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.

This summary reflects 2025 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.

AARP Medicare Advantage from UHC NY-0025 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for the 2025 plan year 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.

Overview IconKey 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 that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.

Out-of-Pocket Maximums

This plan has a Maximum Out-Of-Pocket cost of $8900.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $8900.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.

This plan has a Maximum Out-Of-Pocket cost of $14000.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $14000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.

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:

Regular visits to your primary care doctor are covered and will have a copay of $0.00 and coinsurance of 0% (no coinsurance).

Specialist Visits:

Visits to specialists are covered and will have a copay of $0.00 - $40.00 and coinsurance of 0% (no coinsurance). Specialist visits may require a referral from your primary care doctor or prior authorization.

Emergency Room:

Trips to the Emergency Room are covered, and will have a copay of $110.00 and coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Urgent Care:

Trips to Urgent Care are covered and will have a copay of $0.00 - $45.00 and coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Sign up for AARP Medicare Advantage from UHC NY-0025 (PPO)

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Drug Coverage IconDrug 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 IconAdditional 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.

Plan Providers IconPlan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

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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.

* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.

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