Your plan details for Plans for
92833 Orange County

AARP Medicare Advantage Patriot No Rx CA-MA01 (HMO-POS)

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Look for the green-colored pricing as you shop for plans to see your potential cost savings shown by the crossed out dollar amount.

The information provided in this document may be subject to change over time and may become outdated. For the most current and up-to-date information, please refer to our website at UHC.com/medicare.

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Doctor visits

$0
when using an in-network provider

Covered for urgent and emergency care only

Up to $25

$0 copay
when using an in-network provider

Specialist

$15 copay (referral required)
when using an in-network provider

Virtual visits

$0 copay

to talk with a network telehealth provider online through live audio and video.

Annual routine physical

1 per year
$0 copay
when using an in-network provider

Preventive services (such as covered screenings, vaccinations, etc.)

$0 copay

for covered services

when using an in-network provider

Group therapy visit

$15 copay
when using an in-network provider

Individual therapy visit

$25 copay
when using an in-network provider

Opioid treatment services

$0 copay
when using an in-network provider

Medical benefit information

Inpatient hospital care

$195 copay

per day: days 1-5

$0 copay

per day: days 6 and beyond for unlimited days

when using an in-network provider

Skilled nursing facility

$0 copay

per day: days 1-20

$218 copay

per day: days 21-100

when using an in-network provider

Outpatient hospital services (including surgery and observation)

$195 copay
when using an in-network provider

Ambulatory surgical center

$145 copay
when using an in-network provider

Physical and speech therapy

$15 copay (referral required)
when using an in-network provider

Occupational therapy

$15 copay (referral required)
when using an in-network provider

Lab services

$0 copay
when using an in-network provider

Outpatient X-rays

$0 copay
when using an in-network provider

Diagnostic tests and procedures, non-radiological (such as EKG/ECG tests, etc.)

$0 copay
when using an in-network provider

Diagnostic radiology services (such as MRIs, CT scans, etc.)

$260 copay
when using an in-network provider

Diabetes monitoring supplies

$0 copay
when using an in-network provider
Covered items include: Continuous glucose monitors (CGMs), blood glucose monitors, blood glucose test strips, lancet devices, lancets and glucose-control solutions for checking the accuracy of test strips and monitors.

Home health care

$0 copay
when using an in-network provider

Urgent care

$50 copay

per visit ($0 copay when outside of the United States)

Emergency care

$130 copay

per visit ($0 copay when outside of the United States)

Ambulance services

$290 copay

for ground or air

Dental coverage

Routine dental

No coverage



Optional rider

Add $56 to your monthly premium.


As a UnitedHealthcare member, you have the option to get dental coverage through the Platinum Dental Rider for an additional monthly fee. 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.

$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 all comprehensive dental services, like crowns, fillings, extractions, bridges and dentures

See the UnitedHealthcare plan difference

Access to one of Medicare Advantage’s largest national networks of vision providers and retail providers. Eyewear available from many online providers, including Warby Parker and GlassesUSA.

Home-delivered eyewear available nationwide only through UnitedHealthcare Vision (select products only).

Routine eye exam

1 exam per year
$0 copay
when using an in-network provider

Routine eyewear

$0 copay

for standard prescription lenses

$150 allowance

every 2 years for 1 pair of lenses/frames or contacts.

Hearing sounds better with more access

Choose from a broad selection of OTC and brand-name prescription hearing aids through UnitedHealthcare Hearing.

Access to one of the largest national networks with thousands of hearing professionals.

Routine hearing exam

1 exam per year
$0 copay
when using an in-network provider

Hearing aids

$199 - $1,249 copay

per device, up to 2 hearing aids per year

Get more for your everyday needs

Rewards

Earn up to $150

in rewards every year for getting an annual wellness visit, being physically active, connecting with others and more.

Rewards

Earn up to $150

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.

Gyms near you Opens in a new window

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.

Gyms near you Opens in a new window

Routine chiropractic

12 visits per year
$0 copay
when using an in-network provider

Routine acupuncture

12 visits per year
$0 copay
when using an in-network provider

Plan resources

Important documents that provide the details you need about this plan's coverage and benefits, prescription drugs, enrollment, providers and more.

Language

General Plan Information

Medical Providers

General Plan Information

footnote
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. Enrollment in a Dual Special Needs plan (D-SNP) depends on the plan's contract renewal with a Medicare Advantage organization with a Medicare contract and a contract with the state Medicaid program.

 

AARP-related Disclaimer:

UnitedHealthcare Insurance Company pays 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 in a Medicare Advantage or Prescription Drug Plan. AARP encourages you to consider your needs when selecting products and does not make specific product recommendations for individuals. AARP does not employ or endorse agents, producers or brokers.

 

Other Languages:

This information is available for free in other languages. Please contact Customer Service for additional information. 

 

Esta información está disponible sin costo en otros idiomas. Para obtener más información comuníquese con nuestro Servicio al Cliente. 

 

本資訊可以其他語言免費提供。如需更多資訊，請聯絡客戶服務部。 

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