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AARP Medicare Advantage from UHC IL-6 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC IL-6 (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-6 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC IL-6 (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 3.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC IL-6 (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-6 (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-6 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $45.00. 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:
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Drug Coverage
The AARP Medicare Advantage from UHC IL-6 (PPO) plan has an annual drug deductible of $600. Tier 1 preferred generic drugs feature no copay for both 1-month and 3-month supplies at standard pharmacies and through mail order. Tier 2 generic drugs require a $10 copay for a 1-month supply at standard pharmacies, but members can receive a 3-month supply with no copay through preferred mail order. Brand-name and specialty medications are covered under a coinsurance structure. Tier 3 preferred brand drugs require a 15% coinsurance, while Tier 4 non-preferred drugs have a 43% coinsurance. Tier 5 specialty drugs carry a 26% coinsurance for a 1-month supply at standard pharmacies and through mail order.
Additional Benefits
The AARP Medicare Advantage from UHC IL-6 (PPO) plan offers robust coverage with no copay and no coinsurance for primary care, telehealth, home health, and annual preventive services. For inpatient hospital stays, members pay a daily copay of $525 for the first few days and no copay thereafter, while emergency room visits carry a $130 copay. Outpatient services, diagnostic labs, and specialist visits are also highly accessible, featuring low to no copays and no coinsurance. Additional benefits include routine dental, vision, and hearing exams with no copay, alongside allowances for eyewear and hearing aids. For specialized medical needs, the plan covers durable medical equipment and dialysis with no copay and a 20% coinsurance, while skilled nursing facility stays feature no copay for the first 20 days. Members also benefit from covered over-the-counter items and chronic illness meals with no copay or coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC IL-6 (PPO) covers inpatient hospital services with no coinsurance, although prior authorization is required. Acute inpatient stays carry a $525 daily copay for days 1 through 5 with no copay for days 6 and beyond, while psychiatric inpatient stays require a $525 daily copay for days 1 through 4 and no copay for days 5 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC IL-6 (PPO) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital and observation services require a copay ranging from $0 to $525, while outpatient substance abuse sessions have a copay of $0 to $25 for individual visits and $15 for group visits.
Partial Hospitalization See details
Partial hospitalization is covered by the AARP Medicare Advantage from UHC IL-6 (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance services are covered by AARP Medicare Advantage from UHC IL-6 (PPO) with a $290 copay and no coinsurance for both ground and air transport, requiring prior authorization. Routine transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage from UHC IL-6 (PPO) covers emergency services with a $130 copay, which is waived if you are admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services have a copay of up to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC IL-6 (PPO) offers primary care and telehealth services with no copay and no coinsurance. Specialist visits require a $0 to $50 copay, physical and occupational therapies have a $30 copay, and mental health sessions range from a $0 to $25 copay, all with no coinsurance, though routine chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC IL-6 (PPO) covers preventive services with no copays and no coinsurance for annual physical exams, kidney disease education, and screenings like glaucoma and diabetes self-management training. Additional preventive benefits are partially covered, offering a fitness benefit and home safety devices with no copays or coinsurance, though services such as health education, nutritional therapy, and in-home support are not covered.
Hearing Services See details
AARP Medicare Advantage from UHC IL-6 (PPO) partially covers hearing services, providing one annual routine hearing exam with no copay and no coinsurance, while fitting and evaluation exams are not covered. Up to two prescription hearing aids (excluding inner ear, outer ear, and over-the-ear types) and two OTC hearing aids are covered each year with no coinsurance and copays ranging from $199.00 to $1,249.00 and $199.00 to $829.00, respectively.
Vision Services See details
AARP Medicare Advantage from UHC IL-6 (PPO) offers partially covered vision services with no deductibles, no coinsurance, and no copay for one annual routine eye exam, though other eye exam services are not covered. Eyewear is covered with no coinsurance and a $300 limit every two years, featuring no copay for contact lenses and eyeglass frames, and a $0 to $153 copay for eyeglass lenses, while upgrades and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC IL-6 (PPO), offering preventive care like cleanings, exams, and x-rays with no copay and no coinsurance, and Medicare-covered dental with no copay and a 20% coinsurance. Comprehensive services, including restorative work, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC IL-6 (PPO) with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs have no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC IL-6 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
AARP Medicare Advantage from UHC IL-6 (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC IL-6 (PPO), with no coinsurance and no copay for lab services, alongside a $45 copay and no coinsurance for diagnostic procedures and tests. Outpatient x-rays require a $30 copay, while diagnostic radiological services have no copay and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC IL-6 (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 from UHC IL-6 (PPO) plan, as all individual sub-services—including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation—are excluded from coverage.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC IL-6 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance and no required 3-day prior hospital stay, though prior authorization is required. There is no copay for days 1 through 20, a daily copay of $218 for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC IL-6 (PPO) partially covers other services, offering over-the-counter items and chronic illness meal benefits with no copay and no coinsurance, though prior authorization is required for meals. Acupuncture is not covered under these benefits.
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