AARP Medicare Advantage from UHC KS-0003 (PPO)

Inpatient Hospital See details

Inpatient Hospital coverage includes a $340 copay for days 1-5 and no copay for days 6-90 for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. Additional days for Inpatient Hospital-Acute have no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.

Outpatient Services See details

Outpatient Services, including all outpatient hospital services, are covered under this plan. Outpatient Hospital Services have a copay between $0 and $340, Observation Services have a $340 copay, and Ambulatory Surgical Center (ASC) Services have no copay.

Outpatient Substance Abuse Services, including individual and group sessions, are covered, and have varying copays. Outpatient Blood Services are covered with no copay.

Partial Hospitalization See details

Partial Hospitalization is covered by the AARP Medicare Advantage from UHC KS-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, including both ground and air ambulance services, each with a $290 copay and no coinsurance. Transportation Services to any health-related location are not covered.

Emergency Services See details

Emergency Services are covered, with a $140 copay and no coinsurance. Urgently Needed Services have a copay between $0 and $65, with no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered, with no copay and no coinsurance.

Primary Care See details

Primary Care Physician Services, Occupational Therapy, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits and Opioid Treatment Program Services are covered. Chiropractic Services are covered, but routine care is not covered, and there is a $20 copay. For Primary Care Physician Services, there is no copay. For Occupational Therapy, there is a copay between $0 and $25. For Physician Specialist Services, the copay is between $0 and $25. For Mental Health Specialty Services, the copay is between $0 and $25 for individual sessions, and $15 for group sessions. For Podiatry Services, the copay is $25. For Other Health Care Professional, the copay is between $0 and $25. For Psychiatric Services, the copay is between $0 and $25 for individual sessions, and $15 for group sessions. For Physical Therapy and Speech-Language Pathology Services, the copay is between $0 and $25. For Additional Telehealth Benefits and Opioid Treatment Program Services, there is no copay.

Preventive Services See details

Preventive Services include annual physical exams with no copay, and additional preventive services including Fitness Benefit, and Home and Bathroom Safety Devices and Modifications, all with no copay. Other services such as Health Education, Counseling Services, and more are not covered.

Hearing Services See details

Hearing exams are covered with no copay, and routine hearing exams are covered once per year. Prescription hearing aids are covered, but inner ear, outer ear, and over the ear aids are not covered, and have a copay between $199 and $1249, depending on the type. OTC hearing aids are covered with a copay between $99 and $829.

Vision Services See details

The AARP Medicare Advantage from UHC KS-0003 (PPO) plan covers vision services, including eye exams with no copay, and eyewear with a combined maximum of $300 every two years. Eyeglass lenses may have a copay between $0 and $153, and contact lenses and eyeglass frames have no copay. Eyeglasses and upgrades are not covered.

Dental Services See details

The AARP Medicare Advantage from UHC KS-0003 (PPO) plan covers dental services including Medicare Dental Services with 20% coinsurance. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay, while prosthodontics (removable and fixed) have a coinsurance between 0% and 50%.

Home Infusion bundled Services See details

Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0-20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0-20%.

Dialysis Services See details

Dialysis Services are covered under the AARP Medicare Advantage from UHC KS-0003 (PPO) plan, with a coinsurance of 20%. Prior authorization is required.

Medical Equipment See details

The AARP Medicare Advantage from UHC KS-0003 (PPO) plan covers Durable Medical Equipment (DME) with 20% coinsurance and requires prior authorization, but does not cover DME for use outside the home. Prosthetics, medical supplies, and diabetic equipment are also covered, and some services require coinsurance or copays.

Diagnostic and Radiological Services See details

Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered. Diagnostic Procedures/Tests have a $50 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $250, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a $25 copay.

Home Health Services See details

Home Health Services are covered 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 by the AARP Medicare Advantage from UHC KS-0003 (PPO) plan, but the specific services including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, are not covered. Prior authorization is required for these services.

Skilled Nursing Facility (SNF) See details

Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC KS-0003 (PPO) plan. 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 KS-0003 (PPO) plan covers Over-the-Counter (OTC) Items with no copay, and Meal Benefits with no copay, but requires prior authorization. Acupuncture and several other services are not covered.