AARP Medicare Advantage Giveback from UHC PA-12 (PPO) Medicare Advantage Plan H2406-101 • 2026 • Jefferson County, PA

AARP Medicare Advantage Giveback from UHC PA-12 Overview

Coverage Overview for AARP Medicare Advantage Giveback from UHC PA-12

This MAPD PPO Medicare Advantage plan includes Medicare Part A and Part B services along with integrated prescription drug coverage. The monthly premium is $0.00, and the plan allows access to Medicare-approved providers, with lower costs when using in-network providers. The annual Part D deductible is $600.00.

Primary care visits have a $0 copay | Out-of-network: $45 copay, and specialist visits come with a $0-$55 copay | Out-of-network: $85 copay. Urgent care services carry a $0-$40 copay, and ground ambulance transportation is $270 copay | Out-of-network: $270 copay. These costs apply toward the annual maximum out-of-pocket (MOOP) limit of $8900.00. After this limit is reached, in-network services are fully covered.

This plan is recognized by CMS under Plan ID H2406-101. Cost-sharing details are outlined below.

Out-of-Pocket Costs

AARP Medicare Advantage Giveback from UHC PA-12 has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H2406-101.

Certain preventive services are covered 100% by AARP Medicare Advantage Giveback from UHC PA-12 as a Part B benefit.

Prescription Drug Coverage

AARP Medicare Advantage Giveback from UHC PA-12 includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.

This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.

Prescription Drug Plan Premium

The Part D prescription drug plan premium is included in the overall Medicare Special Needs Plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.

For more details, visit the Social Security Extra Help program .

Prescription Drug Plan Deductible

This plan has a $600.00 annual Part D deductible. You'll pay this deductible at the pharmacy before UnitedHealthcare starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, AARP Medicare Advantage Giveback from UHC PA-12 may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

CMS Star Ratings

The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.