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AARP Medicare Advantage Patriot No Rx OK-MA01 (PPO)

H8768 - 028 - 0
3 out of 5 stars (3 / 5)

AARP Medicare Advantage Patriot No Rx OK-MA01 (PPO) is a Medicare Advantage Plan by UnitedHealthcare.

This page features plan details for 2025 AARP Medicare Advantage Patriot No Rx OK-MA01 (PPO) H8768 – 028 – 0 available in Select Counties in Oklahoma.

Locations

AARP Medicare Advantage Patriot No Rx OK-MA01 (PPO) is offered in the following locations.

Adair County, Oklahoma
Alfalfa County, Oklahoma
Atoka County, Oklahoma

Click to see more locations

Plan Overview

AARP Medicare Advantage Patriot No Rx OK-MA01 (PPO) offers the following coverage and cost-sharing.

Insurer:UnitedHealthcare
Health Plan Deductible:$0
MOOP:$6,200 In and Out-of-network
$4,700 In-network
Drugs Covered:No

Ready to sign up for AARP Medicare Advantage Patriot No Rx OK-MA01 (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Medicare Part B Give Back Benefit

The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans. 

AARP Medicare Advantage Patriot No Rx OK-MA01 (PPO) qualifies for a monthly Medicare Give Back Benefit of $105.00.

Premium Reduction:$105.00

Premium Breakdown

AARP Medicare Advantage Patriot No Rx OK-MA01 (PPO) has a monthly premium of $0.00. This amount includes your Part C premium but does not include your Part B premium.
Part B Part C Part B Give Back Total
$185.00 $0.00 $105.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.

Additional Benefits

AARP Medicare Advantage Patriot No Rx OK-MA01 (PPO) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

    • In-Network: No

Comprehensive Dental

  • Adjunctive General Services
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Endodontics
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Maxillofacial Prosthetics
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Maxillofacial Prosthetics
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
  • Oral and Maxillofacial Surgery
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Periodontics
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Prosthodontics, fixed
    • In-Network: 0-50 Coins – No Co pay (Authorization Required)
  • Prosthodontics, removable
    • In-Network: 0-50 Coins – No Co pay (Authorization Required)
  • Restorative Services
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: No Coins – 0.00 Copay
  • Fluoride Treatment
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: No Coins – 0.00 Copay
  • Oral Exams
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: No Coins – 0.00 Copay
  • Other Diagnostic Dental Services
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: No Coins – 0.00 Copay
  • Other Preventive Dental Services
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: No Coins – 0.00 Copay
  • Prophylaxis (cleaning)
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: No Coins – 0.00 Copay

Diagnostic procedures/lab services/imaging

  • Diagnostic radiology services (e.g., MRI)
    • Out-of-Network: $325 copay (Authorization Required)
  • Diagnostic tests and procedures
    • Out-of-Network: $70 copay (Authorization Required)
  • Lab services
    • In-Network: $0 copay (Authorization Required)
  • Outpatient x-rays
    • Out-of-Network: $30 copay (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • In-Network: $0-225 copay (Authorization Required)
  • Outpatient x-rays
    • In-Network: $25 copay (Authorization Required)
  • Diagnostic tests and procedures
    • In-Network: $50 copay (Authorization Required)
  • Lab services
    • Out-of-Network: $0 copay (Authorization Required)

Doctor visits

  • Primary
    • In-Network: $0 copay
    • Out-of-Network: $5 copay per visit
  • Specialist
    • In-Network: $0-40 copay per visit (Authorization Required)
    • Out-of-Network: $50 copay per visit (Authorization Required)

Emergency care/Urgent care

  • Emergency
    • $125 copay per visit (always covered)
  • Urgent care
    • $0-55 copay per visit (always covered)

Foot care (podiatry services)

  • Foot exams and treatment
    • Out-of-Network: $50 copay (Authorization Required)
    • In-Network: $40 copay (Authorization Required)
  • Routine foot care
    • In-Network: $40 copay (Limits Apply, Authorization Required)

