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AARP Medicare Advantage from UHC IL-5 (PPO)
- Monthly premium
- new
- former
- $0
- Primary care provider (PCP)
- Out-of-pocket maximum
- Estimated Annual Drug Cost
Discover the Benefits
Dental benefits
- $0 copay for network preventive dental including oral exams, x-rays, routine cleanings and fluoride
OTC credit
- $40 credit every quarter for OTC products like pain relievers, cold remedies and vitamins in-store or online
Routine vision benefits
- $300 allowance for frames or contacts every 2 years, plus $0 copay for routine eye exam and standard prescription lenses
General plan costs
See how much you'll pay for this plan including your premium, deductible and maximum out-of-pocket costs.
| Costs | In-network - What you'll pay | Out-of-network - What you'll pay |
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| Monthly premium |
new
former
$0
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Monthly premium
new
former
$0
$0
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Annual medical deductible
Annual medical deductible
The pre-set, fixed amount you must pay for health care costs before the insurance company or Medicare begins to pay. Please see your Evidence of Coverage for details.
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$0 | $0 |
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Annual medical deductible
Annual medical deductible
The pre-set, fixed amount you must pay for health care costs before the insurance company or Medicare begins to pay. Please see your Evidence of Coverage for details.
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Out-of-pocket maximum
Out-of-pocket maximum
This is the highest amount of money you have to pay out of your pocket for cost sharing (copayments and coinsurance) charged for certain covered services during a calendar year. Not all copayments or coinsurance amounts you pay apply toward the annual out-of-pocket maximum. See the plan’s Evidence of Coverage for more information.
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$6,700 | $10,100 combined in and out-of-network |
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Out-of-pocket maximum
Out-of-pocket maximum
This is the highest amount of money you have to pay out of your pocket for cost sharing (copayments and coinsurance) charged for certain covered services during a calendar year. Not all copayments or coinsurance amounts you pay apply toward the annual out-of-pocket maximum. See the plan’s Evidence of Coverage for more information.
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National Network
National Network
As a member of an eligible health plan, the UnitedHealthcare Medicare National Network allows you to have access to participating care providers across the United States at your in-network cost share, even when getting care outside of your home location. Networks vary by market and exclusions may apply.
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Yes, you can get network care across the country | |
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National Network
National Network
As a member of an eligible health plan, the UnitedHealthcare Medicare National Network allows you to have access to participating care providers across the United States at your in-network cost share, even when getting care outside of your home location. Networks vary by market and exclusions may apply.
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Doctor visits
Find out about this plan's copays for primary care providers and specialists.
| Costs | In-network - what you'll pay | Out-of-network - what you'll pay |
|---|---|---|
| Primary care provider (PCP) | $0 copay | $35 copay |
| Primary care provider (PCP) $0 copay $35 copay | ||
| Specialist | $45 copay | $65 copay |
| Specialist $45 copay $65 copay | ||
| Virtual visits | $0 copay to talk with a network telehealth provider online through live audio and video. | |
| Virtual visits $0 copay to talk with a network telehealth provider online through live audio and video. $0 copay to talk with a network telehealth provider online through live audio and video. | ||
| Annual routine physical | $0 copay, 1 per year | 40% of the cost, combined visits in and out-of-network |
| Annual routine physical $0 copay, 1 per year 40% of the cost, combined visits in and out-of-network | ||
| Preventive services (such as covered screenings, vaccinations, etc.) | $0 copay for covered services | $0 - 40% of the cost (depending on the service) |
| Preventive services (such as covered screenings, vaccinations, etc.) $0 copay for covered services $0 - 40% of the cost (depending on the service) | ||
| Mental health (outpatient) |
Group: $15 copay Individual: $25 copay |
Group: $30 copay Individual: $40 copay |
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Mental health (outpatient)
Group: $15 copay Individual: $25 copay Group: $30 copay Individual: $40 copay |
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| Opioid treatment services | $0 copay | $0 copay |
| Opioid treatment services $0 copay $0 copay | ||
Prescription drug benefits
Learn about this plan's prescription drug coverage and costs. Enter your prescriptions to see what they'd cost with this plan.
