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AARP Medicare Advantage from UHC NY-0018 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NY-0018 (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-0018 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC NY-0018 (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 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC NY-0018 (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-0018 (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-0018 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $19.00. 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 $495.00 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 $14000.00 (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 $14000.00 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-0018 (PPO) plan has a $495.00 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For example, for a standard generic drug, you will pay a $12 copay at a standard pharmacy. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase. In this phase, you will pay nothing for covered drugs. If you qualify for the low-income subsidy, you will pay $19.00.
Additional Benefits
The AARP Medicare Advantage from UHC NY-0018 (PPO) plan offers a range of benefits. Inpatient hospital stays have a $475 copay for the first few days, then no copay. Outpatient services have varying copays, with some services like outpatient hospital services, ASC services, outpatient blood services, and primary care physician services having no copay. This plan also covers a variety of other services. Emergency services have a $110 copay, while preventive services, hearing exams, and vision eye exams are covered with no copay. Dental services include oral exams, dental x-rays, and cleaning with no copay, while other services, such as OTC items, are covered with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $475 for days 1-5 and no copay for days 6-90 for Inpatient Hospital-Acute, and a copay of $475 for days 1-4 and no copay for days 5-90 for Inpatient Hospital Psychiatric. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient Hospital Services have a copay of $0.00 - $475.00, Observation Services have a copay of $475.00, Ambulatory Surgical Center (ASC) Services have no copay, Individual Sessions for Outpatient Substance Abuse have a copay of $0.00 - $25.00, Group Sessions for Outpatient Substance Abuse have a copay of $15.00, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC NY-0018 (PPO) 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 from UHC NY-0018 (PPO) plan. Medicare-covered ground and air ambulance services each have a $290 copay with no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by AARP Medicare Advantage from UHC NY-0018 (PPO) with a $110 copay and no coinsurance. Urgently Needed Services have a copay between $0 and $45, and no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services are covered with a $15 copay, and Occupational Therapy Services have a copay between $0 and $25. Physician Specialist Services, Physical Therapy, and Speech-Language Pathology Services have a copay between $0 and $40. Mental Health Specialty Services, Psychiatric Services, and Podiatry Services have a copay between $0 and $30, and Opioid Treatment Program Services have no copay. Additional Telehealth Benefits have no copay.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, while additional preventive services, kidney disease education services, and other preventive services have a copay. Some additional preventive services like health education, and in-home safety assessments are not covered.
Hearing Services See details
AARP Medicare Advantage from UHC NY-0018 (PPO) covers hearing exams with no copay, as well as routine hearing exams once per year with no copay. Prescription hearing aids (all types) are covered with a copay between $199 and $1249, and over-the-counter hearing aids are covered with a copay between $99 and $829. Fitting/evaluation for hearing aids, 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 NY-0018 (PPO) plan covers vision services, including eye exams with no copay, and eyewear with a combined maximum benefit of $300 every two years. Contact lenses, eyeglass lenses (with a copay of $0-$153), and eyeglass frames (with no copay) are covered, but eyeglasses and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC NY-0018 (PPO) plan covers some dental services, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive services with no copay, but a 20% coinsurance applies to Medicare dental services. Orthodontic, restorative, and other dental services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Other Medicare Part B Drugs and Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis services are covered under the AARP Medicare Advantage from UHC NY-0018 (PPO) plan, but require prior authorization. This plan has a 20% coinsurance for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices and 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 includes coverage for all diagnostic services and all radiological services. Diagnostic Procedures/Tests have a copay of $50, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $250, Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have a copay of $35.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC NY-0018 (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 covered by AARP Medicare Advantage from UHC NY-0018 (PPO), but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required, and the copay information is available in the plan details.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, there is no copay, and for days 21-100, there is a $203 copay.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and Meal Benefit, both with no copay, but Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many other services are not covered. OTC items include nicotine replacement therapy and Naloxone coverage.
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