AARP Medicare Advantage from UHC NY-0013 (PPO)
AARP Medicare Advantage from UHC NY-0013 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare
Plan ID: H3418-002
HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.
Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.
Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.
Learn more about Medicare Advantage plans such as AARP Medicare Advantage from UHC NY-0013 (PPO) - H3418-002 by UnitedHealthcare as well as other Medicare Advantage plans available in your area.
AARP Medicare Advantage from UHC NY-0013 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare
Plan ID: H3418-002
HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.
Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.
Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.
Learn more about Medicare Advantage plans such as AARP Medicare Advantage from UHC NY-0013 (PPO) - H3418-002 by UnitedHealthcare as well as other Medicare Advantage plans available in your area.
AARP Medicare Advantage from UHC NY-0013 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare
Plan ID: H3418-002
HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.
Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.
Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.
Learn more about Medicare Advantage plans such as AARP Medicare Advantage from UHC NY-0013 (PPO) - H3418-002 by UnitedHealthcare as well as other Medicare Advantage plans available in your area.
Basic Costs and Coverage
| Coverage | Cost |
|---|---|
| Monthly Deductible | $570 |
| Out of Pocket Max |
In-Network: $9350 Out-of-Network: N/A |
| Initial Coverage Limit | $2000 |
| Catastrophic Coverage Limit | $2,000 |
| Primary Care Doctor Visit | In-Network: Doctor Office Visit: Copayment for Primary Care Office Visit $0 |
| Specialty Doctor Visit | In Network In-Network: Doctor Specialty Visit: Copayment for Physician Specialist Office Visit $0 to $55 Prior Authorization Required for Doctor Specialty Visit Note: $0 copayment applies to Medicare covered telehealth and remote monitoring. $40 copayment applies to Tier 1 physician specialist services. The higher cost share applies to Tier 2 physician specialist services. Out of Network Out-of-Network: Doctor Specialty Visit Services: Coinsurance for Medicare Covered Physician Specialist Office Visit 50% Note: $0 copayment applies to Medicare covered telehealth and remote monitoring. $40 copayment applies to Tier 1 physician specialist services. The higher cost share applies to Tier 2 physician specialist services. Prior authorization required |
| Inpatient Hospital Care | In Network In-Network: Acute Hospital Services: $275 per day for days 1 to 4 $0 per day for days 5 to 90 Prior Authorization Required for Acute Hospital Services Note: All inpatient substance abuse and mental health care (including both care received in an acute care facility and a Medicare-certified psychiatric facility) are included in category 1b. Out of Network Out-of-Network: Acute Hospital Services: Coinsurance for Acute Hospital Services per Stay 50% Note: All inpatient substance abuse and mental health care (including both care received in an acute care facility and a Medicare-certified psychiatric facility) are included in category 1b. Prior authorization required |
| Urgent Care | Copayment for Urgent Care $0 to $45 Note: $0 copayment applies to Medicare covered telehealth. The higher cost share applies to all other Medicare covered services. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $0 |
| Emergency Room Visit | Copayment for Emergency Care $110 Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital with in 24 hours Worldwide Coverage: Copayment for Worldwide Emergency Coverage $0 Copayment for Worldwide Emergency Transportation $0 |
| Ambulance Transportation | In Network In-Network: Ground Ambulance: Copayment for Ground Ambulance Services $275 Air Ambulance: Copayment for Air Ambulance Services $275 Prior Authorization Required for Air Ambulance Out of Network Out-of-Network: Ambulance Services: Copayment for Medicare Covered Ambulance Services - Ground $275 Copayment for Medicare Covered Ambulance Services - Air $275 Prior authorization required |
Health Care Services and Medical Supplies
AARP Medicare Advantage from UHC NY-0013 (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).