| Costs | What you'll pay |
|---|---|
| Annual prescription deductible |
$0 for Tiers 1-2 $495 for Tiers 3-5 |
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Annual prescription deductible
$0 for Tiers 1-2 $495 for Tiers 3-5 |
| Retail network pharmacy (30-day supply) | What you'll pay |
|---|---|
| Tier 1: Preferred Generic Drugs |
Network pharmacy (30-day) $0 copay |
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Tier 1: Preferred Generic Drugs
Network pharmacy (30-day) $0 copay |
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| Tier 2: Generic Drugs |
Network pharmacy (30-day) $14 copay |
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Tier 2: Generic Drugs
Network pharmacy (30-day) $14 copay |
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| Tier 3: Preferred Brand Drugs |
Network pharmacy (30-day) $47 copay |
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Tier 3: Preferred Brand Drugs
Network pharmacy (30-day) $47 copay |
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| Tier 3: Insulin |
Network pharmacy (30-day) $35 copay |
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Tier 3: Insulin
Network pharmacy (30-day) $35 copay |
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| Tier 4: Non-preferred Drugs |
Network pharmacy (30-day) $100 copay |
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Tier 4: Non-preferred Drugs
Network pharmacy (30-day) $100 copay |
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| Tier 5: Specialty Drugs |
Network pharmacy (30-day) 27% of the cost |
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Tier 5: Specialty Drugs
Network pharmacy (30-day) 27% of the cost |
| Mail order pharmacy | What you'll pay |
|---|---|
| Tier 1: Preferred Generic Drugs | $0 copay |
| Tier 1: Preferred Generic Drugs $0 copay | |
| Tier 2: Generic Drugs | $0 copay |
| Tier 2: Generic Drugs $0 copay | |
| Tier 3: Preferred Brand Drugs | $131 copay |
| Tier 3: Preferred Brand Drugs $131 copay | |
| Tier 3: Insulin | $95 copay |
| Tier 3: Insulin $95 copay |
Dental coverage
Learn about this plan's dental coverage options and costs.
| Costs | What you'll pay | |
|---|---|---|
| Routine dental |
$0 copay for covered network preventive services such as oral exams, routine cleanings, X-rays, and fluoride You will have access to one of Medicare Advantage's largest dental networks, or you can choose any dentist. Seeing a network dentist may save you money. |
$0 copay for covered network preventive services such as oral exams, routine cleanings, X-rays, and fluoride You will have access to one of Medicare Advantage's largest dental networks, or you can choose any dentist. Seeing a network dentist may save you money. |
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Routine dental
$0 copay for covered network preventive services such as oral exams, routine cleanings, X-rays, and fluoride You will have access to one of Medicare Advantage's largest dental networks, or you can choose any dentist. Seeing a network dentist may save you money. |
Optional Services (Riders)
Platinum Dental Rider: add $54 to your monthly premium.
- $1,500 per year for covered dental services through the Platinum Dental Rider.
- $0 copay for covered network preventive services such as oral exams, routine cleanings, X-rays and fluoride
- 50% coinsurance for bridges and dentures, $0 copay for all other covered network comprehensive services such as fillings, crowns, root canals and extractions
- You will have access to one of Medicare Advantage's largest dental networks, or you can choose any dentist. Seeing a network dentist may save you money.
Medical benefit information
See this plan's benefits, costs and copays. For full plan details, see the Evidence of Coverage or Summary of Benefits under the Plan Documents section.
| Costs | In-network - What you'll pay | Out-of-network - What you'll pay |
|---|---|---|
| Urgent care | $55 copay per visit ($0 copay when outside of the United States) | |
| Urgent care $55 copay per visit ($0 copay when outside of the United States) $55 copay per visit ($0 copay when outside of the United States) | ||
| Emergency care | $125 copay per visit ($0 copay when outside of the United States) | |
| Emergency care $125 copay per visit ($0 copay when outside of the United States) $125 copay per visit ($0 copay when outside of the United States) | ||
| Ambulance services | $275 copay for ground or air | |
| Ambulance services $275 copay for ground or air $275 copay for ground or air | ||
| Inpatient hospital care |
$395 copay per day: days 1-5 $0 copay per day: days 6 and beyond for unlimited days |
40% per stay for unlimited days |
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Inpatient hospital care
$395 copay per day: days 1-5 $0 copay per day: days 6 and beyond for unlimited days 40% per stay for unlimited days |
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| Outpatient hospital services (including surgery and observation) | $395 copay | 40% of the cost |
| Outpatient hospital services (including surgery and observation) $395 copay 40% of the cost | ||
| Ambulatory surgical center | $295 copay | 40% of the cost |
| Ambulatory surgical center $295 copay 40% of the cost | ||
| Physical and speech therapy | $40 copay | $65 copay |
| Physical and speech therapy $40 copay $65 copay | ||
| Occupational therapy | $40 copay | $65 copay |
| Occupational therapy $40 copay $65 copay | ||
| Lab services | $0 copay | $0 copay |
| Lab services $0 copay $0 copay | ||
| Outpatient X-rays | $15 copay | $40 copay |
| Outpatient X-rays $15 copay $40 copay | ||
| Diagnostic tests and procedures, non-radiological (such as EKG/ECG tests, etc.) | $50 copay | 40% of the cost |
| Diagnostic tests and procedures, non-radiological (such as EKG/ECG tests, etc.) $50 copay 40% of the cost | ||
| Diagnostic radiology services (such as MRIs, CT scans, etc.) | $150 copay | 40% of the cost |
| Diagnostic radiology services (such as MRIs, CT scans, etc.) $150 copay 40% of the cost | ||
| Skilled nursing facility |
$0 copay per day: days 1-20 $203 copay per day: days 21-100 |
$225 copay per day: days 1-100 |
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Skilled nursing facility
$0 copay per day: days 1-20 $203 copay per day: days 21-100 $225 copay per day: days 1-100 |
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| Home health care | $0 copay | 50% of the cost |
| Home health care $0 copay 50% of the cost | ||
| Diabetes monitoring supplies | $0 copay for covered brands | 50% of the cost |
| Diabetes monitoring supplies $0 copay for covered brands 50% of the cost | ||
Extra benefits and programs
See more of the benefits and programs offered by this plan that are not provided under Original Medicare. For full plan details, see the Evidence of Coverage or Summary of Benefits under the Plan Documents section.
