AARP Medicare Advantage Choice (Regional PPO)
R5329 - 001 - 0
(4 / 5)
AARP Medicare Advantage Choice (Regional PPO) is a Medicare Advantage (Part C) Plan by UnitedHealthcare.
This page features plan details for 2023 AARP Medicare Advantage Choice (Regional PPO) R5329 – 001 – 0 available in Rural ME and NH.
IMPORTANT: This page has been updated with plan and premium data for 2023.
Locations
AARP Medicare Advantage Choice (Regional PPO) is offered in the following locations.
Plan Overview
AARP Medicare Advantage Choice (Regional PPO) offers the following coverage and cost-sharing.
| Insurer: | UnitedHealthcare |
| Health Plan Deductible: | $0.00 |
| MOOP: | $11,300 In and Out-of-network $7,550 In-network |
| Drugs Covered: | Yes |
Please Note:
- This plan does not charge an annual deductible for all drugs. The $295.00 annual deductible only applies to drugs on certain tiers.
Ready to sign up for AARP Medicare Advantage Choice (Regional PPO) ?
Get help from a licensed insurance agent.
Click to Call 1-877-354-4611 TTY 711.
Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.
Premium Breakdown
AARP Medicare Advantage Choice (Regional PPO) has a monthly premium of $50.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.| Part B | Part C | Part D | Part B Give Back | Total |
|---|---|---|---|---|
| $164.90 | $6.50 | $43.50 | $0.00 | $214.90 |
- Your Part B premium may differ based on factors including late enrollment, income, and disability status.
- You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.
Drug Info
AARP Medicare Advantage Choice (Regional PPO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.
| Drug Deductible: | $295.00 |
| Initial Coverage Limit: | $4,660.00 |
| Catastrophic Coverage Limit: | $7,400.00 |
| Drug Benefit Type: | Enhanced |
| Gap Coverage: | Yes |
| Formulary Link: | Formulary Link |
Part D Premium Reduction
The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs. The table below shows how the LIS impacts the Part D premium of this plan.| Part D | LIS 25% | LIS 50% | LIS 75% | LIS Full |
|---|---|---|---|---|
| $43.50 | $35.70 | $27.90 | $20.20 | $12.40 |
Initial Coverage Phase
After you pay your $295.00 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 $4,660.00. Once you reach that amount, you will enter the next coverage phase.
30 Day
60 Day
90 Day
30 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Preferred Generic) | $3.00 copay | |||
| 2 (Generic) | $12.00 copay | |||
| 3 (Preferred Brand) | $47.00 copay | |||
| 4 (Non-Preferred Drug) | $100.00 copay | |||
| 5 (Specialty Tier) | 28% | 28% | 28% |
60 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Preferred Generic) | ||||
| 2 (Generic) | ||||
| 3 (Preferred Brand) | ||||
| 4 (Non-Preferred Drug) | ||||
| 5 (Specialty Tier) |
90 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Preferred Generic) | $9.00 copay | $0.00 copay | $9.00 copay | |
| 2 (Generic) | $36.00 copay | $0.00 copay | $36.00 copay | |
| 3 (Preferred Brand) | $141.00 copay | $131.00 copay | $141.00 copay | |
| 4 (Non-Preferred Drug) | $300.00 copay | $290.00 copay | $300.00 copay | |
| 5 (Specialty Tier) |
Gap Coverage Phase
After your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00, you will pay no more than the amounts below for any drug tier until you reach $7,400.00.
30 Day
90 Day
30 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Preferred Generic) | $3.00 copay | |||
| 2 (Generic) * | $12.00 copay |
90 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Preferred Generic) | $9.00 copay | $0.00 copay | $9.00 copay | |
| 2 (Generic) * | $36.00 copay | $0.00 copay | $36.00 copay |
| Tier | Cost |
|---|---|
| All other tiers (Generic) | 25% |
| All other tiers (Brand-name) | 25% |
Catastrophic Coverage Phase
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.
| Drug Type | Cost Share |
|---|---|
| Generic drugs | $4.15 copay or 5% (whichever costs more) |
| Brand-name drugs | $10.35 copay or 5% (whichever costs more) |
Additional Benefits
AARP Medicare Advantage Choice (Regional PPO) also provides the following benefits.
Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?
| In-Network: No |
Dental (comprehensive)
| Diagnostic services: | Not covered (no limits) |
| Endodontics: | Not covered (no limits) |
| Extractions: | Not covered (no limits) |
| Non-routine services: | Not covered (no limits) |
| Periodontics: | Not covered (no limits) |
| Prosthodontics, other oral/maxillofacial surgery, other services: | Not covered (no limits) |
| Restorative services: | Not covered (no limits) |
Dental (preventive)
| Cleaning: | Not covered (no limits) |
| Dental x-ray(s): | Not covered (no limits) |
| Fluoride treatment: | Not covered (no limits) |
| Oral exam: | Not covered (no limits) |
Diagnostic procedures/lab services/imaging
| Diagnostic radiology services (e.g., MRI): | In-Network: $0-150 copay (authorization required) (referral not required) |
| Diagnostic radiology services (e.g., MRI): | Out-of-Network: 50% coinsurance (authorization required) (referral not required) |
| Diagnostic tests and procedures: | In-Network: $40 copay (authorization required) (referral not required) |
| Diagnostic tests and procedures: | Out-of-Network: 50% coinsurance (authorization required) (referral not required) |
| Lab services: | In-Network: $0 copay (authorization required) (referral not required) |
| Lab services: | Out-of-Network: $0 copay (authorization required) (referral not required) |
| Outpatient x-rays: | In-Network: $20 copay (authorization required) (referral not required) |
| Outpatient x-rays: | Out-of-Network: $20 copay (authorization required) (referral not required) |
Doctor visits
| Primary: | In-Network: $10 copay per visit |
| Primary: | Out-of-Network: 50% coinsurance per visit |
| Specialist: | In-Network: $45 copay per visit (authorization required) (referral not required) |
| Specialist: | Out-of-Network: 50% coinsurance per visit (authorization required) (referral not required) |
Emergency care/Urgent care
| Emergency: | $90 copay per visit (always covered) |
| Urgent care: | $40 copay per visit (always covered) |
Foot care (podiatry services)
| Foot exams and treatment: | In-Network: $45 copay (authorization required) (referral not required) |
| Foot exams and treatment: | Out-of-Network: 50% coinsurance (authorization required) (referral not required) |
| Routine foot care: | In-Network: $45 copay (limits may apply) (authorization required) (referral not required) |
| Routine foot care: | Out-of-Network: 50% coinsurance (limits may apply) (authorization required) (referral not required) |
Ground ambulance
| In-Network: $250 copay | |
| Out-of-Network: $250 copay |
Health plan deductible
| $0.00 |
Health plan deductibles (other)
| In-Network: No |
Hearing
| Fitting/evaluation: | Not covered (no limits) |
| Hearing aids: | In-Network: $175-1,225 copay (limits may apply) (authorization required) (referral not required) |
| Hearing aids: | Out-of-Network: $175-1,225 copay (limits may apply) (authorization required) (referral not required) |
| Hearing exam: | In-Network: $0 copay (authorization required) (referral not required) |
| Hearing exam: | Out-of-Network: 50% coinsurance (authorization required) (referral not required) |
Hospital coverage (inpatient)
| In-Network: $1,400 per stay $0 per day for days 91 and beyond (authorization required) (referral not required) | |
| Out-of-Network: 50% per stay (authorization required) (referral not required) |
Hospital coverage (outpatient)
| In-Network: $0-450 copay per visit (authorization required) (referral not required) | |
| Out-of-Network: 50% coinsurance per visit (authorization required) (referral not required) |
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
| $11,300 In and Out-of-network $7,550 In-network |
Medical equipment/supplies
| Diabetes supplies: | In-Network: $0 copay (authorization required) |
| Diabetes supplies: | Out-of-Network: 50% coinsurance per item (authorization required) |
| Durable medical equipment (e.g., wheelchairs, oxygen): | In-Network: 20% coinsurance per item (authorization required) |
