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AARP Medicare Advantage from UHC IA-0004 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC IA-0004 (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 IA-0004 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC IA-0004 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Iowa and Illinois. 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 IA-0004 (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 IA-0004 (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 IA-0004 (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 $495.00 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 IA-0004 (PPO) plan has an "Enhanced Alternative" drug benefit. The plan has a deductible of $495.00. After the deductible, your costs will vary depending on the drug tier and pharmacy. For example, for a standard pharmacy, you will pay a $12 copay for tier 1 drugs, a $47 copay for tier 2 drugs, and a $100 copay for tier 3 drugs.
Additional Benefits
The AARP Medicare Advantage from UHC IA-0004 (PPO) plan offers a variety of benefits with varying cost-sharing. You can expect no copay for primary care, preventive services, hearing exams, routine eye exams, eyewear, and home health services. Other services, like inpatient hospital stays, outpatient services, ambulance services, and specialist visits, have copays ranging from $0 to $415. The plan also covers services like dental, vision, and medical equipment. For dental services, you will pay 20% coinsurance for Medicare dental services, and have no copay for preventative dental services. Vision services include routine eye exams and eyewear with no copay. Diagnostic and radiological services, skilled nursing facilities, and home infusion bundled services are also covered, with a mix of copays and coinsurance depending on the service.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered. For Inpatient Hospital-Acute, you will pay a $415 copay for days 1-5, and no copay for days 6-90, and no coinsurance. For Additional Days for Inpatient Hospital-Acute, there is no copay or coinsurance for days 91-999. For Inpatient Hospital Psychiatric, you will pay a $415 copay for days 1-4, and no copay for days 5-90, and no coinsurance. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include Outpatient Hospital Services with a copay between $0 and $415, Observation Services with a $415 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a copay between $0 and $5 for individual sessions and a $5 copay for group sessions, and Outpatient Blood Services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the AARP Medicare Advantage from UHC IA-0004 (PPO) plan. Ground and Air Ambulance Services have a copay of $290, 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 by AARP Medicare Advantage from UHC IA-0004 (PPO). Emergency Services has a $125 copay, while Urgently Needed Services has a copay between $0 and $55. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The AARP Medicare Advantage from UHC IA-0004 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, and occupational therapy services with a copay between $0 and $35. Physician specialist services have a copay between $0 and $45, and mental health specialty services have a copay between $0 and $5 for individual sessions and $5 for group sessions. Podiatry services and other health care professional services have a copay between $35 and $45 respectively, and psychiatric services have a copay between $0 and $5 for individual sessions and $5 for group sessions. Physical therapy and speech-language pathology services have a copay between $0 and $40, additional telehealth benefits have no copay, and opioid treatment program services have no copay. Routine chiropractic care is not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, and an annual physical exam with no copay. Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are also covered with no copay. However, Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services 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 with a copay between $199 and $1249, with coverage for two hearing aids per year. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision services include eye exams, eyewear, contact lenses, eyeglass lenses, and eyeglass frames. Routine eye exams have no copay, and are covered once per year. Eyewear has no copay, and is covered up to a combined maximum of $200 every two years, and includes contact lenses, eyeglass lenses, and eyeglass frames. Contact lenses have no copay, and are unlimited. Eyeglass lenses have a copay of $0-$153 and are covered once every two years. Eyeglass frames have no copay and are covered once every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, with 20% coinsurance for Medicare dental services, and no copay for oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
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 a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
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, including Durable Medical Equipment with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a $50 copay, lab services with no copay, diagnostic radiological services with a copay of at most $250, therapeutic radiological services with a copay of at least $80, and outpatient X-ray services with a $25 copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC IA-0004 (PPO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage from UHC IA-0004 (PPO), but no specific services are covered under this benefit. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC IA-0004 (PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100, with no coinsurance.
Other Services See details
Other Services include a meal benefit with no copay, but 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.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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