- Entity
- plan:H1278-031-0
- Digest
- 2026-cms-snp-plan
- Source URL
- https://www.medicareplans.com/medicare-advantage/plan/H1278-031-0/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-H1278-031-0-performance
- CMS Plan ID
- All MA/MAPD and PDP plans have a CMS plan ID consisting of a contract ID, plan ID, and segment ID formatted like: H1234-001-0.
- Value
- H1278-031-0
- Derived
- true
- Contract Year
- The calendar year in which the plan's benefits, premiums, and rules are effective as defined by CMS.
- Value
- 2026
- Derived
- false
- Contract Category Type
- The CMS-assigned contract type for the plan, such as MA, MAPD, SNP, or PDP, which indicates the scope of services and population the contract is designed to serve.
- Value
- MA
- Derived
- false
- Contract ID
- The unique contract ID assigned to a carrier by CMS. All plans have a contract ID.
- Value
- H1278
- Derived
- false
- Plan ID
- The unique plan ID within a CMS contract.
- Value
- 031
- Derived
- false
- Segment ID
- A segment ID is used to identify specific geographic market segments or subdivisions for variations in benefits, costs, and premiums.
- Value
- 0
- Derived
- false
- Parent Organization Name
- The legal parent company that owns the Medicare Advantage contract and is ultimately responsible for the plan’s administration.
- Value
- UnitedHealth Group, Inc.
- Derived
- false
- Organization Marketing Name
- The publicly marketed name of the Medicare Advantage plan carrier as displayed to consumers, which may differ from the legal or corporate entity name.
- Value
- UnitedHealthcare
- Derived
- false
- Organization Type
- A descriptive label that classifies the Medicare plan contract type in plain language, such as Local HMO, Regional PPO, or SNP.
- Value
- Local CCP
- Derived
- true
- Plan Name
- The official name of the Medicare Advantage plan as listed in CMS source data.
- Value
- AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO)
- Derived
- false
- Plan Type
- The type of Medicare plan, such as PDP, Regional PPO, HMO-POS, HMO D-SNP, which determines how the plan manages care and provider access.
- Value
- PPO
- Derived
- false
- Special Needs Plan (SNP) Indicator
- Indicates whether the plan is a Special Needs Plan (SNP), designed to serve people with specific diseases, dual eligibility, or institutional needs.
- Value
- No
- Derived
- false
- SNP Type
- Specifies the type of Special Needs Plan, such as D-SNP for dual-eligible individuals, C-SNP for chronic conditions, or I-SNP for institutional care.
- Value
- Not Applicable
- Derived
- false
- Part D Coverage Indicator
- Indicates whether the Medicare Advantage plan includes Part D prescription drug coverage.
- Value
- No
- Derived
- false
- Drug Benefit Category
- Specifies whether the plan’s drug benefit is defined as basic, enhanced, or other CMS-classified categories.
- Value
- Not Applicable
- Derived
- false
- Drug Benefit Type
- Specifies the delivery structure of the plan’s drug benefit, such as defined standard, actuarially equivalent, or enhanced alternative.
- Value
- Not Applicable
- Derived
- false
- Voluntary De Minimis
- Indicates whether the plan participates in the voluntary de minimis policy, allowing small premium differences without disqualifying LIS benchmark eligibility.
- Value
- No
- Derived
- false
- Part D Basic Premium Benchmark
- The CMS-calculated benchmark for basic Part D premiums used to determine Low-Income Subsidy (LIS) eligibility thresholds.
- Value
- Not Applicable
- Derived
- false
- LIS Auto-Enrollment Eligible
- Indicates whether the plan is eligible for automatic enrollment of Low-Income Subsidy (LIS) beneficiaries by CMS.
- Value
- Not Applicable
- Derived
- false
- Drug Tiers with No Deductible
- Indicates which drug tiers are excluded from the plan’s Part D deductible, allowing members to access medications without paying the deductible first.
