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AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Spokane County. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS).
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 Patriot No Rx WA-MA02 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $80.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5500.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network 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:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS)
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Drug Coverage
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while many outpatient services have no copay or a small copay. Emergency services and primary care visits also have low or no copays. This plan includes coverage for preventive services, hearing, vision, and dental, with some services having no copay. The plan also covers home health services, skilled nursing facilities, and other services such as ambulance, diagnostic and radiological services, and dialysis services, with a mix of copays and coinsurance.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you'll pay a $490 copay for days 1-5, and no copay for days 6-90, with additional days 91-999 having no copay. Inpatient Hospital Psychiatric has a $490 copay for days 1-4, and no copay for days 5-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay ranging from $0 to $490, observation services with a $490 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with copays ranging from $0 to $25 for individual sessions and $15 for group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS) plan. Ground and Air Ambulance Services have a $275 copay, with no coinsurance. Transportation Services to plan-approved and any health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $125 copay with no coinsurance, Urgently Needed Services have a copay between $0 and $55 with no coinsurance, and Worldwide Emergency Services have a $0 copay with no coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, and occupational therapy services with a copay between $0 and $45. The plan also covers physician specialist services with a copay between $0 and $55, mental health specialty services, podiatry services with a $45 copay, other health care professional services with a copay between $0 and $55, psychiatric services, physical therapy and speech-language pathology services with a copay between $0 and $50, additional telehealth benefits with no copay, and opioid treatment program services with no copay.
Preventive Services See details
The AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services such as Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Medicare-covered Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay. However, some services like Health Education, In-Home Safety Assessment, and others are not covered.
Hearing Services See details
Hearing Services include hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have no copay, and routine hearing exams are covered for 1 visit per year. Prescription Hearing Aids have a copay between $199 and $1249 for all types, while OTC hearing aids have a copay between $99 and $829 for 2 aids per year. 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
Vision services include routine eye exams and eyewear. Routine eye exams and contact lenses have no copay, while eyeglass lenses may have a copay between $0 and $153, and eyeglass frames have no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, with 20% coinsurance for Medicare dental services. Other dental services include oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery, all with no copay, but with varying limitations on the number of visits and periodicity. Orthodontic services are covered under Diagnostic and Preventive Dental. Implant and orthodontic services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. 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, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by the AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS) plan, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance, with no copay, while Prosthetic Devices and Medical Supplies have a 20% coinsurance with no copay; Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures and tests, are covered with a copay of $25.00. Lab services have no copay, while diagnostic radiological services have a copay of up to $250.00, therapeutic radiological services have a copay of $80.00, and outpatient X-ray services have a copay of $5.00.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS) 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 the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the AARP Medicare Advantage Patriot No Rx WA-MA02 (HMO-POS) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100, while additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other services include coverage for over-the-counter (OTC) items and a meal benefit. OTC items have no copay, and the meal benefit also has no copay, but requires prior authorization. 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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