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AARP Medicare Advantage from UHC HI-5 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC HI-5 (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 HI-5 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC HI-5 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Hawaii. 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 HI-5 (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 HI-5 (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 HI-5 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $47.70. 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 $590.00 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 HI-5 (PPO) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the cost of your drugs in each tier until your total drug costs reach $2000. Once you reach $2000 in drug costs, you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), you may have a reduced premium. During the initial coverage phase, after you meet the deductible, your costs will vary depending on the specific drug tier and pharmacy, but the specific costs are not listed in this summary.
Additional Benefits
The AARP Medicare Advantage from UHC HI-5 (PPO) plan offers a range of benefits with varying costs. It covers inpatient hospital stays with a copay, and outpatient services with copays. Preventive, vision, and hearing services are available, and include no copay for routine services. The plan includes benefits for dental, home health, and medical equipment, with varying copays and coinsurance. Additional coverage includes ambulance services, emergency services, and some transportation services. The plan also offers coverage for a variety of other services, such as primary care visits, and covers some mental health services with copays.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care, with a copay of $425 for days 1-4 and no copay for days 5-90. Additional days for inpatient hospital acute care have no copay, while non-Medicare-covered stays and upgrades for inpatient hospital acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $425, observation services with a $425 copay, ambulatory surgical center 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 under the AARP Medicare Advantage from UHC HI-5 (PPO) plan, with a copay of $55. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground and air ambulance services have a $275 copay, while transportation services to a plan-approved health-related location have no copay for up to 12 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the AARP Medicare Advantage from UHC HI-5 (PPO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency, Urgent, and Transportation services have no copay.
Primary Care See details
Primary Care Physician Services have no copay. Chiropractic Services have a $10 copay. Occupational Therapy Services have a $0-$30 copay. Physician Specialist Services have a $0-$35 copay. Mental Health Specialty Services, including individual and group sessions, have a $0-$25 copay and a $15 copay, respectively. Podiatry Services and Routine Foot Care have a $35 copay. Other Health Care Professional services have a $0-$35 copay. Individual and Group Sessions for Psychiatric Services have a $0-$25 and $15 copay, respectively. Physical Therapy and Speech-Language Pathology Services have a $0-$30 copay. Additional Telehealth Benefits have no copay. Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, while other services such as Health Education, In-Home Safety Assessment, and Personal Emergency Response System (PERS) are not covered. Fitness Benefit, Glaucoma Screening, and Diabetes Self-Management Training are covered with no copay.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and OTC hearing aids. Routine hearing exams have no copay, and are limited to one per year. OTC hearing aids have a copay between $99 and $829. Prescription hearing aids have a copay between $199 and $1249, and are limited to two per year. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
The AARP Medicare Advantage from UHC HI-5 (PPO) plan covers vision services, including routine eye exams with no copay. Eyewear is covered, including contact lenses, eyeglass lenses, and eyeglass frames, all with no copay; however, eyeglasses (lenses and frames) and upgrades are not covered. Eyeglass lenses are limited to one pair every two years, while eyeglass frames are limited to one every two years, with a combined maximum of $300 for all eyewear every two years.
Dental Services See details
Dental services are covered, including Medicare dental services with 20% coinsurance. Oral exams, dental X-rays, other diagnostic and preventive services, and oral surgery are covered with no copay, while some services have visit limits that vary. Prosthodontics (removable and fixed) have coinsurance of 0-50%. Implants and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, there is 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 under the AARP Medicare Advantage from UHC HI-5 (PPO) plan, but prior authorization is required. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered. Diagnostic Procedures/Tests have a $25 copay, while Lab Services have no copay. Diagnostic Radiological Services may have a copay up to $250, and Therapeutic Radiological Services have at least 20% coinsurance, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC HI-5 (PPO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the AARP Medicare Advantage from UHC HI-5 (PPO) plan. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with a $0 copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
AARP Medicare Advantage from UHC HI-5 (PPO) covers acupuncture with a $10 copay, over-the-counter items with no copay, and a meal benefit with no copay; however, 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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