AARP Medicare Advantage from UHC WI-0017 (HMO-POS)

Inpatient Hospital See details

Inpatient Hospital services, including acute and psychiatric care, are covered. For acute care, you will pay a $310 copay for days 1-6, and no copay for days 7-90, while additional days 91-999 have no copay; non-Medicare-covered stays and upgrades are not covered.

For psychiatric care, you will pay a $310 copay for days 1-5, and no copay for days 6-90; additional days and non-Medicare-covered stays are not covered.

Outpatient Services See details

Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $310, Observation Services with a $310 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a copay between $0 and $20 for individual sessions and a $15 copay for group sessions, and Outpatient Blood Services with no copay.

Partial Hospitalization See details

Partial Hospitalization is covered with a $55 copay, and prior authorization is required.

Ambulance and Transportation Services See details

Ambulance and Transportation Services are covered by AARP Medicare Advantage from UHC WI-0017 (HMO-POS). Ground and air ambulance services have a $290 copay, with no coinsurance, while transportation services to any health-related location are not covered.

Emergency Services See details

Emergency Services, including urgently needed and worldwide emergency services, are covered. Emergency services have a $125 copay, and there is no coinsurance. Urgently needed services have a copay between $0 and $55, and no coinsurance. Worldwide emergency services have a $0 copay for worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation, with no coinsurance.

Primary Care See details

The AARP Medicare Advantage from UHC WI-0017 (HMO-POS) plan covers primary care services with no copay, chiropractic services with a $20 copay, and occupational therapy services with a copay of $0-$30. The plan also covers physician specialist services with a copay of $0-$45, mental health specialty services with a copay of $0-$20 for individual sessions and $15 for group sessions, and podiatry services with a $45 copay. Other health care professional services, psychiatric services with a copay of $0-$20 for individual sessions and $15 for group sessions, physical therapy and speech-language pathology services with a copay of $0-$30, additional telehealth benefits with no copay, and opioid treatment program services with no copay are also covered.

Preventive Services See details

The AARP Medicare Advantage from UHC WI-0017 (HMO-POS) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, including fitness benefits, are also covered with no copay.

Hearing Services See details

Hearing exams are covered with no copay, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with a copay between $199 and $1249, and OTC hearing aids are covered with 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, and contact lenses are covered. Eyeglasses (lenses and frames) and upgrades are not covered.

Dental Services See details

Dental Services are covered, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive services with no copay, but with some visit limits. Medicare Dental Services are covered with a 20% coinsurance, and other services like orthodontics, restorative services, and more, are not covered.

Home Infusion bundled Services See details

Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and 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 by the AARP Medicare Advantage from UHC WI-0017 (HMO-POS) plan and require prior authorization. The coinsurance for this service is 20%.

Medical Equipment See details

Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME and Prosthetic Devices have a 20% coinsurance, while Medical Supplies have a 20% coinsurance. Diabetic Supplies have no copay, and 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 diagnostic procedures/tests with a $50 copay, lab services with no copay, diagnostic radiological services with a copay up to $210, therapeutic radiological services with 20% coinsurance, and outpatient X-ray services with a $25 copay. Prior authorization is required for all diagnostic and radiological services.

Home Health Services See details

Home Health Services are covered under the AARP Medicare Advantage from UHC WI-0017 (HMO-POS) plan with no copay and no coinsurance, but Additional Hours of Care and Personal Care Services are not covered. Authorization is required.

Cardiac Rehabilitation Services See details

Cardiac Rehabilitation Services are covered with prior authorization, but the plan does not cover any of the sub-services, including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. The cost-sharing details for these services are not provided.

Skilled Nursing Facility (SNF) See details

Skilled Nursing Facility (SNF) services are covered, but require prior authorization. You will have no copay for days 1-20, and a $203 copay per day for days 21-100; there is no coinsurance.

Other Services See details

Other Services include coverage for over-the-counter items and a meal benefit. Over-the-counter items have no copay, while the meal benefit also has no copay and requires prior authorization.