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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 2026, 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 2026 to people living in Select Counties of New Hampshire. 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 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 $39.00. 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 NH-0004 (PPO) plan features a $600 annual drug deductible. For Tier 1 preferred generic drugs, you will pay no copay for standard pharmacy fills or three-month mail orders. Tier 2 generic medications cost a $12 copay for a one-month supply at standard pharmacies, though you can receive a three-month supply with no copay through preferred mail order. Tier 3 preferred brand drugs require a 16% coinsurance for both standard pharmacy fills and mail order options. Higher-tier medications, including Tier 4 non-preferred drugs and Tier 5 specialty drugs, carry a coinsurance of 34% and 26% respectively for a one-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC NH-0004 (PPO) plan offers comprehensive coverage for core medical services with predictable copayments and no coinsurance for many benefits. You will pay no copay for primary care doctor visits, telehealth services, and annual preventive physicals, while specialist visits require a copay of up to $55. For hospital care, acute inpatient stays require a $485 copay for the first five days and no copay for additional days, with no coinsurance required. Routine dental cleanings, annual eye exams, and yearly hearing tests are covered with no copay, and members receive a $300 eyewear allowance every two years. For specialized medical needs, there is a 20% coinsurance for dialysis and durable medical equipment, while home health services and laboratory tests require no copay. Emergency room visits carry a $115 copay, which is waived if you are admitted to the hospital within 24 hours.
Inpatient Hospital See details
AARP Medicare Advantage from UHC NH-0004 (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute stays require a $485 copay for days 1-5 and no copay for days 6 and beyond, whereas psychiatric stays require a $485 copay for days 1-4 and no copay for days 5-90. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC NH-0004 (PPO) with no coinsurance, featuring a $0 to $485 copay for outpatient hospital services and a $485 daily copay for observation services. Ambulatory surgical center and blood services require no copay, while outpatient substance abuse sessions carry a copay of $0 to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
Partial hospitalization services are covered by AARP Medicare Advantage from UHC NH-0004 (PPO) with a $55.00 copay and no coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC NH-0004 (PPO) covers ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required and the copay is not waived if you are admitted to the hospital. Routine transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage from UHC NH-0004 (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 feature a copay ranging from $0 to $40 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 NH-0004 (PPO) offers primary care and telehealth services with no copay and no coinsurance, while specialists and other healthcare professionals require a copay of $0 to $55 and no coinsurance. Therapy services feature copays of $25 to $45 with no coinsurance, but chiropractic services are only partially covered as routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by the AARP Medicare Advantage from UHC NH-0004 (PPO) plan, offering no copay and no coinsurance for covered benefits like annual physical exams, fitness benefits, kidney disease education, and various screenings. However, several supplemental benefits are not covered, including health education, weight management programs, nutritional benefits, personal emergency response systems, and in-home safety assessments.
Hearing Services See details
AARP Medicare Advantage from UHC NH-0004 (PPO) partially covers hearing services, providing one routine hearing exam per year with no copay and no coinsurance, while fitting and evaluation exams are not covered. Covered prescription hearing aids (copays of $199.00 to $1,249.00) and OTC hearing aids (copays of $199.00 to $829.00) both feature no coinsurance and a limit of two devices per year, although inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
AARP Medicare Advantage from UHC NH-0004 (PPO) provides partially covered vision services with no deductibles and no coinsurance. One routine eye exam is covered annually with no copay, and eyewear is covered up to a $300 limit every two years with a $0 copay for contacts or frames and a $0 to $153 copay for lenses, though other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC NH-0004 (PPO) offers partially covered dental services, featuring no copay and no coinsurance for preventive care like exams, cleanings, and x-rays. Medicare-covered dental services require prior authorization and have no copay with a 20% coinsurance, but comprehensive services such as restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC NH-0004 (PPO) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Covered Medicare Part B drugs, including chemotherapy and other drugs, carry coinsurance ranging from no coinsurance to 20%, while covered insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by AARP Medicare Advantage from UHC NH-0004 (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
AARP Medicare Advantage from UHC NH-0004 (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these medical equipment benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC NH-0004 (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Members will pay a $30 copay for diagnostic procedures, tests, and outpatient X-rays, a $60 copay for therapeutic radiological services, and no copay for lab services and diagnostic radiological services.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC NH-0004 (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC NH-0004 (PPO) provides coverage for cardiac rehabilitation services with no copay and no coinsurance, meaning some services are covered, though prior authorization is required. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD) are not covered in practice.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC NH-0004 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC NH-0004 (PPO) partially covers other services, featuring a chronic illness meal benefit with no copay, no coinsurance, and prior authorization required. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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