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inurance organization provider

UnitedHealth Group, Inc.

Plan ID: H2406-122-0

AARP Medicare Advantage from UHC VA-0015 (PPO)

2025 AARP Medicare Advantage from UHC VA-0015 (PPO) H2406 — 122 — 0 is a Medicare Advantage plan with drug coverage. It has received a 4-out-of-5 star rating from CMS for 2025.

Learn more about AARP Medicare Advantage from UHC VA-0015 (PPO) H2406 - 122 - 0, including the health and drug services it covers, by reading our easy-to-use guide. Or contact a licensed insurance agent for help now.

4 / 5 stars for 2025

$0.00 /mo

Monthly premium

$420.00

Drug deductible

$7900.00

Out-of-pocket maximum

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Call to enroll

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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week!

OverviewBenefits & CostsDrug CoverageAdditional Benefits
Overview Icon

Plan Overview

2025 AARP Medicare Advantage from UHC VA-0015 (PPO) H2406 — 122 — 0 is a PPO offered in Select Counties in Virginia by UnitedHealth Group, Inc.. It has a monthly premium of $0.00.

Premium Breakdown

Standard Part B Premium

$185.00

Part B premium reduction

- $0

Monthly Plan Premium

$0.00

Total Premium:

$185.00

Note:

The standard Medicare Part B premium for 2025 is $185.00. Your premium may differ based on factors like late enrollment, income (IRMAA), or disability status. Most people enrolled in Medicare Part B are required to pay this premium.

Special needs plan type

No

Out-of-pocket maximum

$7900.00

Plan Organization:

UnitedHealth Group, Inc.

Plan Type:

PPO

Location:

Select Counties in Virginia

Drugs Covered:

Yes

Drug Formulary:

Formulary Link

Pharmacies:

Pharmacies Link

Doctor Choice:

Doctors Link:

Doctors Link

Deductibles

The amount you must pay each year before your plan starts to pay for covered services or drugs.

Drug deductible

$420

Note:

This plan does not charge an annual deductible for all drugs. The $420.00 annual deductible only applies to drugs in certain tiers.

Sign up for AARP Medicare Advantage from UHC VA-0015 (PPO)

Enroll online

Call to enroll

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Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week

Drug Coverage Icon

Drug Coverage

AARP Medicare Advantage from UHC VA-0015 (PPO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Benefit Type

Enhanced Alternative

Prescription drug deductible

$420.00

Part D Premium Reduction

This plan's premium may be reduced for you if you qualify for the low-income subsidy (also known as LIS or "Extra help"). The following is what you'll pay for with LIS.

Part D

LIS Full

$0.00

$0.00

Initial Coverage Phase

After you pay your $420.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $2000.00. Once you reach that amount, you will enter the next coverage phase.

30 Days
60 Days
90 Days

Tier

Preferred Pharmacy

Standard Pharmacy

Preferred Mail

Standard Mail

1. Preferred Generic

-

-

-

-

2. Standard Generic

-

-

-

-

3. Preferred Brand

-

-

-

-

4. Non-Preferred Drug

-

-

-

-

5. Specialty Tier

-

-

-

-

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $2000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.

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Additional Benefits

AARP Medicare Advantage from UHC VA-0015 (PPO) also provides the following benefits.

Note:

Limits, Authorizations, and Referrals may apply for the benefits below. Contact the plan for details.

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Comprehensive dental

AARP Medicare Advantage from UHC VA-0015 (PPO) does not provide this type of benefit.

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Preventive dental

Dental X-Rays
In-Network: No Coins - 0.00 Copay
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Out-Of-Network: No Coins - 0.00 Copay
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Fluoride Treatment
In-Network: No Coins - 0.00 Copay
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Out-Of-Network: No Coins - 0.00 Copay
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Oral Exams
In-Network: No Coins - 0.00 Copay
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Out-Of-Network: No Coins - 0.00 Copay
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Other Preventive Dental Services
In-Network: No Coins - 0.00 Copay
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Out-Of-Network: No Coins - 0.00 Copay
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Prophylaxis (cleaning)
In-Network: No Coins - 0.00 Copay
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Out-Of-Network: No Coins - 0.00 Copay
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Additional Coverage Icon

