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AARP Medicare Advantage from UHC KS-0003 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC KS-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 KS-0003 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC KS-0003 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Kansas. 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 KS-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 KS-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 KS-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 $520.00 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 $9200.00 (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 $9200.00 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 KS-0003 (PPO) plan features an annual drug deductible of $520. For Tier 1 preferred generic drugs, you will pay no copay for standard pharmacy fills or 3-month mail-order prescriptions. Tier 2 generic drugs cost a $10 copay for a 1-month supply at a standard pharmacy, but you can receive a 3-month supply with no copay through preferred mail order. Higher-tier medications under this plan require coinsurance instead of flat copays. Tier 3 preferred brand drugs require a 16% coinsurance, while Tier 4 non-preferred drugs carry a 40% coinsurance for a 1-month supply. Specialty drugs in Tier 5 require a 27% coinsurance for a 1-month supply across standard pharmacies and mail-order options.
Additional Benefits
The AARP Medicare Advantage from UHC KS-0003 (PPO) plan offers robust medical coverage with no copay for primary care visits, annual physicals, and home health services. Specialist visits require a copay of up to $40, while inpatient hospital stays feature a $455 daily copay for the first six days and no copay thereafter. Emergency room services are covered with a $130 copay, which is waived if you are admitted within 24 hours. Additional benefits include routine dental, vision, and hearing exams with no copay, alongside a $1,000 annual allowance for preventive dental care. While diagnostic lab services and home infusions are available at no copay, other services like durable medical equipment and dialysis require a 20% coinsurance. This plan successfully balances essential medical coverage with extra wellness benefits to help minimize your out-of-pocket expenses.
Inpatient Hospital See details
Inpatient hospital services are covered by AARP Medicare Advantage from UHC KS-0003 (PPO) with no coinsurance and prior authorization required, featuring a $455 daily copay for days 1 to 6 of acute stays and days 1 to 5 of psychiatric stays, with no copay for subsequent days. While unlimited additional acute days are covered at no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC KS-0003 (PPO) with no coinsurance, though prior authorization is required for most care. There is no copay for ambulatory surgical center and outpatient blood services, while outpatient hospital copays range from no copay up to $455, observation services require a $455 daily copay, and outpatient substance abuse sessions cost between no copay and $25.
Partial Hospitalization See details
Partial hospitalization services are covered under the AARP Medicare Advantage from UHC KS-0003 (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by AARP Medicare Advantage from UHC KS-0003 (PPO) with a $290 copay and no coinsurance for both ground and air transport, with prior authorization required. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services are covered under the AARP Medicare Advantage from UHC KS-0003 (PPO) plan with a $130 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC KS-0003 (PPO) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits range from a $0 to $40 copay with no coinsurance. Other covered benefits like physical, occupational, and speech therapies require a $40 copay and no coinsurance, though chiropractic services are only partially covered with routine care excluded.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage from UHC KS-0003 (PPO) with no copay and no coinsurance for covered services like annual physicals, fitness benefits, and kidney disease education. However, sub-services such as health education, personal emergency response systems, weight management, alternative therapies, and in-home support are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC KS-0003 (PPO), which offers one routine hearing exam per year with no copay and no coinsurance, though fitting and evaluation exams are not covered. The plan also covers up to two prescription or OTC hearing aids yearly with no coinsurance and copays ranging from $199.00 to $1,249.00, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC KS-0003 (PPO), offering one routine eye exam per year with no copay or coinsurance, while other eye exam services are not covered. Eyewear benefits have no coinsurance and feature a $150 combined maximum benefit every two years, covering contact lenses and frames with no copay, and lenses with a $0 to $153 copay, though upgrades and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC KS-0003 (PPO), excluding implant services and orthodontics. Preventive and diagnostic services feature no copay and no coinsurance up to a $1,000 annual maximum, while Medicare-covered services require no copay and 20% coinsurance, and covered comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC KS-0003 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and radiation, require no coinsurance up to 20% coinsurance, while insulin is covered with a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC KS-0003 (PPO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
AARP Medicare Advantage from UHC KS-0003 (PPO) covers durable medical equipment (DME), 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, with prior authorization required for these services.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC KS-0003 (PPO) covers diagnostic and radiological services, featuring no copay or coinsurance for lab services and a $50 copay with no coinsurance for diagnostic tests. Diagnostic radiological services start at no copay, outpatient X-rays require a $30 copay with coinsurance, and therapeutic radiological services carry a 20% coinsurance, with prior authorization required for all services.
Home Health Services See details
AARP Medicare Advantage from UHC KS-0003 (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage from UHC KS-0003 (PPO) with no copay and no coinsurance under prior authorization. However, only some services are covered, as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC KS-0003 (PPO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 copay per day for days 21 through 100. Prior authorization is required and a three-day prior hospital stay is not necessary, but additional days beyond the Medicare-covered 100 days are not covered.
Other Services See details
AARP Medicare Advantage from UHC KS-0003 (PPO) partially covers other services, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, while acupuncture is not covered. Prior authorization is required for the meal benefit.
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