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2021 Medicare Advantage Plan Benefit Details for the AARP Medicare Advantage Patriot (PPO)
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2021 Medicare Advantage Plan Details
Medicare Plan Name:AARP Medicare Advantage Patriot (PPO)
Location:Mahoning, Ohio     Click to see other locations
Plan ID:H8768 - 021 - 0     Click to see other plans
Member Services:1-800-643-4845 TTY users 711
— This plan information is for research purposes only. —
Click here to see plans for the current plan year
Medicare Contact Information:Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.
TTY users 1-877-486-2048
or contact your local SHIP for assistance
Email a copy of the AARP Medicare Advantage Patriot (PPO) benefit details
— Medicare Plan Features —
Monthly Premium:$0.00 (see Plan Premium Details below)
Medicare Part B Premium Reduction:This plan has a $25 Part B monthly premium rebate (or giveback). However, you must continue to pay your Medicare Part B premium.
Annual Deductible:no drug coverage
Health Plan Type:Local PPO *
Maximum Out-of-Pocket Limit for Parts A & B (MOOP):$4,500
Number of Members enrolled in this plan in Mahoning, Ohio:29 members
Number of Members enrolled in this plan in (H8768 - 021):951 members
Plan’s Summary Star Rating: 4 out of 5 Stars.
• Customer Service Rating: 5 out of 5 Stars.
• Member Experience Rating: 4 out of 5 Stars.
• Drug Cost Accuracy Rating: 4 out of 5 Stars.
— Plan Premium Details —
Monthly Premium with Extra Help Low-Income Subsidy (LIS):data not available
— Plan Health Benefits —
** Base Plan **
Premium
• Health plan premium: $0
• Drug plan premium: $0
• You must continue to pay your Part B premium.
• Part B premium reduction: $25
Deductible
• Health plan deductible: $0
• Other health plan deductibles: In-network: No
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
• $10,000 In and Out-of-network
$4,500 In-network
Optional supplemental benefits
• No
Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?
• In-network: No
Doctor visits
• Primary In-network: $0 copay
• Primary Out-of-network: $25 copay per visit
• Specialist In-network: $35 copay per visit (authorization required)
• Specialist Out-of-network: $50 copay per visit (authorization required)
Diagnostic procedures/lab services/imaging
• Diagnostic tests and procedures In-network: $25 copay (authorization required)
• Diagnostic tests and procedures Out-of-network: 40% coinsurance (authorization required)
• Lab services In-network: $0 copay (authorization required)
• Lab services Out-of-network: $0 copay (authorization required)
• Diagnostic radiology services (e.g., MRI) In-network: $0-90 copay (authorization required)
• Diagnostic radiology services (e.g., MRI) Out-of-network: 40% coinsurance (authorization required)
• Outpatient x-rays In-network: $15 copay (authorization required)
• Outpatient x-rays Out-of-network: $20 copay (authorization required)
Emergency care/Urgent care
• Emergency: $90 copay per visit (always covered)
• Urgent care: $30-40 copay per visit (always covered)
Inpatient hospital coverage
• In-network: $325 per day for days 1 through 4
$0 per day for days 5 through 90
$0 per day for days 91 and beyond (authorization required)
• Out-of-network: 40% per stay (authorization required)
Outpatient hospital coverage
• In-network: $0-325 copay per visit (authorization required)
• Out-of-network: 40% coinsurance per visit (authorization required)
Skilled Nursing Facility
• In-network: $0 per day for days 1 through 20
$184 per day for days 21 through 45
$0 per day for days 46 through 100 (authorization required)
• Out-of-network: $225 per day for days 1 through 45
$0 per day for days 46 through 100 (authorization required)
Preventive care
• In-network: $0 copay
• Out-of-network: 0-40% coinsurance
Ground ambulance
• In-network: $250 copay
• Out-of-network: $250 copay
Rehabilitation services
• Occupational therapy visit In-network: $20 copay (authorization required)
• Occupational therapy visit Out-of-network: $50 copay (authorization required)
• Physical therapy and speech and language therapy visit In-network: $20 copay (authorization required)
• Physical therapy and speech and language therapy visit Out-of-network: $50 copay (authorization required)
Mental health services
• Inpatient hospital - psychiatric In-network: $325 per day for days 1 through 4
$0 per day for days 5 through 90 (authorization required)
• Inpatient hospital - psychiatric Out-of-network: 40% per stay (authorization required)
• Outpatient group therapy visit with a psychiatrist In-network: $15 copay (authorization required)
