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AARP Medicare Advantage from UHC IL-0003 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC IL-0003 (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 IL-0003 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC IL-0003 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Illinois. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC IL-0003 (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 IL-0003 (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 IL-0003 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $48.00. 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 $420.00 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:
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Drug Coverage
The AARP Medicare Advantage from UHC IL-0003 (PPO) plan has a $420 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance for your prescriptions, depending on the drug tier and pharmacy. For example, you will pay no copay for preferred generic drugs at a standard pharmacy, and $47 for standard generic drugs. For preferred brand drugs, the copay is $100. Non-preferred drugs have a 28% coinsurance. After your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC IL-0003 (PPO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services have copays depending on the service. The plan also includes coverage for primary care, preventive services, hearing, vision, dental, and home health services, often with no copays or low copays. Diagnostic and radiological services, medical equipment, and dialysis services are covered with coinsurance, and other services like emergency care, ambulance, and skilled nursing facilities have copays.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care, with a copay of $395 per day for days 1-5, and no copay for days 6-90, with no coinsurance. Additional days for inpatient hospital acute care are covered with no copay. Non-Medicare-covered stays and upgrades for inpatient hospital acute, and additional days and non-Medicare-covered stays for inpatient hospital psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $395, and observation services with a $395 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, while Outpatient Substance Abuse Services have a copay between $0 and $25 for individual sessions, and a $15 copay for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC IL-0003 (PPO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC IL-0003 (PPO) plan. Ground and air ambulance services have a copay of $290, with no coinsurance, and transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the AARP Medicare Advantage from UHC IL-0003 (PPO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55, and Worldwide Emergency Services have a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage from UHC IL-0003 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a copay between $0 and $20, physician specialist services with a copay between $0 and $30, mental health specialty services with a copay between $0 and $25 for individual sessions and $15 for group sessions, podiatry services with a $30 copay, other health care professional services with a copay between $0 and $30, psychiatric services with a copay between $0 and $25 for individual sessions and $15 for group sessions, physical therapy and speech-language pathology services with a copay between $0 and $20, additional telehealth benefits with no copay, and opioid treatment program services with no copay. Prior authorization is required for chiropractic, occupational therapy, physician specialist, mental health specialty, podiatry, other health care professional, psychiatric, physical therapy, and opioid treatment program services.
Preventive Services See details
The AARP Medicare Advantage from UHC IL-0003 (PPO) plan covers preventive services, including an annual physical exam with no copay. This plan also covers additional preventive services, as well as kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit with no copay. However, health education, in-home safety assessment, personal emergency response systems, medical nutrition therapy, 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 benefits, 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, and counseling services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, while fitting and evaluation for hearing aids are not covered. Prescription hearing aids are covered with a copay between $199 and $1249 depending on the type, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
The AARP Medicare Advantage from UHC IL-0003 (PPO) plan covers vision services including eye exams with no copay, and eyewear. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, all with no copay, but eyeglasses (lenses and frames) and upgrades are not covered. There is a combined maximum plan benefit coverage of $250 for all eyewear every two years.
Dental Services See details
Dental services are covered, including Medicare Dental Services with 20% coinsurance and other services with a $1,250 maximum benefit per year. Oral exams, dental x-rays, other diagnostic services, prophylaxis, fluoride treatments, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, oral and maxillofacial surgery are covered with no copay, though the periodicity and number of visits vary by service. Prosthodontics (removable and fixed) are covered with 0%-50% coinsurance, and implant and orthodontic services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the AARP Medicare Advantage from UHC IL-0003 (PPO) plan. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC IL-0003 (PPO) plan. This benefit requires prior authorization and has a coinsurance of 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetic Devices, and Medical Supplies, are covered with a 20% coinsurance, and Diabetic Equipment is covered, with a 20% coinsurance for Medicare-covered Diabetic Supplies, and a 20% coinsurance for Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered, and there is no copay for any of these services.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a $25 copay, lab services with no copay, diagnostic radiological services with a copay up to $250, therapeutic radiological services with a minimum $60 copay, and outpatient X-ray services with a $10 copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC IL-0003 (PPO) 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 under the AARP Medicare Advantage from UHC IL-0003 (PPO) plan, but the plan does not cover any of the sub-services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage from UHC IL-0003 (PPO) plan, with prior authorization required. 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 are not covered.
Other Services See details
The AARP Medicare Advantage from UHC IL-0003 (PPO) plan covers Over-the-Counter (OTC) items and Meal Benefits. OTC items have no copay, while Meal Benefits also have no copay, but require 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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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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