| Costs | In-network - What you'll pay | Out-of-network - What you'll pay |
|---|---|---|
| Routine eye exam | $0 copay, 1 per year | $65 copay, combined visits in and out-of-network |
| Routine eye exam $0 copay, 1 per year $65 copay, combined visits in and out-of-network | ||
| Routine eyewear |
Plan pays up to $300 every two years for 1 pair of frames or contact lenses. Standard single, bifocal, trifocal, or progressive lenses are covered in full. Home-delivered eyewear available nationwide only through UnitedHealthcare Vision (select products only). |
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Routine eyewear
Plan pays up to $300 every two years for 1 pair of frames or contact lenses. Standard single, bifocal, trifocal, or progressive lenses are covered in full. Home-delivered eyewear available nationwide only through UnitedHealthcare Vision (select products only). Plan pays up to $300 every two years for 1 pair of frames or contact lenses. Standard single, bifocal, trifocal, or progressive lenses are covered in full. Home-delivered eyewear available nationwide only through UnitedHealthcare Vision (select products only). |
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| Routine hearing exam | $0 copay, 1 per year | $65 copay, combined visits in and out-of-network |
| Routine hearing exam $0 copay, 1 per year $65 copay, combined visits in and out-of-network | ||
| Hearing aids | Copays from $99 - $1,249 for a broad selection of OTC and brand-name prescription hearing aids through UnitedHealthcare Hearing, up to 2 hearing aids every year | |
| Hearing aids Copays from $99 - $1,249 for a broad selection of OTC and brand-name prescription hearing aids through UnitedHealthcare Hearing, up to 2 hearing aids every year Copays from $99 - $1,249 for a broad selection of OTC and brand-name prescription hearing aids through UnitedHealthcare Hearing, up to 2 hearing aids every year | ||
| OTC credit | $40 credit per quarter to buy covered OTC products. | |
| OTC credit $40 credit per quarter to buy covered OTC products. $40 credit per quarter to buy covered OTC products. | ||
| Rewards | Earn up to $155 in rewards every year for getting an annual wellness visit, being physically active, connecting with others and more. | |
| Rewards Earn up to $155 in rewards every year for getting an annual wellness visit, being physically active, connecting with others and more. Earn up to $155 in rewards every year for getting an annual wellness visit, being physically active, connecting with others and more. | ||
| Fitness program | $0 copay for Renew Active®, which includes a free membership at core and premium gyms, plus online fitness classes and brain health challenges. | |
| Fitness program $0 copay for Renew Active®, which includes a free membership at core and premium gyms, plus online fitness classes and brain health challenges. $0 copay for Renew Active®, which includes a free membership at core and premium gyms, plus online fitness classes and brain health challenges. | ||
| Routine foot care | $45 copay, 6 visits per year | $65 copay, combined visits in and out-of-network |
| Routine foot care $45 copay, 6 visits per year $65 copay, combined visits in and out-of-network | ||
| Meal benefit | $0 copay for 28 home-delivered meals immediately after an inpatient hospitalization or skilled nursing facility (SNF) stay. | |
| Meal benefit $0 copay for 28 home-delivered meals immediately after an inpatient hospitalization or skilled nursing facility (SNF) stay. $0 copay for 28 home-delivered meals immediately after an inpatient hospitalization or skilled nursing facility (SNF) stay. | ||
Plan documents
Important documents that provide the details you need about this plan's coverage and benefits, prescription drugs, enrollment, providers and more.
| General Plan Information |
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General Plan Information
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| Provider Directory | |
| Provider Directory | |
| Prescription Drug Coverage |
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Prescription Drug Coverage
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| Pharmacy Directory | |
| Pharmacy Directory |
| General Plan Information |
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General Plan Information
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| Provider Directory |
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Provider Directory
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| Prescription Drug Coverage |
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Prescription Drug Coverage
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| Pharmacy Directory | |
| Pharmacy Directory |
Footnotes & disclaimers
Footnotes
1Savings benefit
Savings apply during the Initial Coverage period, which begins after the payment of your required deductible (if any) and ends when the total cost of your drugs (paid by UnitedHealthcare, you and others) reaches $5,030 (2024).
