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AARP Medicare Advantage from UHC FL-0031 (Regional PPO)

Available to residents of Escambia County, FL for 2027. Contract R0759, plan 001, segment 0.

2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.

New for 2027. This plan has no 2026 predecessor in the CMS crosswalk. Every FL plan’s 2026–2027 changes →

Plan details

Monthly premium (Part C + D)$127.00
— medical (Part C) part$12.20
— drug (Part D) part$114.80?
Monthly premium with full Extra Help (LIS)$119.70?drug (Part D) part $107.50; Extra Help does not cover the medical (Part C) premium
Part B premium reduction (giveback)None
In-network out-of-pocket maximum$9,850.00?
In- and out-of-network out-of-pocket maximum$14,800.00
Drug deductible$685.00Tier 1 and 2 exempt
Drug out-of-pocket threshold$2,400.00
Plan typeRegional PPO?
Contract / planR0759-001-0
Offered byUnitedHealthcare
Parent organizationUnitedHealth Group, Inc.
Formulary tiers5
Formulary exception tier4?
Pharmacy searchAARPMedicarePlans.com
Member services(800)555-5757TTY 711

CMS star ratings

Overall
3.5 out of 5 stars for Overall
Health plan (Part C)
3.5 out of 5 stars for Health plan (Part C)
Drug plan (Part D)
3.5 out of 5 stars for Drug plan (Part D)

Published per contract — every plan under contract R0759 shares this rating.

