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AARP Medicare Advantage from UHC OH-0016 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC OH-0016 (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 OH-0016 (PPO) in 2025, please refer to our full plan details page.
This summary reflects 2025 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
AARP Medicare Advantage from UHC OH-0016 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for the 2025 plan year to people living in Select Counties in Ohio. 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 OH-0016 (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 OH-0016 (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 OH-0016 (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 that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6700.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $6700.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $10100.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $10100.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
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:
Sign up for AARP Medicare Advantage from UHC OH-0016 (PPO)
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Drug Coverage
The AARP Medicare Advantage from UHC OH-0016 (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. For preferred generic drugs at a standard pharmacy, the copay is $12.00. For standard generic drugs at a standard pharmacy, the copay is $47.00. For preferred brand drugs, the copay is $100.00, regardless of the pharmacy. For non-preferred drugs, you pay 28% coinsurance. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC OH-0016 (PPO) plan offers a range of benefits, including no copay for primary care, preventive services, hearing exams, vision exams, and many dental services. Inpatient hospital stays have a copay, starting at $375, while outpatient services have varying copays. This plan also covers ambulance services with a $250 copay, and emergency services with a $115 copay. Additional benefits include coverage for home health services with no copay, and skilled nursing facility stays with no copay for the first 20 days.
Inpatient Hospital See details
Inpatient Hospital coverage includes a $375 copay for days 1-5 and no copay for days 6-90 for acute care, and a $375 copay for days 1-4 and no copay for days 5-90 for psychiatric care. Additional days for inpatient hospital acute care have no copay.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a copay between $0 and $375, observation services have a $375 copay, ambulatory surgical center services have no copay, individual outpatient substance abuse sessions have a copay between $0 and $25, group outpatient substance abuse sessions have a $15 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC OH-0016 (PPO) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC OH-0016 (PPO) plan. Ground and Air Ambulance Services each have a $250 copay, and there is no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under this plan. Emergency Services have a $115 copay, while Urgently Needed Services have a copay between $0 and $45; there is no coinsurance for either. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
The "AARP Medicare Advantage from UHC OH-0016 (PPO)" plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a copay between $0 and $40, and physician specialist services with a copay between $0 and $40. Mental health specialty services, podiatry services, other health care professional, psychiatric services, physical therapy and speech-language pathology services, and opioid treatment program services have varying copays, and additional telehealth benefits have no copay. Routine chiropractic care is not covered.
Preventive Services See details
Preventive Services includes coverage for Medicare-covered preventive services with no copay, as well as annual physical exams with no copay. Additional preventive services include Fitness Benefit, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
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 with a copay between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/Evaluation for Hearing Aids, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Vision services include eye exams with no copay, routine eye exams with no copay, and eyewear with no copay for contact lenses, eyeglass frames, and eyeglass lenses with a copay of $0 - $153. Eyeglasses (lenses and frames) and upgrades are not covered. There is a combined maximum benefit of $300 for eyewear every two years.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare dental services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. Orthodontic services, restorative services, and other dental services 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 the other drug categories have 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered, with a 20% coinsurance for Durable Medical Equipment, Prosthetic Devices, and Medical Supplies. 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 $45 copay, lab services with no copay, diagnostic radiological services with a copay of at most $115, therapeutic radiological services with at most 20% coinsurance, and outpatient X-ray services with a $15 copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC OH-0016 (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with prior authorization required. There is no copay for days 1-20, and a $203 copay for days 21-100; there is no coinsurance.
Other Services See details
Other Services include a meal benefit with no copay, while acupuncture, over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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