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AARP Medicare Advantage from UHC NH-0004 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NH-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 NH-0004 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC NH-0004 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select counties in New Hampshire. 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 NH-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 NH-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 NH-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 $14000.00 (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 $14000.00 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 NH-0004 (PPO) plan has an enhanced alternative drug benefit. The plan has a $495 deductible for prescription drugs. After the deductible, you will pay a copay for your prescriptions. For example, you will pay a $10 copay for a standard generic drug. For a preferred brand drug, you will pay a $100 copay. If you qualify for the low-income subsidy, you will pay no copay. After your total drug costs reach $2000, you will enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC NH-0004 (PPO) plan offers a range of benefits, including inpatient hospital stays with a $395 copay for days 1-5, and no copay for days 6-90, along with various outpatient services with copays varying between $0 and $395. This plan also covers emergency services with a $110 copay, primary care with no copay, and provides coverage for hearing exams, vision exams, and dental services with no copay for certain services.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, you pay a $395 copay for days 1-5, and no copay for days 6-90, with no coinsurance. For Inpatient Hospital Psychiatric, you also pay a $395 copay for days 1-5, and no copay for days 6-90, with no coinsurance. Additional Days for Inpatient Hospital-Acute are covered with no copay and no coinsurance. 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 include coverage for all outpatient hospital services with a copay between $0 and $395, observation services with a $395 copay, and Ambulatory Surgical Center (ASC) Services with no copay. Outpatient Substance Abuse Services are covered with copays between $0 and $25 for individual sessions and a $15 copay for group sessions, and Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC NH-0004 (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 NH-0004 (PPO) plan. Ground and Air Ambulance Services have a $120 copay, with no coinsurance, while Transportation Services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay, while Urgently Needed Services have a copay between $0 and $40; Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
Under the AARP Medicare Advantage from UHC NH-0004 (PPO) plan, primary care physician services have no copay, chiropractic services have a $15 copay, and occupational therapy services have a copay between $0 and $25. Physician specialist services have a copay between $0 and $40, while mental health individual sessions have a copay between $0 and $25, and group sessions have a $15 copay. Podiatry services have a $40 copay, and other health care professional services have a copay between $0 and $40. Psychiatric individual sessions have a copay between $0 and $25, and group sessions have a $15 copay. Physical therapy and speech-language pathology services have a copay between $0 and $25, and additional telehealth benefits and opioid treatment program services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, an annual physical exam with no copay, and additional preventive services with a copay as described in the plan details. Other services such as Health Education, In-Home Safety Assessment, and others are not covered.
Hearing Services See details
Hearing exams are covered with no copay, while fitting/evaluation for hearing aids are not covered. Prescription hearing aids are partially covered, with a copay between $199 and $1249 for prescription hearing aids (all types), but not for inner ear, outer ear, or over-the-ear hearing aids. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision Services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear has a combined maximum benefit of $300 every two years, and contact lenses, eyeglass lenses, and eyeglass frames are covered with no copay, while eyeglasses and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC NH-0004 (PPO) plan covers dental services including oral exams, dental X-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services with no copay; however, other diagnostic dental services are offered as an optional supplemental benefit, and orthodontics, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are not covered. Medicare Dental Services have a 20% coinsurance and require prior authorization.
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. 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 under the AARP Medicare Advantage from UHC NH-0004 (PPO) plan, but prior authorization is required. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $25 copay, lab services with no copay, and outpatient X-ray services with a $25 copay. Diagnostic radiological services have a maximum copay of $185, and therapeutic radiological services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC NH-0004 (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the AARP Medicare Advantage from UHC NH-0004 (PPO) plan, but not covered in practice. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage from UHC NH-0004 (PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The AARP Medicare Advantage from UHC NH-0004 (PPO) plan covers meal benefits 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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