Ground ambulance

    • In-Network: $290 copay
    • Out-of-Network: $290 copay

Health plan deductible

    • $0

Hearing

  • Medicare-Covered Hearing Exam
    • Out-of-Network: $50 copay (Authorization Required)
  • Hearing aids OTC
    • In-Network: $99-829 copay (Limits Apply)
  • Medicare-Covered Hearing Exam
    • In-Network: $0 copay (Authorization Required)
  • Fitting/evaluation
    • Not covered
  • Hearing aids
    • In-Network: $199-1,249 copay (Limits Apply, Authorization Required)
    • Out-of-Network: $199-1,249 copay (Limits Apply, Authorization Required)
  • Hearing aids OTC
    • Out-of-Network: $99-829 copay (Limits Apply)

Inpatient hospital coverage

    • Out-of-Network: $495 per day for days 1 through 6
      $0 per day for days 7 and beyond (Authorization Required)
    • In-Network: $425 per day for days 1 through 6
      $0 per day for days 7 through 90
      $0 per day for days 91 and beyond (Authorization Required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

    • $6,200 In and Out-of-network
      $4,700 In-network

Medical equipment/supplies

  • Diabetes supplies
    • In-Network: $0 copay per item (Authorization Required)
    • Out-of-Network: 50% coinsurance per item (Authorization Required)
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • In-Network: 20% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • 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)
    • Out-of-Network: 50% coinsurance per item (Authorization Required)

Medicare Part B drugs

  • Chemotherapy
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Other Part B drugs
    • Out-of-Network: 0-40% coinsurance (Authorization Required)
  • Chemotherapy
    • In-Network: 0-20% coinsurance (Authorization Required)
  • Other Part B drugs
    • In-Network: 0-20% coinsurance (Authorization Required)

Mental health services

  • Outpatient group therapy visit
    • Out-of-Network: $30 copay (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $15 copay (Authorization Required)
    • Out-of-Network: $30 copay (Authorization Required)
  • Outpatient individual therapy visit
    • In-Network: $0-25 copay (Authorization Required)
    • Out-of-Network: $40 copay (Authorization Required)
  • Inpatient hospital – psychiatric
    • In-Network: $425 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)
    • Out-of-Network: $495 per day for days 1 through 6
      $0 per day for days 7 through 90 (Authorization Required)
  • Outpatient group therapy visit
    • In-Network: $15 copay (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • Out-of-Network: $40 copay (Authorization Required)
    • In-Network: $0-25 copay (Authorization Required)

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • Out-of-Network: $475 copay per visit (Authorization Required)
    • In-Network: $0-425 copay per visit (Authorization Required)

Preventive care

    • In-Network: $0 copay
    • Out-of-Network: $0 copay

Rehabilitation services

  • Physical therapy and speech and language therapy visit
    • Out-of-Network: $50 copay (Authorization Required)
    • In-Network: $0-40 copay (Authorization Required)
  • Occupational therapy visit
    • In-Network: $0-40 copay (Authorization Required)
    • Out-of-Network: $50 copay (Authorization Required)

Skilled Nursing Facility

    • Out-of-Network: $225 per day for days 1 through 100 (Authorization Required)
    • In-Network: $0 per day for days 1 through 20
      $203 per day for days 21 through 100 (Authorization Required)

Transportation

    • Not covered

Vision

  • Eyeglass lenses
    • In-Network: $0-153 copay (Limits Apply)
  • Other
    • Not covered
  • Routine eye exam
    • Out-of-Network: $50 copay (Limits Apply, Authorization Required)
  • Eyeglass frames
    • In-Network: $0 copay (Limits Apply)
    • Out-of-Network: $0-153 copay (Limits Apply)
  • Eyeglass lenses
    • Out-of-Network: $0-153 copay (Limits Apply)
  • Routine eye exam
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Contact lenses
    • In-Network: $0 copay (Limits Apply)
    • Out-of-Network: $0-153 copay (Limits Apply)
  • Eyeglasses (frames and lenses)
    • Not covered
  • Upgrades
    • Not covered

Wellness programs (e.g., fitness, nursing hotline)

    • Covered

Ready to sign up for AARP Medicare Advantage Patriot No Rx OK-MA01 (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Need more information on AARP Medicare Advantage Patriot No Rx OK-MA01 (PPO)? See 2025 AARP Medicare Advantage Patriot No Rx OK-MA01 (PPO) at MedicareAdvantageRX.com.

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