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AARP Medicare Advantage Patriot No Rx EP-MA1 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx EP-MA1 (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 Patriot No Rx EP-MA1 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx EP-MA1 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Texas and New Mexico. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage Patriot No Rx EP-MA1 (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage Patriot No Rx EP-MA1 (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 Patriot No Rx EP-MA1 (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. Additionally, this plan comes with a Part B Premium reduction of $50.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx EP-MA1 (PPO).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx EP-MA1 (PPO) plan offers a range of benefits with varying cost-sharing. You can expect no copay for primary care visits, preventive services, vision exams, and dental cleanings. You will pay a copay for inpatient hospital stays, outpatient services, ambulance services, and many other services, with some services having a coinsurance. This plan covers a variety of services, including hearing exams and hearing aids, with a copay for hearing aids. You will also find coverage for home health services, skilled nursing facilities, and diagnostic services. The plan includes coverage for emergency services, and offers additional benefits like an over-the-counter allowance and a meal benefit with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $425 copay for days 1-7, and no copay for days 8-90, with no coinsurance. For Inpatient Hospital Psychiatric, you will pay a $425 copay for days 1-5, and no copay for days 6-90, with no coinsurance. Additional Days for Inpatient Hospital-Acute has no copay and no coinsurance for days 91-999. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay 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 $425, and observation services with a $425 copay. Ambulatory Surgical Center (ASC) services and outpatient blood services have no copay, while individual outpatient substance abuse sessions have a copay between $0 and $25, and group sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the AARP Medicare Advantage Patriot No Rx EP-MA1 (PPO) plan, with a $290 copay for both ground and air ambulance services and no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered with a $125 copay, and there is no coinsurance. Urgently Needed Services are covered with a copay between $0 and $55, with no coinsurance. Worldwide Emergency Services are covered, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, all with no copay and no coinsurance.
Primary Care See details
The AARP Medicare Advantage Patriot No Rx EP-MA1 (PPO) plan covers primary care physician services with no copay. Chiropractic services have a $20 copay, while routine chiropractic care is not covered. Occupational therapy services have a copay between $0 and $45. Physician specialist services have a copay between $0 and $55. Mental health specialty services have copays of $0 to $25 for individual sessions and $15 for group sessions. Podiatry services and routine foot care have a $45 copay. Other health care professional services have a copay between $0 and $55. Psychiatric services have copays of $0 to $25 for individual sessions and $15 for group sessions. Physical therapy and speech-language pathology services have a copay between $0 and $50. Additional telehealth benefits have no copay, and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and other preventive services with a copay as specified. Additional services such as Health Education, In-Home Safety Assessment, and others are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered with no copay for one visit per year. Prescription hearing aids (all types) are covered with a copay between $199 and $1249 for up to two hearing aids every year, while OTC hearing aids have a copay between $99 and $829. Fitting/evaluation for hearing aids, and prescription hearing aids (inner ear, outer ear, and 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, and eyewear has no copay, although eyeglasses (lenses and frames) and upgrades are not covered. Contact lenses, eyeglass lenses, and eyeglass frames have no copay.
Dental Services See details
Dental services are covered, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive services, each with a $0 copay. Medicare Dental Services are covered with a 20% coinsurance, and orthodontic, restorative, and other services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered with a coinsurance of 20%. Prior authorization is required.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with varying cost sharing. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
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 up to $250, while Therapeutic Radiological Services have a coinsurance of up to 20%. Outpatient X-Ray Services have a $35 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Patriot No Rx EP-MA1 (PPO) plan 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 not covered by the AARP Medicare Advantage Patriot No Rx EP-MA1 (PPO) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage Patriot No Rx EP-MA1 (PPO) plan. There is no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) items and a meal benefit, with no copay for either. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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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.
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