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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 2025, 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 3.5 out of 5 stars in 2025.
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 $14000.00 (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 $14000.00 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 a range of benefits, including inpatient hospital stays with a copay, outpatient services with varying copays, and emergency services with a copay. You'll also find coverage for primary care visits with no copay, preventive services with no copay, and hearing and vision services with copays. This plan provides additional benefits like dental services with coinsurance, home infusion services with copays and coinsurance, and medical equipment with coinsurance. The plan also covers home health services with no copay, and skilled nursing facility services with a copay.
Inpatient Hospital See details
The AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) plan covers inpatient hospital stays with a $445 copay for days 1-5, and no copay for days 6-90. Additional days for inpatient hospital-acute have no copay. Inpatient Hospital Psychiatric stays have a $445 copay for days 1-4, and no copay for days 5-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with copays ranging from $0.00 to $445.00, and observation services with a copay of $445.00. Ambulatory Surgical Center (ASC) Services have no copay, while outpatient substance abuse services have copays of $0.00 to $25.00 for individual sessions and $15.00 for group sessions. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) plan. You will have a $55 copay for this service, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) plan. Medicare-covered 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, Urgently Needed Services, and Worldwide Emergency Services are covered by the AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) plan. Emergency Services have a $110 copay, while Urgently Needed Services have a copay between $0 and $45; both have no coinsurance. Worldwide Emergency, Urgent, and Transportation Services have no copay and no coinsurance.
Primary Care See details
The AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, and occupational therapy services with a copay between $0 and $35. Physician specialist services, physical therapy, and speech-language pathology services have a copay between $0 and $50, and mental health and psychiatric services have a copay between $0 and $25 for individual sessions and $15 for group sessions. The plan also covers podiatry services with a $45 copay, other health care professional 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
Preventive Services include coverage for Medicare-covered services with no copay, an annual physical exam with no copay, and other preventive services including Fitness Benefit, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay. Some preventive services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids have a copay between $199 and $1249, depending on the type of aid, while OTC hearing aids have a copay between $99 and $829.
Vision Services See details
Vision services with the AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) plan include eye exams with no copay, and eyewear with no copay for contact lenses and eyeglass frames, but eyeglass lenses have a copay of $0-$153. Eyeglass frames, and eyeglass lenses are limited to one pair every two years, and there is a combined maximum of $250 for all eyewear every two years. Eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with 20% coinsurance, Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services with no copay. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered. Other Diagnostic Dental Services is offered as an optional, supplemental benefit.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. 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, but require prior authorization. You will pay 20% coinsurance for covered services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services and radiological services, with prior authorization required. Diagnostic Procedures/Tests have a copay of $45, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $225, Therapeutic Radiological Services have a 20% coinsurance, and Outpatient X-Ray Services have a copay of $25.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage Patriot No Rx WV-MA01 (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 covered, but the specific services of Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD are not covered. Prior authorization is required, and there is a copay for services, but the specific amount is not listed.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage Patriot No Rx WV-MA01 (PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes a meal benefit with no copay, but requires prior authorization; Acupuncture, Over-the-Counter (OTC) 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.
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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.
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