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AARP Medicare Advantage Patriot No Rx IL-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 IL-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 IL-MA01 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx IL-MA01 (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 Patriot No Rx IL-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 IL-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 IL-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 $125.00. 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 $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
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) plan offers robust coverage for essential medical services, featuring no copay and no coinsurance for primary care visits, telehealth, and routine preventive services. For specialized care, specialist visits and outpatient therapies carry copays of up to $60 with no coinsurance. Inpatient hospital stays require a daily copay of $550 for the first few days with no coinsurance, while emergency room visits carry a $130 copay that is waived if you are admitted. This plan also includes valuable supplemental coverage, such as up to $1,000 annually for dental services, which feature no copay for preventive care and a 50% coinsurance for comprehensive care. Routine vision and hearing exams are available with no copay, and the plan provides generous coverage limits or set copays for eyewear and hearing aids. For other critical needs, skilled nursing facility stays have no copay for the first 20 days, while durable medical equipment and dialysis require a 20% coinsurance with no copay.
Inpatient Hospital See details
AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) covers inpatient hospital services with no coinsurance, requiring prior authorization and a daily copay of $550 for days 1 to 5 of acute stays (no copay for days 6 and beyond) or days 1 to 4 of psychiatric stays (no copay for days 5 to 90). Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $550 for outpatient hospital services and a $550 daily copay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance. Outpatient substance abuse services also have no coinsurance, with copays of $0 to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) covers partial hospitalization with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) covers ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. Although some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency Services under the AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) plan are covered with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a copay of $0 to $60 and no coinsurance. Other covered services, including physical therapy, occupational therapy, mental health, and podiatry, have copays ranging from $0 to $60 and no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) with no copay and no coinsurance for annual physical exams, kidney disease education, and routine screenings. While a fitness benefit is covered with no copay and no coinsurance, several other supplemental benefits, including health education, nutritional therapy, and in-home support services, are not covered.
Hearing Services See details
Hearing services are partially covered by the AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) plan, featuring no copay or coinsurance for one routine annual hearing exam, while fitting and evaluation exams are not covered. Prescription hearing aids (up to two per year) require a $199 to $1,249 copay with no coinsurance, though inner ear, outer ear, and over the ear types are not covered. Up to two OTC hearing aids are also covered annually with a copay of $199 to $829 and no coinsurance.
Vision Services See details
AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) partially covers vision services with no deductible and no coinsurance, offering one routine eye exam per year with no copay. Eyewear is covered up to a combined $150 limit every two years with no copay for contacts or frames and a $0 to $153 copay for lenses, while upgrades, combined eyeglasses, and other eye exams are not covered.
Dental Services See details
Dental services are partially covered by the AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) plan, which provides up to $1,000 in annual coverage. Diagnostic and preventive services have no copay and no coinsurance, while comprehensive services require a 50% coinsurance with no copay, and Medicare-covered dental services carry a 20% coinsurance with no copay; however, implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) with no copay and no coinsurance, though prior authorization is required. Covered Medicare Part B chemotherapy and other drugs require no copay and 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical Equipment benefits under the AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) are covered with no copay, though a 20% coinsurance applies to durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) covers diagnostic and radiological services with prior authorization, featuring no copay and no coinsurance for lab services. Diagnostic procedures and tests require a $50 copay with no coinsurance, outpatient X-rays require a $30 copay, and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice under the AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) plan. Although the benefit technically features no coinsurance, all key sub-services—including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation—are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) partially covers other services, featuring a meal benefit for chronic illnesses with no copay and no coinsurance, subject to prior authorization. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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