- Value
- Not Applicable
- Derived
- false
- Part D Deductible
- The annual amount a member must pay out of pocket for Part D drugs before the plan begins to pay.
- Value
- Not Applicable
- Derived
- false
- Part D Basic Premium
- The portion of the plan's monthly premium that covers the standard Part D drug benefit.
- Value
- Not Applicable
- Derived
- false
- Part D Supplemental Premium
- The monthly premium amount for any supplemental drug coverage offered beyond the standard Part D benefit.
- Value
- Not Applicable
- Derived
- false
- Part D Total Premium
- The total monthly premium for the Part D plan, including both the basic and any supplemental components.
- Value
- Not Applicable
- Derived
- true
- Low Income Premium Subsidy (LIPS) Amount
- The amount of monthly premium subsidized by CMS for Low-Income Subsidy (LIS) eligible members enrolled in the plan.
- Value
- 10.46
- Derived
- false
- Part D LIPS (CMS Pays)
- The total amount CMS pays on behalf of LIS-eligible enrollees to cover premium costs under the Low-Income Subsidy program.
- Value
- Not Applicable
- Derived
- false
- Part D Low Income Beneficiary Premium Amount
- The amount that a Low-Income Subsidy (LIS) beneficiary is responsible for paying after CMS premium subsidies have been applied.
- Value
- Not Applicable
- Derived
- true
- Part D Out-of-Pocket (OOP) Threshold
- The total amount a member must spend on covered Part D drugs in a calendar year before entering the catastrophic coverage phase.
- Value
- Not Applicable
- Derived
- false
- Part C Premium
- The monthly premium a member pays for Medicare Advantage (Part C) coverage, excluding prescription drug (Part D) premiums.
- Value
- $0.00
- Derived
- false
- Monthly Consolidated Premium (Part C + D)
- The total monthly premium a member pays for the Medicare Advantage plan, including both Part C and Part D coverage.
- Value
- Not Applicable
- Derived
- true
- In-Network Maximum Out-of-Pocket (MOOP) Amount
- The maximum amount a member will pay out of pocket for in-network Medicare-covered services during the plan year, after which the plan pays 100%.
- Value
- Derived
- false
- Record Checksum
- Checksum value associated with this published plan record.
- Value
- VXQ-731-H1278-031-0
- Derived
- true
- Entity
- contract:H1278
- Digest
- 2026-cms-part-c-and-d-performance
- Source URL
- https://www.medicareplans.com/medicare-advantage/plan/H1278-031-0/
- Glossary Scope
- cms_performance
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-H1278-031-0-landscape
- Overall Star Rating
- The overall CMS star rating for the plan, based on quality and performance across all measured domains.
- Value
- 3.5
- Unit
- stars
- Derived
- false
- Staying Healthy Measure
- Includes preventive screenings, vaccines, and wellness checks that help members stay healthy.
- Value
- 4
- Unit
- stars
- Derived
- false
- Managing Chronic Conditions Measure
- Evaluates how effectively the plan helps members manage chronic health conditions like diabetes, COPD, or hypertension.
- Value
- 3
- Unit
- stars
- Derived
- false
- Member Experience Measure (Health Plan)
- Captures what members say about their experience with the health plan.
- Value
- 3
- Unit
- stars
- Derived
- false
- Plan Complaints Measure
- Tracks member complaints and changes in the plan’s performance over time.
- Value
- 3
- Unit
- stars
- Derived
- false
- Health Plan Customer Service Measure
- Measures how well the plan handles member appeals and customer inquiries.
- Value
- 5
- Unit
- stars
- Derived
- false
AARP Medicare Advantage Patriot No Rx WA-MA01 (PPO) Medicare Advantage Plan H1278-031 • 2026
AARP Medicare Advantage Patriot No Rx WA-MA01 is a Medicare Advantage PPO plan offered by UnitedHealthcare for the 2026 plan year. It uses a Preferred Provider Organization (PPO) provider network and comes without prescription drug coverage. CMS Plan ID H1278-031 identifies this plan.
