AARP Medicare Advantage Essentials from UHC KC-4 (PPO)

3.5 out of 5 stars
$0.00
Monthly Premium

AARP Medicare Advantage Essentials from UHC KC-4 (PPO) is a PPO plan offered by UnitedHealthcare

Plan ID: H8768-023

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 Essentials from UHC KC-4 (PPO) - H8768-023 by UnitedHealthcare as well as other Medicare Advantage plans available in your area.

$0.00
Monthly Premium

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $600
Out of Pocket Max In-Network: $4900
Out-of-Network: 7400
Initial Coverage Limit $0
Catastrophic Coverage Limit $2100
Primary Care Doctor Visit

Out-of-Network:

Doctor Office Visit Services:
Copayment for Medicare Covered Primary Care Office Visit $25
Specialty Doctor Visit
$35 copay
Inpatient Hospital Care
In-Network:

Acute Hospital Services:
$455 per day for days 1 to 6
$0 per day for days 7 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.
Urgent Care
$50 copay per visit ($0 copay when outside of the United States)
Emergency Room Visit

Emergency Care:
Copayment for Emergency Care $130
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:

Ground Ambulance:
Copayment for Ground Ambulance Services $290

Air Ambulance:
Copayment for Air Ambulance Services $290
Prior Authorization Required for Air Ambulance

Health Care Services and Medical Supplies

AARP Medicare Advantage Essentials from UHC KC-4 (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

Out-of-Network:

Chiropractic Services:
Copayment for Medicare Covered Chiropractic Services $85
In-Network:

Chiropractic Services:
Copayment for Medicare-covered Chiropractic Services $15
Prior Authorization Required for Chiropractic Services
Diabetes Supplies, Training, Nutrition Therapy and Monitoring

Out-of-Network:

Diabetic Supplies and Services:
Coinsurance for Medicare Covered Diabetic Supplies 50%
Coinsurance for Medicare Covered Diabetic Therapeutic Shoes or Inserts 50%
Durable Medical Equipment (DME)
In-Network:

Durable Medical Equipment:
Coinsurance for Medicare-covered Durable Medical Equipment 20%
Prior Authorization Required for Durable Medical Equipment
Diagnostic Tests, Lab and Radiology Services, and X-Rays
Diagnostic Procedures/Tests: $50 copay
Lab Services: $0 copay
Diagnostic Radiology Services: $210 copay
X-Rays: $30 copay
Home Health Care

Out-of-Network:

Home Health Services:
Coinsurance for Medicare Covered Home Health 50%
Mental Health Inpatient Care
In-Network:

Psychiatric Hospital Services:
$455 per day for days 1 to 5
$0 per day for days 6 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.
Mental Health Outpatient Care

Out-of-Network:

Mental Health Services:
Copayment for Medicare Covered Individual Sessions $40
Copayment for Medicare Covered Group Sessions $30
Outpatient Services / Surgery
Outpatient Hospital Services:
Copayment for Outpatient Hospital Services $455 copay
Outpatient Substance Abuse Care

Out-of-Network:

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.
In-Network:

Outpatient Substance Abuse Services:
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.
Over-the-counter (OTC) Items
Podiatry Services
$35 copay 6 visits per year
Out-of-Network:

Podiatry Services:
Copayment for Medicare Covered Podiatry Services $85
Skilled Nursing Facility Care

Out-of-Network:

Skilled Nursing Facility Services:
$250 per day for days 1 to 100

Dental Benefits

The following dental services are covered from in-network providers.

Coverage Cost
Dental Care

Out-of-Network:

Preventive Dental Services:
Coinsurance for Medicare Covered Preventive Dental 40%

Vision Benefits

The following vision services are covered from in-network providers.

Coverage Cost
Vision Benefits

Out-of-Network:

Eye Exams Services:
Copayment for Medicare Covered Eye Exams $85
Coinsurance for Medicare Covered Eyewear 40%

Hearing Benefits

The following hearing services are covered from in-network providers.

Coverage Cost
Hearing Benefits
Hearing Aids Package: $199 - $1,249 copay per device, up to 2 hearing aids per year
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.

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:
$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:
  • COVID-19 shots
  • Flu shots
  • Hepatitis B shots
  • Pneumococcal shots
Tobacco use cessation
Yearly "Wellness" visit

Prescription Drug Costs and Coverage

The AARP Medicare Advantage Essentials from UHC KC-4 (PPO) plan offers the following prescription drug coverage, with an annual drug deductible of $600 (excludes Tiers 1 and 2) per year.

Coverage Cost
Coverage & Cost
Annual Drug Deductible $600 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share mail order N/A
  • Standard retail $0.00
  • Standard mail order N/A
Generic
  • Preferred cost-share mail order N/A
  • Standard retail $8.00
  • Standard mail order N/A
Annual Drug Deductible $600 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share mail order N/A
  • Standard retail N/A
  • Standard mail order N/A
Generic
  • Preferred cost-share mail order N/A
  • Standard retail N/A
  • Standard mail order N/A
Annual Drug Deductible $600 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share mail order $0.00
  • Standard retail $0.00
  • Standard mail order $0.00
Generic
  • Preferred cost-share mail order $0.00
  • Standard retail $24.00
  • Standard mail order $24.00
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