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AARP Medicare Advantage from UHC RI-0003 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC RI-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 RI-0003 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC RI-0003 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Rhode Island. 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 RI-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 RI-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 RI-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 $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 RI-0003 (PPO) drug plan features an annual prescription deductible of $520. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic drugs cost a $10 copay for a 1-month supply at standard pharmacies, but you can secure a 3-month supply with no copay using preferred mail order. Tier 3 preferred brand drugs require a 16% coinsurance for both 1-month and 3-month supplies at standard pharmacies and mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 37% coinsurance and 27% coinsurance, respectively, for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC RI-0003 (PPO) plan offers comprehensive medical coverage with no copays and no coinsurance for primary care visits, routine preventive services, and home health care. For inpatient hospital stays, members pay a $550 daily copay for days 1 through 5 and no copay for additional days, while emergency room visits carry a $130 copay. Specialist visits range from a $0 to $55 copay, and most diagnostic lab services are covered with no copay and no coinsurance. Routine vision and hearing exams are covered with no copay, with additional allowances available for eyewear and prescription hearing aids. While preventive dental care has no copay, Medicare-covered dental services, dialysis, and durable medical equipment require a 20% coinsurance. Additionally, skilled nursing facility stays feature no copay for the first 20 days, followed by a $218 daily copay up to 100 days.
Inpatient Hospital See details
AARP Medicare Advantage from UHC RI-0003 (PPO) covers inpatient acute hospital stays with no coinsurance and a $550 daily copay for days 1 to 5, with no copay for days 6 and beyond. Inpatient psychiatric hospital care is also covered with no coinsurance, requiring a $550 daily copay for days 1 to 4 and no copay for days 5 to 90.
Outpatient Services See details
Outpatient services covered under the AARP Medicare Advantage from UHC RI-0003 (PPO) feature no coinsurance, with copays ranging from $0 to $550 for outpatient hospital and observation services. Ambulatory surgical center and outpatient blood services are offered with no copay and no coinsurance, while outpatient substance abuse services carry a copay of $0 to $25 depending on the session type.
Partial Hospitalization See details
AARP Medicare Advantage from UHC RI-0003 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC RI-0003 (PPO) covers ground and air ambulance services with a $275 copay and no coinsurance, while transportation services to health-related locations are not covered. Prior authorization is required for ambulance services, and the copay is not waived if you are admitted to the hospital.
Emergency Services See details
AARP Medicare Advantage from UHC RI-0003 (PPO) covers emergency services 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 copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC RI-0003 (PPO) covers primary care and telehealth services with no copay and no coinsurance. Other services like specialist visits ($0-$55 copay), mental health sessions ($0-$25 copay), and physical therapy ($55 copay) feature no coinsurance, while chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC RI-0003 (PPO) provides partially covered preventive services with no copay and no coinsurance, including annual physical exams, fitness benefits, and home safety devices. While key screenings and diabetes training are covered at no cost, several supplemental options such as health education, nutritional therapy, and in-home support services are not covered.
Hearing Services See details
AARP Medicare Advantage from UHC RI-0003 (PPO) partially covers hearing services, offering one routine hearing exam annually with no copay or coinsurance, though fitting and evaluation exams are not covered. Up to two prescription hearing aids (copay of $199.00 to $1,249.00) and two OTC hearing aids (copay of $199.00 to $829.00) are covered yearly with no coinsurance, but inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
AARP Medicare Advantage from UHC RI-0003 (PPO) partially covers vision services with no deductible, no coinsurance, and no copay for annual routine eye exams, contact lenses, and eyeglass frames. Eyeglass lenses are covered with a copay of $0 to $153 up to a $150 eyewear limit every two years, whereas other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC RI-0003 (PPO) partially covers dental services, providing Medicare-covered dental care with no copay and a 20% coinsurance, and preventive services with no copay and no coinsurance. Specific sub-services such as restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC RI-0003 (PPO) with no copay, though prior authorization is required. Under this benefit, Part B chemotherapy, radiation, and other drugs have no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC RI-0003 (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC RI-0003 (PPO), featuring no copay and 20% coinsurance for durable medical equipment, prosthetics, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay, though they are limited to specified manufacturers, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the AARP Medicare Advantage from UHC RI-0003 (PPO) plan, though prior authorization is required. Lab services and diagnostic radiological services have no copay and no coinsurance, while diagnostic procedures require a $50 copay with no coinsurance, outpatient X-rays require a $30 copay, and therapeutic radiological services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage from UHC RI-0003 (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC RI-0003 (PPO) covers Cardiac Rehabilitation Services with no copay and no coinsurance, although only some services are covered. Under this plan, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered, and prior authorization is required for covered services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by AARP Medicare Advantage from UHC RI-0003 (PPO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a three-day prior hospital stay is not needed before admission, additional days beyond the standard 100 days are not covered.
Other Services See details
AARP Medicare Advantage from UHC RI-0003 (PPO) offers partial coverage for other services, providing over-the-counter (OTC) items and a chronic illness meal benefit with no copay and no coinsurance, though meals require prior authorization. Acupuncture and other additional services are not covered under this plan.
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