance for covered benefits like annual physical exams, fitness benefits, and kidney disease education. However, several additional services are not covered, including health education, in-home safety assessments, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
AARP Medicare Advantage from UHC ID-0011 (PPO) partially covers hearing services, featuring routine hearing exams with no copay and no coinsurance, while excluding fitting and evaluation exams. Prescription and OTC hearing aids are covered 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
AARP Medicare Advantage from UHC ID-0011 (PPO) partially covers vision services with no deductibles and no coinsurance, offering routine eye exams, contact lenses, and eyeglass frames with no copay. Eyeglass lenses are covered with a copay of $0 to $153 under a $300 maximum limit every two years, but other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC ID-0011 (PPO) partially covers dental services, offering Medicare-covered dental with no copay and 20% coinsurance, and preventive care like cleanings and exams with no copay and no coinsurance. However, orthodontic, restorative, endodontic, periodontic, prosthodontic, implant, and oral surgery services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by AARP Medicare Advantage from UHC ID-0011 (PPO) with no copay, though prior authorization and step therapy are required. Under this benefit, covered Medicare Part B chemotherapy and other Part B drugs require no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the AARP Medicare Advantage from UHC ID-0011 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC ID-0011 (PPO) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are available with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC ID-0011 (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Outpatient lab services and diagnostic radiology are available with no copay, while diagnostic procedures and X-rays require a $5 copay, and therapeutic radiology requires a $15 copay.
Home Health Services See details
AARP Medicare Advantage from UHC ID-0011 (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage from UHC ID-0011 (PPO) with no copay and no coinsurance, though prior authorization is required. Although some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by AARP Medicare Advantage from UHC ID-0011 (PPO) with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not necessary, and additional days beyond the standard 100 days are not covered.
Other Services See details
AARP Medicare Advantage from UHC ID-0011 (PPO) partially covers other services, offering a chronic illness meal benefit with no copay and no coinsurance, though prior authorization is required. Acupuncture, over-the-counter (OTC) items, and other supplemental services are not covered under this benefit.
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