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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 2025, 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 out of 5 stars in 2025.
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 $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 NJ-6 (PPO) plan has a $495 deductible for prescription drugs. In the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, in the initial coverage phase, you will pay a $14 copay for a standard generic drug at a standard pharmacy, and a $100 copay for a preferred brand drug. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC NJ-6 (PPO) plan offers comprehensive coverage with a variety of benefits. This plan covers inpatient hospital stays with a $425 copay for the first few days, with no copay thereafter. Outpatient services, emergency services, primary care, preventive services, hearing, vision, and dental services are covered with varying copays, or no copay. Additional benefits include ambulance services with a $275 copay, and home health services with no copay. The plan also provides coverage for home infusion, dialysis, medical equipment, and diagnostic services with copays or coinsurance. However, some services like cardiac rehabilitation and skilled nursing facilities have copays, and some services like private duty nursing and additional hours of care are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization; for Inpatient Hospital-Acute, you pay a $425 copay for days 1-4, and no copay for days 5-90, and for Inpatient Hospital Psychiatric, you pay a $425 copay for days 1-3, and no copay for days 4-90. Additional days for Inpatient Hospital-Acute are covered with no copay, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, 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 ranging from $0 to $425, observation services with a $425 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with copays between $0 and $25 for individual sessions and $15 for group sessions, and outpatient blood services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground and air ambulance services have a $275 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 by AARP Medicare Advantage from UHC NJ-6 (PPO). Emergency Services have a $110 copay, while Urgently Needed Services have a copay between $0 and $45; Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The AARP Medicare Advantage from UHC NJ-6 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a copay between $0 and $35, and specialist services with a copay between $0 and $45. Mental health and psychiatric services have varying copays depending on the type of session, and podiatry services have a $40 copay. Physical therapy and speech-language pathology services have a copay between $0 and $50, additional telehealth benefits have no copay, and opioid treatment program services have no copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and other services, such as glaucoma screening and diabetes self-management training, are covered with no copay. However, services like health education and in-home safety assessments are not covered.
Hearing Services See details
Hearing exams are covered with no copay, while routine hearing exams are limited to one per year. Prescription hearing aids are partially covered, with a copay between $199 and $1249 for all types, but specific types like inner ear, outer ear, and over the ear are not covered. OTC hearing aids are covered with a copay between $99 and $829, with a limit of two per year.
Vision Services See details
Vision Services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered with no copay. Eyewear is covered with no copay for contact lenses and eyeglass frames, and a copay of $0 - $153 for eyeglass lenses, but eyeglass (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with 20% coinsurance, oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery with no copay, while implant services and orthodontics are not covered. The plan also covers orthodontic services under Diagnostic and Preventive Dental.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. For Medicare Part B Insulin Drugs, you pay a $35 copay and 0-20% coinsurance, while for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you pay 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC NJ-6 (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and no copay, Prosthetic Devices with 20% coinsurance, Medical Supplies with 20% coinsurance, Diabetic Supplies with no copay, and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a $40 copay, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $180, Therapeutic Radiological Services with up to 20% coinsurance, and Outpatient X-Ray Services with a $40 copay. All services require prior authorization.
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, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but all listed sub-services, including Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services, are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage from UHC NJ-6 (PPO) plan, with a prior authorization requirement. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items and Meal Benefit coverage. Over-the-Counter (OTC) Items have no copay, while Meal Benefits also have no copay and require prior authorization. Acupuncture, 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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