AARP Medicare Advantage Patriot No Rx WA-MA01 Overview
Plan Overview for
H1278-031-0
|
|
|---|---|
| CMS Plan ID: |
H1278-031-0
|
| Plan Type: | PPO |
| Plan Year: | 2026 |
| Monthly Premium: |
$0.00
Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $6700.00 (In-Network) |
| Part B Give Back: | −$105.00 reduction |
| Prescription Drug Coverage: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | See List |
| Enrollment (Nationwide): | 5,249 beneficiaries |
| Provided By: | UnitedHealthcare |
Plan Availability
AARP Medicare Advantage Patriot No Rx WA-MA01 (H1278-031-0) is available in the following locations (click to open):
Plan Details for AARP Medicare Advantage Patriot No Rx WA-MA01
This Medicare Advantage Preferred Provider Organization (PPO) plan provides access to Medicare-approved providers and covers Medicare Part A and Part B services. The monthly premium is $0.00, with lower costs when using in-network providers.
Primary care visits have a $0 copay | Out-of-network: $25 copay, specialist visits come with a $0-$60 copay | Out-of-network: $80 copay, urgent care services carry a $0-$50 copay, and ambulance transportation is $290 copay | Out-of-network: $290 copay. These costs apply toward the annual maximum out-of-pocket (MOOP) limit of $6700.00. Once this limit is reached, in-network services are fully covered.
This plan is listed by CMS under Plan ID H1278-031. Cost-sharing details for key services are provided below.
Cost Sharing Expenses
AARP Medicare Advantage Patriot No Rx WA-MA01 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 H1278-031.
This section outlines in-network costs for primary care and specialist office visits, along with related preventive services.
| Covered Service | In-Network Cost |
|---|---|
| Primary: | In-network: $0 copay | Out-of-network: $25 copay |
| Specialist: | In-network: $0-$60 copay | Out-of-network: $80 copay |
This section outlines in-network costs for preventive and wellness services included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | Not covered |
| Fitness benefits: | In-network: $0 copay | Out-of-network: $0 copay |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over-the-counter drug benefits: | In-network: $0 copay | Out-of-network: $0 copay |
| Health transportation (non-emergency): | Not covered |
This section outlines in-network costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Covered Service | In-Network Cost |
|---|---|
| Diagnostic radiology services: | In-network: $0-$260 copay | Out-of-network: 30% coinsurance |
| Lab services: | In-network: $0 copay | Out-of-network: $0 copay |
| Outpatient x-rays: | In-network: $5 copay | Out-of-network: $10 copay |
| Diagnostic tests and procedures: | In-network: $5 copay | Out-of-network: 30% coinsurance |
This section outlines in-network costs for emergency services, urgent care, ambulance transportation, inpatient hospital stays, and skilled nursing facility care.
| Covered Service | In-Network Cost |
|---|---|
| Emergency room care: | $130 copay |
| Worldwide emergency care: | $0 copay |
| Urgent care: | $0-$50 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $550 per day for days 1-5 | $0 per day for days 6-90 | $0 per stay | Out-of-network: | $660 per day for days 1-16 | $0 per day for days 17-999 | $0 per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $218 per day for days 21-100 | Out-of-network: | $250 per day for days 1-100 | $0 per stay |
| Ground ambulance: | In-network: $290 copay | Out-of-network: $290 copay |
This section outlines in-network costs for mental health services, including outpatient therapy and inpatient psychiatric care.
| Covered Service | In-Network Cost |
|---|---|
| Outpatient individual therapy: | In-network: $0-$25 copay | Out-of-network: $40 copay |
| Outpatient group therapy: | In-network: $15 copay | Out-of-network: $30 copay |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $550 per day for days 1-5 | $0 per day for days 6-90 | $0 per stay | Out-of-network: | $660 per day for days 1-16 | $0 per day for days 17-999 | $0 per stay |
This section outlines in-network costs for rehabilitation services, including physical therapy, speech and language therapy, and occupational therapy.