Optum Home Delivery Pharmacy and Optum Rx are affiliates of UnitedHealthcare Insurance Company. You are not required to use Optum Home Delivery Pharmacy for your regular medication. There may be other pharmacies in our network. If you have not used Optum Home Delivery Pharmacy, you must approve the first prescription order sent directly from your doctor before it can be filled. New prescriptions from the pharmacy should arrive within ten business days from the date the completed order is received, and refill orders should arrive in about seven business days. Contact Optum Home Delivery Pharmacy anytime at 1-877-266-4832 / TTY 711, 8 a.m. to 8 p.m., 7 days a week.
$0 copays may be restricted to preferred home delivery prescriptions during the initial coverage phase and may not apply during the coverage or catastrophic stage. Benefits vary by plan/area. Limitations and exclusions apply.
Disclaimer information
Enrollment Disclaimer Information:
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan’s contract renewal with Medicare. UnitedHealthcare Insurance Company paid royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and its affiliates are not insurers. You do not need to be an AARP member to enroll. AARP encourages you to consider your needs when selecting products and does not make specific product or pharmacy recommendations for individuals. UnitedHealthcare contracts directly with Walgreens for this plan; AARP and its affiliates are not parties to that contractual relationship.
Extra Help:
If you receive Extra Help from Medicare, your copays may be lower or you may have no copays.
Featured Benefits:
- Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.
- Other hearing exam providers are available in the UnitedHealthcare network. The plan only covers hearing aids from a UnitedHealthcare Hearing network provider.
- For Chronic Special Needs Plans - You will pay a maximum of $25 for each 1-month supply of Part D covered insulin drug through all coverage stages, except the Catastrophic drug payment stage where you pay $0.
- For All Other Plans - You will pay a maximum of $35 for each 1-month supply of Part D covered insulin drug through all coverage stages, except the Catastrophic drug payment stage where you pay $0.
- Food, OTC and utility benefits have expiration timeframes. Call your plan or review your Evidence of Coverage (EOC) for more information.
- Eligibility for the healthy food and utilities benefit under the Value-Based Insurance Design model is limited to members with Extra Help from Medicare and will be determined after enrollment.
- For C-SNP: The healthy food benefit is a special supplemental benefit only available to chronically ill enrollees with a qualifying condition, such as diabetes, chronic heart failure and/or cardiovascular disorders, and who also meet all applicable plan coverage criteria. Contact us for details.
- For D-SNP, TN only: The healthy food benefit is a special supplemental benefit only available to chronically ill enrollees with a qualifying condition, such as high blood pressure, high cholesterol, chronic and disabling mental health conditions, diabetes and/or cardiovascular disorders, and who also meet all applicable plan coverage criteria. There may be other qualified conditions not listed. Contact us for details.
- The fitness benefit includes a standard fitness membership. The information provided is for informational purposes only and is not medical advice. Consult your doctor prior to beginning an exercise program or making changes to your lifestyle or health care routine. Gym network may vary in local market and plan.
- If your plan offers out-of-network dental coverage and you see an out-of-network dentist, you might be billed more. Network size varies by local market.
- Routine transportation not for use in emergencies.
- Virtual visits may require video-enabled smartphone or other device. Not for use in emergencies. Not all network providers offer virtual care.
- $0 copays may be restricted to preferred home delivery prescriptions during the initial coverage phase and may not apply during the Catastrophic stage. Optum® Home Delivery Pharmacy and Optum Rx are affiliates of the UnitedHealthcare Insurance Company. You are not required to use Optum Home Delivery Pharmacy for medications you take regularly. There may be other pharmacies in your network.
The Medicare Prescription Payment Plan:
Starting Jan. 1, 2025, if you spend more than $2,000 for covered Part D prescription drugs each year, you may want to participate in the Medicare Prescription Payment Plan. This payment plan spreads your out-of-pocket prescription drug costs over the remainder of the calendar year. Learn more about the Medicare Prescription Payment Plan.
Out-of-network:
Out-of-network/non-contracted providers are under no obligation to treat members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
State-Level Medicaid, D-SNP Disclaimer:
D-SNP and C-SNP: The values shown in-network represent a range based upon the amount of the Medicare Parts A and B plan cost sharing covered by the state. Depending on your Medicaid eligibility, your Medicaid program may have cost sharing. For complete information, and for costs for those without Medicare Parts A and B plan cost sharing covered by the state, and applicable Medicaid cost sharing, please refer to your Summary of Benefits or Evidence of Coverage. Limitations, exclusions, and restrictions may apply.
Other Languages:
This information is available for free in other languages. Please contact Customer Service for additional information.
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