AARP Medicare Advantage from UHC IL-0002 (HMO-POS)

Inpatient Hospital See details

Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For days 1-6, there is a $250 copay, and days 7-90 have no copay; additional days for Inpatient Hospital-Acute have no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric, are not covered.

Outpatient Services See details

Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a copay between $0 and $250, observation services have a $250 copay, ambulatory surgical center services have no copay, individual outpatient substance abuse sessions have a copay between $0 and $25, group outpatient substance abuse sessions have a $15 copay, and outpatient blood services have no copay.

Partial Hospitalization See details

Partial Hospitalization is covered under the AARP Medicare Advantage from UHC IL-0002 (HMO-POS) plan, with a $55 copay. Prior authorization is required for this benefit.

Ambulance and Transportation Services See details

Ambulance and Transportation Services are covered by AARP Medicare Advantage from UHC IL-0002 (HMO-POS). Ground and air ambulance services have a copay of $275, with no coinsurance. Transportation services to any health-related location are not covered.

Emergency Services See details

Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $140 copay with no coinsurance, while Urgently Needed Services have a copay between $0 and $40 with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay, and no coinsurance.

Primary Care See details

Primary Care Physician Services are covered with no copay. Chiropractic Services have a $20 copay, but Routine Care is not covered.

Occupational Therapy Services have a copay between $0 and $30. Physician Specialist Services have a copay between $0 and $30.

Mental Health Specialty Services have a copay for Individual Sessions between $0 and $25, and a $15 copay for Group Sessions. Podiatry Services and Routine Foot Care have a $30 copay for up to 6 visits per year.

Other Health Care Professional services have a copay between $0 and $30. Psychiatric Services have a copay for Individual Sessions between $0 and $25, and a $15 copay for Group Sessions. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $30. Additional Telehealth Benefits have no copay.

Opioid Treatment Program Services have no copay.

Preventive Services See details

Preventive Services include coverage for Medicare-covered services with no copay, an annual physical exam with no copay, and additional preventive services, including Fitness Benefit and Home and Bathroom Safety Devices and Modifications, with no copay. Other 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, while routine hearing exams are limited to one per year with no copay. Prescription hearing aids (all types) are covered with a copay between $199 and $1249 for two per year, and OTC hearing aids are covered with a copay between $99 and $829 for 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

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 for contact lenses and eyeglass frames, but eyeglass lenses have a copay between $0 and $153, and the plan provides a combined maximum of $300 every two years for all eyewear, excluding upgrades.

Dental Services See details

Dental Services includes coverage for Medicare Dental Services with 20% coinsurance, and other services like oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (both 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, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%.

Dialysis Services See details

Dialysis Services are covered under the AARP Medicare Advantage from UHC IL-0002 (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.

Medical Equipment See details

Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. For DME and Prosthetic Devices, you pay 20% coinsurance, and for Medical Supplies, you pay 20% coinsurance. For Diabetic Supplies, there is no copay, and for Diabetic Therapeutic Shoes/Inserts, you pay 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 $110, and therapeutic radiological services have at most 20% coinsurance. Outpatient X-ray services have a $25 copay.

Home Health Services See details

Home Health Services are covered by AARP Medicare Advantage from UHC IL-0002 (HMO-POS) 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 the following services: Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD 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 with prior authorization required. 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 for SNF are not covered.

Other Services See details

Other Services includes Over-the-Counter (OTC) Items and Meal Benefit, both with no copay, but Acupuncture, 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.