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AARP Medicare Advantage from UHC NY-0019 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NY-0019 (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-0019 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC NY-0019 (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-0019 (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-0019 (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-0019 (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-0019 (PPO) plan has a $495.00 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, in the initial coverage phase, you may pay $12.00 for a preferred generic drug at a standard pharmacy, or 27% coinsurance for a non-preferred drug at any pharmacy. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC NY-0019 (PPO) plan offers a range of benefits with varying costs. This plan covers inpatient hospital stays with a copay, and outpatient services, including substance abuse, with copays between $0 and $405. Emergency and urgent care have copays, while preventive services like annual exams have no copay. Additional benefits include hearing exams with no copay, and vision services with no copay for eye exams and eyewear. Dental services like oral exams have no copay, while other services may have coinsurance. Other benefits include home health services with no copay, and skilled nursing facility services with a copay.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $405 copay for days 1-5, and no copay for days 6-90. For days 91-999, there is no copay. For Inpatient Hospital Psychiatric, you will pay a $405 copay for days 1-4, and no copay for days 5-90. 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 include coverage for all Outpatient Hospital Services with a copay between $0 and $405, and Observation Services with a $405 copay. Also covered are Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services, both with no copay, as well as Outpatient Substance Abuse Services. Outpatient Substance Abuse Services include Individual Sessions with a copay between $0 and $25, and Group Sessions with a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the AARP Medicare Advantage from UHC NY-0019 (PPO) plan. Both ground and air ambulance services have a copay of $290, 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-0019 (PPO) with a $110 copay and no coinsurance. Urgently needed services have a copay between $0 and $45, and no coinsurance. Worldwide emergency services are also covered, with no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage from UHC NY-0019 (PPO) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, physician specialist services, and additional telehealth benefits have a copay that ranges from $0 to $40. Chiropractic services have a $15 copay, while occupational therapy services have a copay that ranges from $0 to $25. Podiatry services have a $35 copay. Other health care professional services have a copay that ranges from $0 to $40. Mental health and psychiatric individual sessions have a copay that ranges from $0 to $25, and group sessions have a $15 copay. Physical therapy and speech-language pathology services have a copay that ranges from $0 to $40. Opioid treatment program services have no copay.
Preventive Services See details
Preventive services are covered. The plan covers an annual physical exam with no copay. Fitness benefit, Home and Bathroom Safety Devices and Modifications, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit all have no copay. Health Education, In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, but fitting/evaluation for hearing aids are not covered. Prescription hearing aids are covered with a copay between $199 and $1249, while OTC hearing aids have a copay between $99 and $829.
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, with a combined maximum benefit of $300 every two years for contact lenses, eyeglass lenses, and eyeglass frames; however, eyeglasses and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC NY-0019 (PPO) plan covers dental services, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services with no copay. Other dental services have a 20% coinsurance. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but prior authorization is 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, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC NY-0019 (PPO) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance and Diabetic Supplies have no copay. Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a copay for Medicare-covered diagnostic procedures/tests. Lab services have no copay, while diagnostic radiological services have a copay up to $250, and therapeutic radiological services have a coinsurance of at least 20%. Outpatient X-ray services have a $35 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC NY-0019 (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 covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. The plan requires prior authorization, but the copay is not specified.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC NY-0019 (PPO). 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 meal benefits, with no copay for OTC items, and a $0 copay for meal benefits. However, 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.
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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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