| Coverage | Cost |
|---|---|
| Chiropractic Services | In Network In-Network: Copayment for Medicare-covered Chiropractic Services $15 Prior Authorization Required for Chiropractic Services Out of Network Out-of-Network: Medicare Covered Chiropractic Services: Coinsurance for Medicare Covered Chiropractic Services 50% Prior authorization required |
| Diabetes Supplies, Training, Nutrition Therapy and Monitoring | In Network In-Network: Copayment for Medicare-covered Diabetic Supplies $0 Coinsurance for Medicare-covered Diabetic Therapeutic Shoes or Inserts 20% Out of Network Out-of-Network: Medicare Covered Diabetic Supplies and Services: Coinsurance for Medicare Covered Diabetic Supplies 50% Coinsurance for Medicare Covered Diabetic Therapeutic Shoes or Inserts 50% |
| Durable Medical Eqipment (DME) | In Network In-Network: Coinsurance for Medicare-covered Durable Medical Equipment 20% Prior Authorization Required for Durable Medical Equipment Out of Network Out-of-Network: Medicare Covered Durable Medical Equipment Services: Coinsurance for Medicare Covered Durable Medical Equipment 50% Prior authorization required |
| Diagnostic Tests, Lab and Radiology Services, and X-Rays | Diagnostic Tests and Procedures: $50 copay Lab Services: $0 copay Diagnostic Radiology Services: $250 copay X-rays: $35 copay |
| Home Health Care | In Network In-Network: Copayment for Medicare-covered Home Health Services $0 Prior Authorization Required for Home Health Services Out of Network Out-of-Network: Medicare Covered Home Health Services: Coinsurance for Medicare Covered Home Health 50% Prior authorization required |
| Mental Health Inpatient Care | In Network In-Network: Psychiatric Hospital Services: $275 per day for days 1 to 4 $0 per day for days 5 to 90 Prior Authorization Required for Psychiatric Hospital Services Benefit Details - General Note - NOTE ON INPATIENT SUBSTANCE ABUSE: All inpatient substance abuse and mental health care (including both care received in an acute care facility and a Medicare-certified psychiatric facility) are included in category 1b. Out of Network Out-of-Network: Psychiatric Hospital Services: Coinsurance for Psychiatric Hospital per Stay 50% Benefit Details - General Note - NOTE ON INPATIENT SUBSTANCE ABUSE: All inpatient substance abuse and mental health care (including both care received in an acute care facility and a Medicare-certified psychiatric facility) are included in category 1b. Prior authorization required |
| Mental Health Outpatient Care | In Network In-Network: Copayment for Medicare-covered Individual Sessions $0 to $25 Copayment for Medicare-covered Group Sessions $15 Out of Network Out-of-Network: Medicare Covered Mental Health Services: Copayment for Medicare Covered Individual Sessions $40 Copayment for Medicare Covered Group Sessions $30 |
| Outpatient Services / Surgery | In Network In-Network: Outpatient Hospital Services: Copayment for Medicare Covered Outpatient Hospital Services $0 to $275 Prior Authorization Required for Outpatient Hospital Services Note: $0 copayment for outpatient diagnostic colonoscopies. The higher cost share applies to all other outpatient procedures.Note: Benefit category includes both the facility and professional component. Outpatient Observation Services: Copayment for Medicare Covered Observation Services - Per day $275 Prior Authorization Required for Outpatient Observation Services Benefit Details - General 9a2 Note - NOTE ON OBSERVATION SERVICES: Benefit category includes both the facility and professional component. Ambulatory Surgical Center Services: Copayment for Ambulatory Surgical Center Services $0 to $325 Prior Authorization Required for Ambulatory Surgical Center Services Benefit Details - General 9b Note - NOTE ON ASC SERVICES: Benefit category 9b includes both the facility and professional component.Benefit Details - General 9b Note - NOTE ON COST SHARING FOR ASC: $0 copayment for outpatient diagnostic colonoscopies. $225 copayment for services received from Tier 1 providers. $325 for services received from Tier 2 providers. Out of Network Out-of-Network: Medicare Covered Outpatient Hospital Services: Coinsurance for Medicare Covered Outpatient Hospital Services 50% Coinsurance for Medicare Covered Ambulatory Surgical Center Services 50% Note: $0 copayment for outpatient diagnostic colonoscopies. The higher cost share applies to all other outpatient procedures.Note: Benefit category includes both the facility and professional component. Prior authorization required |
