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AARP Medicare Advantage from UHC NY-0025 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NY-0025 (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-0025 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC NY-0025 (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-0025 (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-0025 (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-0025 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $35.00. 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 $570.00 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-0025 (PPO) plan has an enhanced alternative drug benefit. The plan has a $570 deductible for prescription drugs. After the deductible is met, you will pay a copay for your prescriptions. For example, a standard generic drug will have a $47 copay, while a preferred brand drug will have a $100 copay. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC NY-0025 (PPO) plan offers a range of benefits, including inpatient hospital stays with a $375 copay for the first few days, and outpatient services with copays varying from $0 to $375. The plan also covers primary care, preventive services, and home health services with no copay, and offers vision and dental coverage, including eye exams and preventative dental services with no copay. This plan includes coverage for ambulance and emergency services, with copays ranging from $0 to $275. It also provides coverage for hearing and vision services, as well as medical equipment and diagnostic services. However, it's important to note that certain services, like cardiac rehabilitation and some other specific services, are not covered by this plan.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for acute and psychiatric inpatient stays, with a copay of $375 for days 1-5 and $0 for days 6-90 of acute stays, and a copay of $375 for days 1-4 and $0 for days 5-90 of psychiatric stays. Additional days for acute stays are covered with no copay, while non-Medicare covered stays and upgrades for acute and psychiatric stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $375, and observation services, with a $375 copay. Ambulatory Surgical Center (ASC) Services have no copay, while outpatient substance abuse services for individual sessions have a copay between $0 and $25, and group sessions have a $15 copay. Outpatient Blood Services have no 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 by AARP Medicare Advantage from UHC NY-0025 (PPO), with no coinsurance. Medicare-covered ground and air ambulance services have a $275 copay, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including urgently needed services and worldwide emergency services, are covered by the AARP Medicare Advantage from UHC NY-0025 (PPO) plan. Emergency services have a $110 copay, while urgently needed services have a copay between $0 and $45; there is no coinsurance for either. Worldwide emergency services, worldwide urgent coverage, and worldwide emergency transportation all have no copay.
Primary Care See details
The AARP Medicare Advantage from UHC NY-0025 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $0-$20 copay, physician specialist services with a $0-$40 copay, and mental health specialty services with a $0-$25 copay for individual sessions and a $15 copay for group sessions. This plan also covers podiatry services with a $30 copay, other health care professional services with a $0-$40 copay, psychiatric services with a $0-$25 copay for individual sessions and a $15 copay for group sessions, physical therapy and speech-language pathology services with a $0-$35 copay, additional telehealth benefits with no copay, and opioid treatment program services with no copay.
Preventive Services See details
Preventive services include annual physical exams with no copay, while additional preventive services are covered, but may have a copay. Kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit have no copay. However, 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. Routine hearing exams are covered once per year with no copay, while fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with a copay between $199 and $1249. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision services include coverage for eye exams and eyewear. Eye exams have no copay. Eyewear has a combined maximum benefit of $300 every two years, and contact lenses, eyeglass lenses, and eyeglass frames are covered with no copay; however, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC NY-0025 (PPO) plan covers dental services including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services with no copay, but a 20% coinsurance for Medicare dental services; however, orthodontic, restorative, and other services are not covered. Oral exams and prophylaxis are limited to 2 visits per year, while fluoride treatments are limited to 2 visits per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and a coinsurance between 0% and 20%, Medicare Part B Chemotherapy/Radiation Drugs with a coinsurance between 0% and 20%, and Other Medicare Part B Drugs with a coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC NY-0025 (PPO) plan, but prior authorization is required. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment and Prosthetics/Medical Supplies, is covered by this plan. Durable Medical Equipment has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered. Medicare-covered prosthetic devices and medical supplies have a 20% coinsurance, and Diabetic Supplies have no copay. Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a $50 copay, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $230, Therapeutic Radiological Services with a minimum $80 copay, and Outpatient X-Ray Services with a $35 copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC NY-0025 (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the AARP Medicare Advantage from UHC NY-0025 (PPO) plan. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the AARP Medicare Advantage from UHC NY-0025 (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203 per day; additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The "Other Services" benefit for AARP Medicare Advantage from UHC NY-0025 (PPO) covers a meal benefit with no copay, but requires prior authorization; however, acupuncture, over-the-counter items, 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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