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AARP Medicare Advantage from UHC WV-0001 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC WV-0001 (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 WV-0001 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC WV-0001 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of West Virginia. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC WV-0001 (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 WV-0001 (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 WV-0001 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $57.00. 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 $600.00 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 $10100.00 (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 $10100.00 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:
Sign up for AARP Medicare Advantage from UHC WV-0001 (PPO)
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Drug Coverage
The AARP Medicare Advantage from UHC WV-0001 (PPO) plan features an annual prescription drug deductible of $600. Under this plan, Tier 1 preferred generic drugs offer no copay for a one-month or three-month supply at standard pharmacies and through mail order. Tier 2 generic drugs cost a $12 copay for a one-month supply at standard pharmacies, but you can receive a three-month supply with no copay when using preferred mail order. For higher-tier medications, cost-sharing transitions from set copays to coinsurance. Tier 3 preferred brand drugs require a 15% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 42% and 26% coinsurance respectively for a one-month supply. These structured costs help you estimate your annual out-of-pocket prescription expenses under this Medicare Advantage plan.
Additional Benefits
The AARP Medicare Advantage from UHC WV-0001 (PPO) plan offers robust medical coverage with no copay and no coinsurance for primary care visits, preventive care, and home health services. For specialized medical care, members pay no coinsurance but face a daily copay of $455 for the first few days of inpatient hospital stays and a $290 copay for emergency ambulance services. Emergency room visits carry a $130 copay, which is waived upon admission, while outpatient hospital services feature copays ranging from no copay up to $455. This plan also provides valuable supplemental benefits, including dental care up to a $1,500 annual limit with no copay and 20% to 50% coinsurance, alongside no copay for routine vision and hearing exams. Additionally, prescription hearing aids require copays starting at $199, while medical equipment and dialysis services are covered with no copay and a 20% coinsurance. Members also benefit from no copay and no coinsurance on chronic illness meals and select over-the-counter items.
Inpatient Hospital See details
Inpatient hospital services are covered by AARP Medicare Advantage from UHC WV-0001 (PPO) with no coinsurance, featuring a daily copay of $455 for days 1 to 6 for acute stays and days 1 to 5 for psychiatric stays, with no copay for subsequent covered days. Prior authorization is required, and some services, including upgrades, non-Medicare-covered stays, and additional psychiatric days, are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC WV-0001 (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $455 (including a $455 daily copay for observation services), while outpatient substance abuse services have copays ranging from $0 to $25, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization is covered under the AARP Medicare Advantage from UHC WV-0001 (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC WV-0001 (PPO) covers Medicare-approved ground and air ambulance services with a $290 copay and no coinsurance, though prior authorization is required. Additional transportation services to health-related locations are not covered by this plan.
Emergency Services See details
AARP Medicare Advantage from UHC WV-0001 (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature a copay ranging from no copay to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits under the AARP Medicare Advantage from UHC WV-0001 (PPO) plan feature no copay and no coinsurance for primary care physician visits, telehealth, and opioid treatment. Specialist visits range from a $0 to $50 copay, mental health and psychiatric sessions range from a $0 to $25 copay, and physical, occupational, speech, and podiatry services require a $45 copay, all with no coinsurance. Some chiropractic services are covered, but routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage from UHC WV-0001 (PPO) with no copay and no coinsurance for covered options like annual physicals, fitness benefits, and glaucoma screenings. However, multiple supplemental services are not covered, including health education, in-home safety assessments, personal emergency response systems, and nutritional or medical nutrition therapy.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC WV-0001 (PPO), featuring no coinsurance for all covered benefits and no copay for one annual routine hearing exam. Up to two prescription hearing aids (with copays from $199.00 to $1,249.00) and two OTC hearing aids (with copays from $199.00 to $829.00) are covered annually, but fitting/evaluation exams and inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
AARP Medicare Advantage from UHC WV-0001 (PPO) partially covers vision services, offering routine eye exams, contact lenses, and eyeglass frames with no copay and no coinsurance, as well as eyeglass lenses with a $0 to $153 copay and no coinsurance up to a $200 limit every two years. Other eye exam services, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC WV-0001 (PPO) up to a $1,500 annual limit, excluding implant services and orthodontics which are not covered. Preventive care is available with no copay and no coinsurance, while comprehensive services require no copay with a 50% coinsurance, and Medicare-covered dental services have no copay and a 20% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC WV-0001 (PPO) with no copay and no coinsurance, though prior authorization and step therapy apply. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry no copay and 0% to 20% coinsurance, while Part B insulin requires a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC WV-0001 (PPO) with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
AARP Medicare Advantage from UHC WV-0001 (PPO) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes, with no copay and a 20% coinsurance. Diabetic supplies are also covered with no copay, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC WV-0001 (PPO), with prior authorization required. Diagnostic tests require a $55 copay and no coinsurance, lab and diagnostic radiology services have no copay, outpatient X-rays have a $30 copay and coinsurance, and therapeutic radiology requires a minimum 20% coinsurance and a copay.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage from UHC WV-0001 (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no copay and no coinsurance under the AARP Medicare Advantage from UHC WV-0001 (PPO) plan. However, some services are covered but cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC WV-0001 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC WV-0001 (PPO) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and other additional services under this benefit category are not covered.
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