2027 Medicare Advantage plan
AARP Medicare Advantage Patriot No Rx WI-MA02 (HMO-POS): 2027 benefits and costs
UnitedHealthcare HMO-POS
CMS plan ID: H5253-021-0 · Plan year: 2027
AARP Medicare Advantage Patriot No Rx WI-MA02 (HMO-POS) is a 2027 Medicare Advantage plan offered by UnitedHealthcare. It is listed in Wisconsin.
2027 plan costs at a glance
Monthly plan premium$0.00
In-network medical out-of-pocket maximum$7,150.00
- Organization
- UnitedHealthcare
- Plan organization
- UNITEDHEALTHCARE OF WISCONSIN, INC.
- Parent company
- UnitedHealth Group, Inc.
- Plan type
- HMO-POS
- Part C premium
- $0.00
- Prescription drug coverage
- No
- 2027 CMS Star Rating
- Standard monthly Medicare Part B premium
- $209.50 (estimated)
- Monthly Part B premium after plan reduction
- $104.50 (estimated)$209.50 standard premium less $105.00 plan reduction.
You must continue to pay your Medicare Part B premium.
- In-network medical deductible
- None
- Combined in/out-of-network medical deductible
- None
- Out-of-network medical deductible
- None
- In-network medical maximum
- $7,150.00
- Combined in/out-of-network medical maximum
- Not applicable
- Out-of-network medical maximum
- Not applicable
- Part B premium reduction
- $105.00
2027 benefit summary
Doctor visits and medical care
| Service | In-network | What to know |
|---|---|---|
| Primary care doctor | $0.00 copay
| |
| Specialist visit | $0.00 to $65.00 copay
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| Emergency care | $130.00 copay | |
| Urgent care | $0.00 to $50.00 copay | |
| Home health | $0.00 copay
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| Dialysis | 20% coinsurance
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| Part B chemotherapy and radiation drugs | 0% to 20% coinsurance
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| Other Part B drugs | 0% to 20% coinsurance
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| Kidney disease education services | $0.00 copay
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| Medicare-covered chiropractic | $15.00 copay
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| Medicare-covered foot care | $45.00 copay
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| Other health professionals | $0.00 to $65.00 copay
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Hospital, outpatient surgery and observation care
Inpatient stays and skilled nursing care
| Care | Your share of the cost | What to know |
|---|---|---|
| Inpatient hospital stay | $0.00 copay per stay Days 1–4: $670.00 copay per day Days 5–90: $0.00 copay per day |
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| Inpatient mental health care | $0.00 copay per stay Days 1–3: $670.00 copay per day Days 4–90: $0.00 copay per day |
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| Skilled nursing facility | Days 1–20: $0.00 copay per day Days 21–100: $221.00 copay per day |
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See plan documents for out-of-network hospital and skilled nursing costs.
| Service | In-network | What to know |
|---|---|---|
| Outpatient hospital care | $0.00 to $670.00 copay
| |
| Hospital observation services | $670.00 copay
| |
| Ambulatory surgical center | $0.00 to $570.00 copay
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| Outpatient blood | $0.00 copay
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Tests, imaging and laboratory services
| Service | In-network | What to know |
|---|---|---|
| Diagnostic procedures and tests | $50.00 copay
|
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| Laboratory services | $0.00 copay
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| Diagnostic radiology (CT, MRI) | $0.00 to $320.00 copay
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| Therapeutic radiology | 20% coinsurance
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| X-rays | $30.00 copay
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Mental health and substance use treatment
| Service | In-network | What to know |
|---|---|---|
| Partial hospitalization | $55.00 copay
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| Intensive outpatient program | $55.00 copay
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| Substance use treatment, individual sessions | $0.00 to $25.00 copay
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| Substance use treatment, group sessions | $15.00 copay
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| Opioid treatment program | $0.00 copay
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| Mental health, individual sessions | $0.00 to $25.00 copay
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| Mental health, group sessions | $15.00 copay
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| Psychiatry, individual sessions | $0.00 to $25.00 copay
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| Psychiatry, group sessions | $15.00 copay
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Therapy and rehabilitation
| Service | In-network | What to know |
|---|---|---|
| Occupational therapy | $50.00 copay
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| Physical and speech therapy | $65.00 copay
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| Cardiac rehabilitation | $0.00 copay
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| Intensive cardiac rehabilitation | $0.00 copay
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| Pulmonary rehabilitation | $0.00 copay