Diagnostic procedures/lab services/imaging

Diagnostic radiology services
Diagnostic tests and procedures
In-Network: $50 copay
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Out-Of-Network: 30% coinsurance
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Lab services
In-Network: $0 copay
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Out-Of-Network: $0 copay
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Outpatient x-rays
In-Network: $25 copay
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Out-Of-Network: $40 copay
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Doctor visits

Primary
In-Network: $0 copay
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Out-Of-Network: $20 copay per visit
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Specialist
In-Network: $0-35 copay per visit
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Out-Of-Network: $60 copay per visit
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Emergency care/Urgent care

Emergency
$110 copay per visit (always covered)
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Urgent care
$0-45 copay per visit (always covered)
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Additional Coverage Icon

Foot care (podiatry services)

Foot exams and treatment
In-Network: $35 copay
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Out-Of-Network: $60 copay
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Routine foot care
In-Network: $35 copay
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Ground ambulance

All service types
In-Network: $290 copay
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Out-Of-Network: $290 copay
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Additional Coverage Icon

Hearing

Hearing aids OTC
In-Network: $99-829 copay
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Out-Of-Network: $99-829 copay
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Medicare-Covered Hearing Exam
In-Network: $0 copay
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Out-Of-Network: $60 copay
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Fitting/evaluation
Not covered
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Hearing aids
In-Network: $199-1,249 copay
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Out-Of-Network: $199-1,249 copay
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Additional Coverage Icon

Inpatient hospital coverage

All service types
In-Network: $325 per day for days 1 through 5 $0 per day for days 6 through 90 $0 per day for days 91 and beyond
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Out-Of-Network: $500 per day for days 1 through 28 $0 per day for days 29 and beyond
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Outpatient hospital coverage

All service types
In-Network: $0-325 copay per visit
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Out-Of-Network: 30% coinsurance per visit
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Optional benefits

All service types
Yes
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Additional Coverage Icon

Medical equipment/supplies

Diabetes supplies
In-Network: $0 copay per item
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Out-Of-Network: 50% coinsurance per item
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Durable medical equipment
Prosthetics
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Medicare Part B drugs

Chemotherapy
In-Network: 0-20% coinsurance
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Out-Of-Network: 30% coinsurance
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Other Part B drugs
In-Network: 0-20% coinsurance
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Out-Of-Network: 0-30% coinsurance
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Mental health services

Inpatient hospital - psychiatric
In-Network: $325 per day for days 1 through 4 $0 per day for days 5 through 90
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Out-Of-Network: $500 per day for days 1 through 28 $0 per day for days 29 through 90
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Outpatient individual therapy visit
In-Network: $0-25 copay
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Out-Of-Network: $40 copay
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Outpatient individual therapy visit with a psychiatrist
In-Network: $0-25 copay
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Out-Of-Network: $40 copay
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Outpatient group therapy visit
In-Network: $15 copay
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Out-Of-Network: $30 copay
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Outpatient group therapy visit with a psychiatrist
In-Network: $15 copay
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Out-Of-Network: $30 copay
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Preventive care

All service types
In-Network: $0 copay
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Out-Of-Network: 0-30% coinsurance
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Rehabilitation services

Occupational therapy visit
In-Network: $0-20 copay
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Out-Of-Network: $60 copay
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Physical therapy and speech and language therapy visit
In-Network: $0-25 copay
Limit IconExclamation Icon
Out-Of-Network: $60 copay
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Additional Coverage Icon

Skilled Nursing Facility

All service types
In-Network: $0 per day for days 1 through 20 $203 per day for days 21 through 100
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Out-Of-Network: $225 per day for days 1 through 100
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Transportation

All service types
Not covered
Limit Icon
Additional Coverage Icon

Vision

Contact lenses
In-Network: $0 copay
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Out-Of-Network: $0-153 copay
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Eyeglass frames
In-Network: $0 copay
Limit Icon
Out-Of-Network: $0-153 copay
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Upgrades
Not covered
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Eyeglass lenses
In-Network: $0-153 copay
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Out-Of-Network: $0-153 copay
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Eyeglasses (frames and lenses)
Not covered
Limit Icon
Routine eye exam
In-Network: $0 copay
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Out-Of-Network: $60 copay
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Other
Not covered
Limit Icon
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Wellness programs (eg, fitness, nursing hotline)

All service types
Covered
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Overview Icon

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week

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Every year, Medicare evaluates plans based on a 5-star rating system.

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.

* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.

Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period

We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.

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