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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 2026, 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 2026.
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 $45.60. 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 $615.00 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 features an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for covered medications before the plan begins to pay its share of the costs. Understanding this upfront cost is an important step in evaluating your overall yearly healthcare expenses. Specific prescription drug tier details, including individual copayments and coinsurance percentages, are currently not available for this plan. To get a complete picture of your potential medication costs, you will want to verify how your specific prescriptions are categorized once detailed tier information is provided.
Additional Benefits
The AARP Medicare Advantage from UHC HI-5 (PPO) plan offers comprehensive coverage designed to minimize your out-of-pocket costs for essential medical services. Members enjoy no copay for primary care visits, telehealth, annual physicals, and home health services. For hospital stays, there is a $450 copay for days 1 through 5 and no copay for days 6 through 90, while emergency room visits carry a $130 copay that is waived if you are admitted. Supplemental benefits are also highly accessible, featuring no copay for routine dental, vision, and hearing exams, as well as no copay for fitness programs and over-the-counter items. Specialist visits require a low copay of $0 to $50, while services like diagnostic lab work and cardiac rehabilitation also feature no copay. Major medical needs such as durable medical equipment, dialysis, and Medicare Part B drugs require no copay and a standard 20% coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC HI-5 (PPO) covers inpatient hospital services with no coinsurance, requiring a $450 copay for days 1 to 5 and no copay for days 6 to 90. While unlimited additional acute hospital days are covered at no copay, this benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC HI-5 (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital and observation services require copays ranging from $0 to $450, while outpatient substance abuse sessions have copays up to $25.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC HI-5 (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC HI-5 (PPO) covers ground and air ambulance services with a $315 copay and no coinsurance. Transportation services are partially covered with no copay or coinsurance for up to 12 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC HI-5 (PPO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay ranging from $0 to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care and telehealth services are covered by the AARP Medicare Advantage from UHC HI-5 (PPO) plan with no copay and no coinsurance. Specialists, therapies, and mental health services feature copays ranging from $0 to $50 with no coinsurance, while chiropractic benefits are partially covered with a $10 copay for up to 12 routine visits per year (other chiropractic services are not covered).
Preventive Services See details
Preventive services are covered by the AARP Medicare Advantage from UHC HI-5 (PPO) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes training. Additional preventive benefits are only partially covered; while a fitness benefit and home safety devices are covered with no copay and no coinsurance, sub-services such as health education, in-home safety assessments, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services under the AARP Medicare Advantage from UHC HI-5 (PPO) plan are partially covered, providing one routine hearing exam per year with no copay and no coinsurance, but excluding fitting and evaluation services. Prescription and OTC hearing aids are covered up to two per year with no coinsurance and copays ranging from $199 to $1,249 and $199 to $829 respectively, though inner, outer, and over-the-ear prescription models are not covered.
Vision Services See details
AARP Medicare Advantage from UHC HI-5 (PPO) partially covers vision services with no deductibles or coinsurance, offering one routine eye exam per year with no copay, though other eye exams are excluded. Eyewear is covered up to a $150 combined limit every two years with no copay for contact lenses and frames, a $0 to $153 copay for lenses, while upgrades and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC HI-5 (PPO), excluding implant services and orthodontics which are not covered. Preventive care features no copay and no coinsurance up to a $4,000 annual maximum, while Medicare-covered services carry no copay and 20% coinsurance, and comprehensive treatments require no copay and 50% coinsurance.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC HI-5 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B drugs, including chemotherapy, radiation, and insulin, require a 0% to 20% coinsurance, with insulin also having a $35 copay and no plan deductible.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC HI-5 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
AARP Medicare Advantage from UHC HI-5 (PPO) covers medical equipment, including durable medical equipment, prosthetics, and medical supplies, with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for most equipment.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC HI-5 (PPO) covers diagnostic and radiological services with prior authorization, offering no copay or coinsurance for lab services and diagnostic radiology. Diagnostic tests require an $80 copay with no coinsurance, outpatient X-rays have a $30 copay, and therapeutic radiological services incur a 20% coinsurance.
Home Health Services See details
Home health services are covered by the AARP Medicare Advantage from UHC HI-5 (PPO) with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by the AARP Medicare Advantage from UHC HI-5 (PPO) with no copay and no coinsurance, though prior authorization is required. While some services are covered, specific sub-services including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy for symptomatic peripheral artery disease are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC HI-5 (PPO) with no coinsurance, featuring 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 inpatient hospital stay is not required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC HI-5 (PPO) partially covers other services, which include acupuncture with a $10.00 copay and no coinsurance (up to 12 treatments per year), as well as over-the-counter items and meal benefits with no copay and no coinsurance. Specific sub-services, including Other 1, Other 2, Other 3, and Dual Eligible SNPs with Highly Integrated Services, are not covered.
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