| Outpatient Substance Abuse Care | In Network In-Network: Copayment for Medicare-covered Individual Sessions $0 to $25 Copayment for Medicare-covered Group Sessions $15 Prior Authorization Required for Outpatient Substance Abuse Services Note: $0 copayment applies to Medicare covered telehealth for individual sessions. The higher cost share applies to all other Medicare covered services. Out of Network Out-of-Network: Medicare Covered Outpatient Substance Abuse Services: Copayment for Medicare Covered Individual Sessions $40 Copayment for Medicare Covered Group Sessions $30 Note: $0 copayment applies to Medicare covered telehealth for individual sessions. The higher cost share applies to all other Medicare covered services. Prior authorization required |
| Podiatry Services | In Network In-Network: Copayment for Medicare-Covered Podiatry Services $40 Copayment for Routine Foot Care $40
Out of Network Out-of-Network: Medicare Covered Podiatry Services: Coinsurance for Medicare Covered Podiatry Services 50% Non-Medicare Covered Podiatry Services: Coinsurance for Non-Medicare Covered Podiatry Services 50% Prior authorization required |
| Skilled Nursing Facility Care | In-Network: Skilled Nursing Facility Services: $0 per day for days 1 to 20 $203 per day for days 21 to 100 Prior Authorization Required for Skilled Nursing Facility Services Prior authorization required |
Dental Benefits
The following dental services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Dental Care | In Network In-Network: Preventive Dental: Coinsurance for Office Visit 20% Prior Authorization Required for Preventive Dental Comprehensive Dental: Copayment for Non-routine Services $0
Out of Network Out-of-Network: Medicare Covered Preventive Dental Services: Coinsurance for Medicare Covered Preventive Dental 50% Prior authorization required |
Vision Benefits
The following vision services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Vision Benefits | Routine Eye Exam: $0 copay, 1 per year Routine Eyewear: Plan pays up to $200 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). |
Hearing Benefits
The following hearing services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Hearing Benefits | In Network In-Network: Hearing Exams: Copayment for Medicare Covered Benefits $0 Copayment for Routine Hearing Exams $0
Hearing Aids: Copayment for Hearing Aids $199 to $1249
Out of Network Out-of-Network: Medicare Covered Hearing Exams Services: Coinsurance for Medicare Covered Hearing Exams 50% Prior authorization required |
Preventive Services and Health/Wellness Education Programs
The following services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Preventive Services and Health/Wellness Education Programs | In Network In-Network: $0.00 copay for Medicare Covered Preventive Services: Abdominal aortic aneurysm screening Alcohol misuse screenings & counseling Bone mass measurements (bone density) Cardiovascular disease screenings Cardiovascular disease (behavioral therapy) Cervical & vaginal cancer screening Colorectal cancer screenings Depression screenings Diabetes screenings Diabetes self-management training Glaucoma tests Hepatitis B (HBV) infection screening Hepatitis C screening test HIV screening Lung cancer screening Mammograms (screening) Nutrition therapy services Obesity screenings & counseling One-time Welcome to Medicare preventive visit Prostate cancer screenings(PSA) Sexually transmitted infections screening & counseling Shots:
Yearly "Wellness" visit Out of Network Out-of-Network: Medicare Covered Medicare-covered Preventive Services: Coinsurance for Medicare Covered Medicare-covered Preventive Services 0% to 50% |
Prescription Drug Costs and Coverage
The AARP Medicare Advantage from UHC NY-0013 (PPO) plan offers the following prescription drug coverage, with an annual drug deductible of $570 (excludes Tiers 1 and 2) per year.
| Coverage |
Cost
|
|---|---|
|
Coverage & Cost
|
|
| Annual Drug Deductible | $570 (excludes Tiers 1 and 2) |
| Preferred Generic |
|
| Generic |
|
| Annual Drug Deductible | $570 (excludes Tiers 1 and 2) |
| Preferred Generic |
|
| Generic |
|
| Annual Drug Deductible | $570 (excludes Tiers 1 and 2) |
| Preferred Generic |
|
| Generic |
|
