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AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx WV-MA01 (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 Patriot No Rx WV-MA01 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx WV-MA01 (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 Patriot No Rx WV-MA01 (PPO) 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 WV-MA01 (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 Patriot No Rx WV-MA01 (PPO), 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 $110.00. 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 combined Maximum Out-Of-Pocket cost of $13900.00 (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 $13900.00 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
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) plan offers robust health coverage with predictable out-of-pocket costs, featuring no copay for primary care visits, telehealth, annual physicals, and routine vision or hearing exams. Specialist visits range from a $0 to $55 copay, while inpatient hospital stays require a $470 daily copay for the first few days with no copay thereafter and no coinsurance. Emergency room visits carry a $115 copay, which is waived upon hospital admission, and urgent care services cost up to a $40 copay. For supplemental wellness, members benefit from preventive dental care up to a $1,000 annual limit with no copay, alongside a $250 eyewear allowance every two years and no-copay over-the-counter items. Diagnostic lab services and home health care are also covered with no copay, while durable medical equipment and dialysis services generally require a 20% coinsurance. Skilled nursing facility care is highly affordable, requiring no copay for the first 20 days and a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) covers inpatient hospital services with no coinsurance, requiring a $470 daily copay for days 1 to 5 for acute stays and days 1 to 4 for psychiatric stays, with no copay thereafter. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) covers outpatient services with no coinsurance, featuring a $0 to $470 copay for outpatient hospital services and a $470 daily copay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse services carry no coinsurance and a copay of $0 to $25 for individual sessions or $15 for group sessions.
Partial Hospitalization See details
AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under the AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO), featuring a $290 copay and no coinsurance for both ground and air ambulance services. While some transportation services are covered, transportation to plan-approved and any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by the AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay of up to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits, therapy, and mental health services require copays ranging from $0 to $55 with no coinsurance. Chiropractic services are only partially covered, as routine chiropractic care and other chiropractic services are not covered under this plan.
Preventive Services See details
AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) provides partially covered preventive services with no copays and no coinsurance for annual physical exams, kidney disease education, glaucoma screenings, diabetes training, fitness benefits, and home safety devices. However, several additional supplemental benefits, such as health education, in-home safety assessments, personal emergency response systems, and nutritional services, are not covered.
Hearing Services See details
Hearing services are partially covered by the AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) with no coinsurance, offering one routine hearing exam per year with no copay, while fitting and evaluation exams are not covered. Up to two prescription or OTC hearing aids are covered yearly with no coinsurance and copays ranging from $199.00 to $1,249.00, though inner ear, outer ear, and over-the-ear prescription aids are not covered.
Vision Services See details
Vision Services are partially covered by the AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) with no deductible and no coinsurance. Covered benefits include one routine eye exam per year with no copay, and eyewear coverage up to $250 every two years with no copay for contact lenses and frames, and a $0 to $153 copay for lenses; other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by the AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) plan, which features preventive care with no copay and no coinsurance up to a $1,000 annual limit. Medicare-covered dental services have no copay and a 20% coinsurance, and comprehensive services require no copay and a 50% coinsurance, though implants and orthodontics are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no coinsurance to 20% coinsurance, while Medicare Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
The AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
Medical equipment is covered under the AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) plan with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay, and prior authorization is required for most medical equipment and supplies.
Diagnostic and Radiological Services See details
AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) covers diagnostic and radiological services with prior authorization, offering lab services and diagnostic radiological services with no copay. Diagnostic tests require a $50 copay with no coinsurance, outpatient X-rays have a $30 copay plus coinsurance, and therapeutic radiological services carry a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) covers skilled nursing facility (SNF) care with no coinsurance, requiring prior authorization but no prior three-day hospital stay. You pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with additional days beyond the standard 100 days not covered.
Other Services See details
AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) partially covers other services, offering over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance. Acupuncture is not covered under this benefit.
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