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AARP Medicare Advantage from UHC NJ-6 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NJ-6 (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 NJ-6 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC NJ-6 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of New Jersey. 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 NJ-6 (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 NJ-6 (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 NJ-6 (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 $600.00 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 $13900.00 (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 $13900.00 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 NJ-6 (PPO) plan features an annual drug deductible of $600. 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 $14 copay for a 1-month supply at standard pharmacies, though you can get a 3-month supply with no copay through preferred mail order. Higher-tier medications are subject to coinsurance rather than flat copayments. You can expect a 16% coinsurance for Tier 3 preferred brand drugs and a 34% coinsurance for Tier 4 non-preferred drugs. Tier 5 specialty drugs require a 26% coinsurance for a 1-month supply at both standard pharmacies and mail-order services.
Additional Benefits
The AARP Medicare Advantage from UHC NJ-6 (PPO) plan offers comprehensive medical coverage featuring no copay for primary care visits, preventive screenings, and home health services. For specialized care, members can expect predictable costs, including no copay to a $55 copay for specialist visits and a $545 daily copay for the first few days of inpatient hospital stays. Emergency room visits require a $115 copay, which is waived if admitted, while urgent care services are available with no copay to a $40 copay. Additional benefits include annual routine hearing and vision exams with no copay, alongside a $300 eyewear allowance and coverage for hearing aids. While routine dental services are not covered under this plan, Medicare-covered dental care and durable medical equipment are provided with a 20% coinsurance and no copay. Skilled nursing facility care is also covered, offering no copay for the first 20 days of care before a daily copay applies.
Inpatient Hospital See details
Inpatient hospital services are covered by AARP Medicare Advantage from UHC NJ-6 (PPO) with no coinsurance, requiring a $545 copay for days 1 through 4 of acute stays and days 1 through 3 of psychiatric stays, with no copay for subsequent covered days. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC NJ-6 (PPO) covers outpatient services with no coinsurance, including ambulatory surgical and blood services with no copay. Outpatient hospital services require a copay of $0 to $545 (with a $545 daily copay for observation), and outpatient substance abuse services range from no copay to $25.
Partial Hospitalization See details
Partial hospitalization services are covered under the AARP Medicare Advantage from UHC NJ-6 (PPO) plan with a $55 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC NJ-6 (PPO) partially covers ambulance and transportation services, with ground and air ambulance services requiring a $275 copay and no coinsurance. Transportation services to plan-approved or health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage from UHC NJ-6 (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay to a $40 copay with no coinsurance, while worldwide emergency, urgent care, and emergency transportation services are covered with no copays and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC NJ-6 (PPO) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $55 copay and no coinsurance. Covered therapies and mental health services have copays ranging from $0 to $55 with no coinsurance, and although some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC NJ-6 (PPO) provides coverage for preventive services, such as annual physical exams, kidney disease education, and select screenings, with no copay and no coinsurance. While a fitness benefit is covered with no copay, several other additional preventive services, including health education, nutritional counseling, and weight management programs, are not covered.
Hearing Services See details
Hearing services are partially covered by the AARP Medicare Advantage from UHC NJ-6 (PPO), offering one annual routine hearing exam with no copay or coinsurance, though hearing aid fitting and evaluation exams are not covered. Up to two prescription hearing aids are covered yearly with a $199 to $1,249 copay and no coinsurance, excluding inner ear, outer ear, and over the ear models. Up to two OTC hearing aids are also covered annually with a copay of $199 to $829 and no coinsurance.
Vision Services See details
AARP Medicare Advantage from UHC NJ-6 (PPO) partially covers vision services with no deductible and no coinsurance, offering no copay for annual routine eye exams and a $300 combined eyewear allowance every two years. Under this plan, contact lenses and eyeglass frames are covered with no copay, and eyeglass lenses have a $0 to $153 copay, while other eye exams, combined eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
AARP Medicare Advantage from UHC NJ-6 (PPO) partially covers dental services, offering Medicare-covered dental care with no copay and a 20% coinsurance, subject to prior authorization. However, routine and comprehensive dental services—including oral exams, cleanings, x-rays, restorative treatments, and implants—are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC NJ-6 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance up to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered by AARP Medicare Advantage from UHC NJ-6 (PPO) with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage from UHC NJ-6 (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay from specified manufacturers, while diabetic therapeutic shoes and inserts require a 20% coinsurance and no copay. Prior authorization is required for these covered medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the AARP Medicare Advantage from UHC NJ-6 (PPO) plan with prior authorization required. Diagnostic tests require a $50 copay and no coinsurance, lab services have no copay and no coinsurance, and radiological services feature a $30 copay for X-rays, a 20% coinsurance for therapeutic services, and no copay for diagnostic radiology.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC NJ-6 (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by AARP Medicare Advantage from UHC NJ-6 (PPO) with no copay or coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC NJ-6 (PPO) covers Skilled Nursing Facility (SNF) services 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 prior three-day inpatient hospital stay is not needed for admission, additional days beyond the 100-day Medicare limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC NJ-6 (PPO) partially covers other services, offering a meal benefit for chronic illnesses with no copay and no coinsurance, though prior authorization is required. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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