• Outpatient group therapy visit with a psychiatrist Out-of-network: $30-40 copay (authorization required)
• Outpatient individual therapy visit with a psychiatrist In-network: $25 copay (authorization required)
• Outpatient individual therapy visit with a psychiatrist Out-of-network: $30-40 copay (authorization required)
• Outpatient group therapy visit In-network: $15 copay (authorization required)
• Outpatient group therapy visit Out-of-network: $30-40 copay (authorization required)
• Outpatient individual therapy visit In-network: $25 copay (authorization required)
• Outpatient individual therapy visit Out-of-network: $30-40 copay (authorization required)
Medical equipment/supplies
• Durable medical equipment (e.g., wheelchairs, oxygen) In-network: 20% coinsurance per item (authorization required)
• Durable medical equipment (e.g., wheelchairs, oxygen) Out-of-network: 50% coinsurance per item (authorization required)
• Prosthetics (e.g., braces, artificial limbs) In-network: 20% coinsurance per item (authorization required)
• Prosthetics (e.g., braces, artificial limbs) Out-of-network: 50% coinsurance per item (authorization required)
• Diabetes supplies In-network: $0 copay per item (authorization required)
• Diabetes supplies Out-of-network: 40% coinsurance per item (authorization required)
Hearing
• Hearing exam In-network: $0 copay (authorization required)
• Hearing exam Out-of-network: $50 copay (authorization required)
• Fitting/evaluation: Not covered
• Hearing aids In-network: $375-2,075 copay (limits apply, authorization required)
• Hearing aids Out-of-network: $375 copay (limits apply, authorization required)
Preventive dental
• Oral exam In-network: $0 copay (limits apply)
• Oral exam Out-of-network: $0 copay (limits apply)
• Cleaning In-network: $0 copay (limits apply)
• Cleaning Out-of-network: $0 copay (limits apply)
• Fluoride treatment In-network: $0 copay (limits apply)
• Fluoride treatment Out-of-network: $0 copay (limits apply)
• Dental x-ray(s) In-network: $0 copay (limits apply)
• Dental x-ray(s) Out-of-network: $0 copay (limits apply)
Comprehensive dental
• Non-routine services In-network: 50% coinsurance (limits apply, authorization required)
• Non-routine services Out-of-network: 0-50% coinsurance (limits apply, authorization required)
• Diagnostic services In-network: $0 copay (limits apply, authorization required)
• Diagnostic services Out-of-network: 0-50% coinsurance (limits apply, authorization required)
• Restorative services In-network: 0-50% coinsurance (limits apply, authorization required)
• Restorative services Out-of-network: 0-50% coinsurance (limits apply, authorization required)
• Endodontics In-network: $0 copay (limits apply, authorization required)
• Endodontics Out-of-network: 0-50% coinsurance (limits apply, authorization required)
• Periodontics In-network: 50% coinsurance (limits apply, authorization required)
• Periodontics Out-of-network: 0-50% coinsurance (limits apply, authorization required)
• Extractions In-network: 50% coinsurance (limits apply, authorization required)
• Extractions Out-of-network: 0-50% coinsurance (limits apply, authorization required)
• Prosthodontics, other oral/maxillofacial surgery, other services In-network: 0-50% coinsurance (limits apply, authorization required)
• Prosthodontics, other oral/maxillofacial surgery, other services Out-of-network: 0-50% coinsurance (limits apply, authorization required)
Vision
• Routine eye exam In-network: $0 copay (limits apply, authorization required)
• Routine eye exam Out-of-network: $50 copay (limits apply, authorization required)
• Other: Not covered
• Contact lenses: Not covered
• Eyeglasses (frames and lenses): Not covered
• Eyeglass frames: Not covered
• Eyeglass lenses: Not covered
• Upgrades: Not covered
Wellness programs (e.g., fitness, nursing hotline)
• Covered
Transportation
• Not covered
Foot care (podiatry services)
• Foot exams and treatment In-network: $35 copay (authorization required)
• Foot exams and treatment Out-of-network: $50 copay (authorization required)
• Routine foot care In-network: $35 copay (limits apply, authorization required)
• Routine foot care Out-of-network: $50 copay (limits apply, authorization required)
Medicare Part B drugs
• Chemotherapy In-network: 20% coinsurance (authorization required)
• Chemotherapy Out-of-network: 40% coinsurance (authorization required)
• Other Part B drugs In-network: 20% coinsurance (authorization required)
• Other Part B drugs Out-of-network: 40% coinsurance (authorization required)




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