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AARP Medicare Advantage from UHC NY-0015 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NY-0015 (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 NY-0015 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC NY-0015 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in New York. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC NY-0015 (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 NY-0015 (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 NY-0015 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $48.00. 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 $13900.00 (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 $13900.00 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 NY-0015 (PPO) plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic drugs have a $12 copay for a 1-month supply at standard pharmacies, but you can avoid a copay entirely by choosing a 3-month supply through preferred mail order. Higher-tier prescription drugs under this plan require coinsurance instead of flat copays. Tier 3 preferred brand drugs have a 17% coinsurance for standard pharmacy and mail order fills. Tier 4 non-preferred drugs require 40% coinsurance, while Tier 5 specialty drugs carry a 26% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC NY-0015 (PPO) plan offers robust coverage with no coinsurance for many core medical services, including inpatient hospital stays, outpatient procedures, and primary care. Members benefit from no copay for primary care visits, telehealth, and routine preventive services, while specialist and mental health visits require copays ranging from $0 to $50. Emergency care carries a $115 copay that is waived if admitted, and ambulance services require a $270 copay. Routine dental cleanings, routine vision exams, and routine hearing exams are covered with no copay or coinsurance, though comprehensive dental services are not covered by the plan. Prescription hearing aids require copays ranging from $199 to $1,249, while diagnostic lab tests and home health services are available with no copay. For durable medical equipment, dialysis, and Medicare Part B drugs, members will generally pay no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by AARP Medicare Advantage from UHC NY-0015 (PPO) with no coinsurance, though prior authorization is required and upgrades or non-Medicare-covered stays are not covered. Acute stays require a $485 daily copay for days 1-5 and no copay thereafter, while psychiatric stays require a $485 daily copay for days 1-4 and no copay for days 5-90, with no coverage for additional psychiatric days.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC NY-0015 (PPO) with no coinsurance for all categories, offering no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital and observation services have copays ranging from $0 to $485, while outpatient substance abuse sessions require copays between $0 and $25.
Partial Hospitalization See details
Partial hospitalization services are covered by the AARP Medicare Advantage from UHC NY-0015 (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required before receiving these services.
Ambulance and Transportation Services See details
Ambulance services are covered under the AARP Medicare Advantage from UHC NY-0015 (PPO) with a $270 copay and no coinsurance for both ground and air transport, which require prior authorization. Transportation services to health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC NY-0015 (PPO) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a $0 to $40 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are provided with no copays and no coinsurance.
Primary Care See details
Primary Care benefits for the AARP Medicare Advantage from UHC NY-0015 (PPO) are covered with no coinsurance, featuring no copay for primary care and telehealth services, and copays ranging from $0 to $50 for specialists, mental health, and therapy services. Chiropractic services are partially covered as routine and other chiropractic services are not covered, while routine podiatry is limited to six visits per year with a $40 copay.
Preventive Services See details
Preventive services are partially covered under the AARP Medicare Advantage from UHC NY-0015 (PPO) plan, offering no copay and no coinsurance for annual physical exams, kidney disease education, select screenings, and fitness benefits. However, several supplemental services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management programs, and nutritional or dietary benefits.
Hearing Services See details
Hearing services under the AARP Medicare Advantage from UHC NY-0015 (PPO) plan are partially covered, featuring no copay and no coinsurance for annual routine hearing exams, though hearing aid fitting and evaluations are not covered. Prescription hearing aids are covered with a $199 to $1,249 copay and no coinsurance for up to two devices yearly, though inner ear, outer ear, and over the ear types are not covered. OTC hearing aids are also covered with a $199 to $829 copay and no coinsurance for up to two devices per year, with no deductibles required.
Vision Services See details
Vision Services are partially covered by AARP Medicare Advantage from UHC NY-0015 (PPO) with no deductible and no coinsurance, featuring no copay for annual routine eye exams, contact lenses, and eyeglass frames, alongside a $0 to $153 copay for eyeglass lenses up to a $300 combined limit every two years. Other eye exam services, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC NY-0015 (PPO) offers partially covered dental services, featuring Medicare-covered dental with no copay and 20% coinsurance, as well as preventive care like cleanings and exams with no copay and no coinsurance. Comprehensive services, including restorative care, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC NY-0015 (PPO) with no copay, while associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance. Medicare Part B insulin is covered with a $35 copay and 0% to 20% coinsurance, and prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC NY-0015 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
AARP Medicare Advantage from UHC NY-0015 (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with prior authorization required. Patients will pay no copay and a 20% coinsurance for DME, prosthetics, and medical supplies, while diabetic supplies feature no copay and diabetic therapeutic shoes or inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC NY-0015 (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Lab services and diagnostic radiological services feature no copay, while diagnostic procedures and outpatient X-rays require a $5 copay, and therapeutic radiological services have a $40 copay.
Home Health Services See details
AARP Medicare Advantage from UHC NY-0015 (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC NY-0015 (PPO) covers Cardiac Rehabilitation Services with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC NY-0015 (PPO) with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, no prior three-day hospital stay is needed before admission, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC NY-0015 (PPO) partially covers other services, providing a meal benefit for chronic illnesses with no copay and no coinsurance, subject to prior authorization. Acupuncture, over-the-counter (OTC) items, and other additional services are not covered under this plan.
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