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| Supervised exercise for peripheral artery disease | $0.00 copay
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Ambulance, medical equipment and supplies
| Service | In-network | What to know |
|---|---|---|
| Ground ambulance | $350.00 copay
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| Air ambulance | $350.00 copay
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| Durable medical equipment | 30% coinsurance
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| Prosthetic devices | 30% coinsurance
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| Medical supplies | 30% coinsurance
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| Diabetic supplies | $0.00 copay
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| Diabetic shoes and inserts | 30% coinsurance
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| Diabetic monitors | $0.00 copay
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Dental benefits
| Service | In-network | Point-of-service | What to know |
|---|---|---|---|
| Medicare-covered dental | 20% coinsurance | Not summarized. Check coverage with the plan. | |
| Oral examsAdditional plan benefit | $0.00 copay | $0.00 copay
| |
| Dental X-raysAdditional plan benefit | $0.00 copay | $0.00 copay
| |
| Other diagnostic dentalAdditional plan benefit | $0.00 copay | $0.00 copay
| |
| Dental cleaningAdditional plan benefit | $0.00 copay | $0.00 copay
| |
| FluorideAdditional plan benefit | $0.00 copay | $0.00 copay
| |
| Other preventive dentalAdditional plan benefit | $0.00 copay | $0.00 copay
| |
| Restorative dental careAdditional plan benefit | 50% coinsurance | 50% coinsurance
| |
| Root canal treatment (endodontics)Additional plan benefit | 50% coinsurance | 50% coinsurance
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| Gum treatment (periodontics)Additional plan benefit | 50% coinsurance | 50% coinsurance
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| Removable dentures (prosthodontics)Additional plan benefit | 50% coinsurance | 50% coinsurance
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| Maxillofacial prostheticsAdditional plan benefit | 50% coinsurance | 50% coinsurance
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| Fixed dental restorations (prosthodontics)Additional plan benefit | 50% coinsurance | 50% coinsurance
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| Oral surgeryAdditional plan benefit | 50% coinsurance | 50% coinsurance
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| Other dental servicesAdditional plan benefit | 50% coinsurance | 50% coinsurance
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Vision benefits
| Service | In-network | What to know |
|---|---|---|
| Medicare-covered eye exams | $0.00 copay
|
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| Routine eye examsAdditional plan benefit | $0.00 copay |
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| Medicare-covered eyewear | $0.00 copay
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| Contact lensesAdditional plan benefit | $0.00 copay |
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| Eyeglasses, lenses and framesAdditional plan benefit | $0.00 copay |
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Hearing benefits
| Service | In-network | What to know |
|---|---|---|
| Medicare-covered hearing exams | $0.00 copay
|
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| Routine hearing examsAdditional plan benefit | $0.00 copay |
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| Prescription hearing aids (all types)Additional plan benefit | $0.00 copay
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Extra benefits
| Service | In-network | What to know |
|---|---|---|
| Over-the-counter health itemsAdditional plan benefit | $0.00 copay
| |
| Limited-duration mealsAdditional plan benefit | $0.00 copay
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| Annual physical examAdditional plan benefit | $0.00 copay
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| Fitness benefitAdditional plan benefit | $0.00 copay
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Allowances and optional benefits
Combined Benefit 1
One shared limit covers the listed services, not a separate allowance for each service.
- Services sharing this allowance
- Over-the-counter health items; Home and Bathroom Safety Devices and Modifications
- How benefits are provided
- Catalogue Purchase; Debit Card
- Advance choice of benefits required
- No
- Shared benefit limit
- $55.00
- How often this limit applies
- Every three months
- Shared limit on visits or trips
- No
Prescription drug coverage
This plan does not include a Part D prescription drug benefit.
Where this plan is offered
CMS lists this plan in 1 state or territory. Availability can vary by county and ZIP code.
View all locations 29 county listings across 1 state or territory
Wisconsin
- Brown, Wisconsin
- Calumet, Wisconsin
- Florence, Wisconsin
- Fond du Lac, Wisconsin
- Forest, Wisconsin
- Grant, Wisconsin
- Green, Wisconsin
- Jefferson, Wisconsin
- Kewaunee, Wisconsin
- Manitowoc, Wisconsin
- Marathon, Wisconsin
- Marinette, Wisconsin
- Menominee, Wisconsin
- Milwaukee, Wisconsin
- Oconto, Wisconsin
- Oneida, Wisconsin
- Outagamie, Wisconsin
- Ozaukee, Wisconsin
- Portage, Wisconsin
- Racine, Wisconsin
- Rock, Wisconsin
- Shawano, Wisconsin
- Sheboygan, Wisconsin
- Walworth, Wisconsin
- Washington, Wisconsin
- Waukesha, Wisconsin
- Waupaca, Wisconsin
- Winnebago, Wisconsin
- Wood, Wisconsin