| Covered Service | In-Network Cost |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $60 copay | Out-of-network: $80 copay |
| Occupational therapy: | In-network: $50 copay | Out-of-network: $80 copay |
This section outlines in-network costs for medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Covered Service | In-Network Cost |
|---|---|
| Diabetes supplies: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Durable medical equipment: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
This section outlines in-network cost sharing for chemotherapy and other Medicare Part B-covered drugs.
| Covered Service | In-Network Cost |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 30% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 0%-30% coinsurance |
This section outlines in-network cost sharing for dental services, including preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.
| Covered Service | In-Network Cost |
|---|---|
| Oral exam: | In-network: $0 copay | Out-of-network: $0 copay |
| Dental x-rays: | In-network: $0 copay | Out-of-network: $0 copay |
| Cleaning: | In-network: $0 copay | Out-of-network: $0 copay |
| Periodontics: | In-network: 50% coinsurance | Out-of-network: 50% coinsurance |
| Endodontics: | In-network: 50% coinsurance | Out-of-network: 50% coinsurance |
| Restorative services: | In-network: 50% coinsurance | Out-of-network: 50% coinsurance |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: 50% coinsurance | Out-of-network: 50% coinsurance |
This section outlines in-network cost sharing for vision services, including eye exams, eyeglasses, and contact lenses.
| Covered Service | In-Network Cost |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: $80 copay |
| Contact lenses: | In-network: $0 copay | Out-of-network: $0 copay |
| Eyeglass frames only: | In-network: $0 copay | Out-of-network: $0 copay |
| Eyeglass lenses only: | In-network: $0-$153 copay | Out-of-network: $0-$153 copay |
| Eyeglasses (frames & lenses): | Not covered |
| Upgrades: | Not covered |
This section outlines in-network cost sharing for hearing-related services, including exams, fittings, and hearing aids.
| Covered Service | In-Network Cost |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: $80 copay |
| Fitting/evaluation: | Not covered |
| Prescription hearing aids: | In-network: $199-$1249 copay | Out-of-network: $199-$1249 copay |
| OTC hearing aids: | In-network: $199-$829 copay | Out-of-network: $199-$829 copay |
This section outlines in-network cost sharing for additional and special needs services that may be included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Adult day health services: | Not covered |
| Home-based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | Not covered |
| Wigs for chemotherapy-related hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | In-network: $0 copay | Out-of-network: $0 copay |
Certain preventive services are covered 100% by AARP Medicare Advantage Patriot No Rx WA-MA01 as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
Medicare Plan Star Ratings
Medicare Advantage (Part C) and Part D plans are rated each year by CMS on a 5-star scale. Ratings summarize plan performance across clinical care and member experience measures.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
How much does plan H1278-031 cost per month?
The plan’s monthly premium is $0.00 for 2026. The Part B premium is not included.
What is the annual out-of-pocket maximum (MOOP) for this plan?
The annual in-network MOOP is $6700.00 for 2026. After this limit is reached, covered in-network services are fully paid.
How many beneficiaries are enrolled in this plan?
CMS reports 5,249 beneficiaries enrolled in this plan.
What is the prescription drug deductible for 2026?
For 2026, the prescription drug deductible is $0.00.
Contact Information for UnitedHealthcare
| Contact Type | Details |
|---|---|
| Website: | UnitedHealthcare Plan Page |
| New Members: | 1-800-555-5757 |
| Existing Members: | 1-877-370-3249 |
| Plan Address: | P.O. Box 30770 | Salt Lake City, UT 84130 |
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at medicare.gov.
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | September 8, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| UnitedHealthcare (official source) | http://AARPMedicarePlans.com | October 13, 2025 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
| Medicare.gov | Explore your Medicare coverage options | 25 May, 2025 |
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Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.