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AARP Medicare Advantage from UHC KY-0003 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC KY-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 KY-0003 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC KY-0003 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Kentucky. 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 KY-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 KY-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 KY-0003 (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.
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 KY-0003 (PPO) plan has a $420 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy used. For example, in the initial coverage phase, you will pay $12 for preferred generic drugs at a standard pharmacy and $47 for standard generic drugs. For preferred brand drugs, you will pay a $100 copay, regardless of the pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC KY-0003 (PPO) plan offers a range of benefits with varying costs. You'll pay a copay for inpatient hospital stays, outpatient services, ambulance services, emergency services, and specialist visits, while primary care, preventive services, and many hearing and vision services have no copay. The plan also covers home health, some dental services, and durable medical equipment with coinsurance, and it offers additional benefits like an OTC allowance and a meal benefit. Be aware that services like additional days in the hospital, certain dental procedures, and specific therapies are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with prior authorization required. For Inpatient Hospital-Acute, you will pay a $435 copay for days 1-4, and no copay for days 5-90, with no coinsurance. For Inpatient Hospital Psychiatric, you will pay a $435 copay for days 1-3, and no copay for days 4-90, with no coinsurance. Additional days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are also not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient Hospital Services have a copay between $0 and $435, Observation Services have a $435 copay, Ambulatory Surgical Center (ASC) Services have no copay, and Individual Sessions for Outpatient Substance Abuse have a copay between $0 and $25, while Group Sessions for Outpatient Substance Abuse have a $15 copay. Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC KY-0003 (PPO) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $275 copay for both ground and air ambulance services, and no coinsurance. 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 KY-0003 (PPO) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $55; both have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services are covered with no copay, while Chiropractic Services have a $20 copay. Occupational Therapy Services have a copay between $0 and $40, and Physician Specialist Services have a copay between $0 and $40. Mental Health Specialty Services have a copay of $0 to $25 for individual sessions and $15 for group sessions. Podiatry Services and Other Health Care Professional services have a $40 copay, and Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $40. Additional Telehealth Benefits have no copay, and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay. Additional preventive services, including fitness benefit and home and bathroom safety devices and modifications, are covered, but services such as health education, personal emergency response system, and others are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year with no copay. Prescription hearing aids are covered, but the copay ranges from $199 to $1249, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
The AARP Medicare Advantage from UHC KY-0003 (PPO) plan offers vision services including eye exams with no copay, and eyewear with no copay, but a combined maximum benefit of $200 every two years. Contact lenses are covered with no copay, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services with the AARP Medicare Advantage from UHC KY-0003 (PPO) plan covers Medicare Dental Services with a 20% coinsurance, while Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services have 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.
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. Medicare Part B Insulin Drugs have a $35 copay with 0-20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC KY-0003 (PPO) plan. This benefit requires prior authorization and has a coinsurance of 20%.
Medical Equipment See details
Medical Equipment is covered by AARP Medicare Advantage from UHC KY-0003 (PPO). Durable Medical Equipment (DME) has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and there is no copay. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $50 copay, and lab services with no copay. Radiological services include coverage for diagnostic radiological services with a copay of at most $200, therapeutic radiological services with at least 20% coinsurance, and outpatient X-ray services with a $25 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC KY-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, but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required, and there is a copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC KY-0003 (PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100; there is no coinsurance. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items and a Meal Benefit. Over-the-counter items have no copay, while the meal benefit also has no copay, but requires prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many other services are not covered.
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