| Durable medical equipment (e.g., wheelchairs, oxygen): | Out-of-Network: 50% coinsurance per item (authorization required) |
| Prosthetics (e.g., braces, artificial limbs): | In-Network: 20% coinsurance per item (authorization required) |
| Prosthetics (e.g., braces, artificial limbs): | Out-of-Network: 50% coinsurance per item (authorization required) |
Medicare Part B drugs
| Chemotherapy: | In-Network: 20% coinsurance (authorization required) |
| Chemotherapy: | Out-of-Network: 0-50% coinsurance (authorization required) |
| Other Part B drugs: | In-Network: 0-20% coinsurance (authorization required) |
| Other Part B drugs: | Out-of-Network: 0-50% coinsurance (authorization required) |
Mental health services
| Inpatient hospital – psychiatric: | In-Network: $1,400 per stay (authorization required) (referral not required) |
| Inpatient hospital – psychiatric: | Out-of-Network: 50% per stay (authorization required) (referral not required) |
| Outpatient group therapy visit: | In-Network: $15 copay (authorization required) (referral not required) |
| Outpatient group therapy visit: | Out-of-Network: $30-40 copay (authorization required) (referral not required) |
| Outpatient group therapy visit with a psychiatrist: | In-Network: $15 copay (authorization required) (referral not required) |
| Outpatient group therapy visit with a psychiatrist: | Out-of-Network: $30-40 copay (authorization required) (referral not required) |
| Outpatient individual therapy visit: | In-Network: $25 copay (authorization required) (referral not required) |
| Outpatient individual therapy visit: | Out-of-Network: $30-40 copay (authorization required) (referral not required) |
| Outpatient individual therapy visit with a psychiatrist: | In-Network: $25 copay (authorization required) (referral not required) |
| Outpatient individual therapy visit with a psychiatrist: | Out-of-Network: $30-40 copay (authorization required) (referral not required) |
Optional supplemental benefits
| Yes |
Preventive care
| In-Network: $0 copay (authorization not required) (referral not required) | |
| Out-of-Network: 0-50% coinsurance (authorization not required) (referral not required) |
Rehabilitation services
| Occupational therapy visit: | In-Network: $20 copay (authorization required) (referral not required) |
| Occupational therapy visit: | Out-of-Network: 50% coinsurance (authorization required) (referral not required) |
| Physical therapy and speech and language therapy visit: | In-Network: $20 copay (authorization required) (referral not required) |
| Physical therapy and speech and language therapy visit: | Out-of-Network: 50% coinsurance (authorization required) (referral not required) |
Skilled Nursing Facility
| In-Network: $0 per day for days 1 through 20 $196 per day for days 21 through 59 $0 per day for days 60 through 100 (authorization required) (referral not required) | |
| Out-of-Network: $225 per day for days 1 through 51 $0 per day for days 52 through 100 (authorization required) (referral not required) |
Transportation
| Not covered |
Vision
| Contact lenses: | Not covered (no limits) |
| Eyeglass frames: | Not covered (no limits) |
| Eyeglass lenses: | Not covered (no limits) |
| Eyeglasses (frames and lenses): | Not covered (no limits) |
| Other: | Not covered (no limits) |
| Routine eye exam: | In-Network: $0 copay (limits may apply) (authorization required) (referral not required) |
| Routine eye exam: | Out-of-Network: 50% coinsurance (limits may apply) (authorization required) (referral not required) |
| Upgrades: | Not covered |
Wellness programs (e.g., fitness, nursing hotline)
| Covered (authorization not required) (referral not required) |
Optional Benefits
Package #1
| Preventive dental: | Monthly Premium: | $56.00 |
| Preventive dental: | Deductible: | N/A |
| Comprehensive dental: | Monthly Premium: | $56.00 |
| Comprehensive dental: | Deductible: | N/A |
Ready to sign up for AARP Medicare Advantage Choice (Regional PPO) ?
Get help from a licensed insurance agent.
Click to Call 1-877-354-4611 TTY 711.
Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.