Plan health benefits

ServiceIn-networkOut-of-network?
Doctor visits
Primary care doctor$0 copay$40 copay
Specialist$0–$55 copay(authorization required)$85 copay
Other health care professional$0–$55 copay(authorization required)$40–$85 copay
Additional telehealth servicesNot covered—
Preventive care
Medicare-covered preventive services$0 copay0%–40% coinsurance
Annual physical exam$0 copay40% coinsurance
Kidney disease education$0 copay40% coinsurance
Glaucoma screening$0 copay$85 copay
Diabetes self-management training$0 copay40% coinsurance
Diagnostic tests, labs and imaging
Diagnostic tests and procedures$50 copay(authorization required)40% coinsurance
Lab services$0 copay(authorization required)$0 copay
Diagnostic radiology (e.g. MRI, CT)$0–$320 copay(authorization required)40% coinsurance
Therapeutic radiology20% coinsurance(authorization required)40% coinsurance
Outpatient x-rays$30 copay(authorization required)$50 copay
Emergency and urgent care
Emergency room$115 copay—
Urgent care$0–$40 copay—
Worldwide emergency coverageNot covered—
Worldwide urgent careNot covered—
Worldwide emergency transportationNot covered—
Hospital care
Inpatient hospital stay$485 per day for days 1–5; $0 per day for days 6–90; $0 per day for days 91–999 (additional days)(authorization required)40% coinsurance per stay
Outpatient hospital services$0–$485 copay(authorization required)40% coinsurance
Outpatient observation$485 copay(authorization required)40% coinsurance
Ambulatory surgical center$0–$485 copay(authorization required)40% coinsurance
Outpatient blood services$0 copay(authorization required)$0 copay
Skilled nursing and home health
Skilled nursing facility$0 per day for days 1–20; $221 per day for days 21–100(authorization required)$250 per day for days 1–100
Home health care$0 copay(authorization required)50% coinsurance
Kidney dialysis20% coinsurance(authorization required)20% coinsurance
Rehabilitation
Occupational therapy$35 copay(authorization required)$85 copay
Physical therapy and speech-language therapy$55 copay(authorization required)$85 copay
Cardiac rehabilitation$0 copay(authorization required)40% coinsurance
Pulmonary rehabilitation$0 copay(authorization required)40% coinsurance
Mental health and substance use
Inpatient psychiatric hospital stay$485 per day for days 1–4; $0 per day for days 5–90(authorization required)40% coinsurance per stay
Outpatient mental health, individual session$0–$25 copay(authorization required)$40 copay
Outpatient mental health, group session$15 copay(authorization required)$30 copay
Psychiatrist, individual session$0–$25 copay(authorization required)$40 copay
Psychiatrist, group session$15 copay(authorization required)$30 copay
Partial hospitalization$55 copay(authorization required)$75 copay
Intensive outpatient program$55 copay(authorization required)$75 copay
Outpatient substance use, individual session$0–$25 copay(authorization required)$40 copay
Outpatient substance use, group session$15 copay(authorization required)$30 copay
Opioid treatment program$0 copay(authorization required)$0 copay
Ambulance and transportation
Ground ambulance$350 copay(authorization required)$350 copay
Air ambulance$350 copay(authorization required)$350 copay
Transportation to plan-approved locationsNot covered—
Medical equipment and supplies
Durable medical equipment (e.g. wheelchairs, oxygen)20% coinsurance(authorization required)50% coinsurance
Prosthetics (e.g. braces, artificial limbs)20% coinsurance(authorization required)50% coinsurance
Medical supplies20% coinsurance(authorization required)50% coinsurance
Diabetes supplies$0 copay(authorization required)50% coinsurance
Diabetic therapeutic shoes or inserts20% coinsurance(authorization required)50% coinsurance
Chiropractic, acupuncture and foot care
Chiropractic (Medicare-covered)$15 copay(authorization required)$85 copay
Routine chiropractic careNot covered—
AcupunctureNot covered—
Foot exams and treatment (Medicare-covered)$45 copay(authorization required)$85 copay
Routine foot care$45 copay(authorization required, limits apply)$85 copay
Dental?
Medicare-covered dental services20% coinsurance(authorization required)40% coinsurance
Oral examsNot covered—
CleaningsNot covered—
Fluoride treatmentNot covered—
Dental x-raysNot covered—
Other diagnostic dental servicesNot covered—
Other preventive dental servicesNot covered—
Restorative services (fillings, crowns)Not covered—
Endodontics (root canals)Not covered—
Periodontics (gum disease)Not covered—
Dentures and other removable prosthodonticsNot covered—
Maxillofacial prostheticsNot covered—
ImplantsNot covered—
Bridges and other fixed prosthodonticsNot covered—
Oral and maxillofacial surgeryNot covered—
OrthodonticsNot covered—
Adjunctive general servicesNot covered—
Vision?
Eye exam (Medicare-covered)$0 copay(authorization required)$85 copay
Routine eye exam$0 copay(authorization required, limits apply)$85 copay
Eyewear after cataract surgery (Medicare-covered)$0 copay(limits apply)40% coinsurance
Eyewear plan limit$200 plan limit every two years—
Contact lenses$0 copay(limits apply)90% coinsurance
Eyeglasses (frames and lenses)$0 copay(limits apply)90% coinsurance
Eyeglass lensesNot covered—
Eyeglass framesNot covered—
Eyewear upgradesNot covered—
Hearing?
Hearing exam (Medicare-covered)$0 copay(authorization required)$85 copay
Routine hearing exam$0 copay(authorization required, limits apply)$85 copay
Hearing aid fitting and evaluationNot covered—
Hearing aid plan limit$700 plan limit every year—
Hearing aids (all types)$0 copay(authorization required, limits apply)90% coinsurance
Hearing aids, inner earNot covered—
Hearing aids, outer earNot covered—
Hearing aids, over the earNot covered—
Medicare Part B drugs
Part B insulin0%–20% coinsurance(authorization required, step therapy may apply)50% coinsurance
Chemotherapy and radiation drugs0%–20% coinsurance(authorization required, step therapy may apply)50% coinsurance
Other Part B drugs0%–20% coinsurance(authorization required, step therapy may apply)0%–50% coinsurance
Other extra benefits?
Over-the-counter (OTC) allowanceNot covered—
Meals after a hospital stay or for a chronic conditionNot covered—
Fitness benefitNot covered—
Health educationNot covered—
Nutritional / dietary benefitNot covered—
Extra smoking and tobacco cessation counselingNot covered—
Enhanced disease managementNot covered—
TelemonitoringNot covered—
Remote access technologies (web/phone, nurse line)Not covered—
Home and bathroom safety devicesNot covered—
Counseling servicesNot covered—
In-home safety assessmentNot covered—
Personal emergency response system (PERS)Not covered—
Medical nutrition therapyNot covered—
Post-discharge in-home medication reconciliationNot covered—
Re-admission preventionNot covered—
Wigs for hair loss from chemotherapyNot covered—
Weight management programsNot covered—
Alternative therapiesNot covered—
Therapeutic massageNot covered—
Adult day health servicesNot covered—
Home-based palliative careNot covered—
In-home support servicesNot covered—
Support for caregiversNot covered—

In-network cost-sharing as the plan filed it with CMS (CMS plan benefit package (PBP) files, CY2027). A range means the cost depends on the service or setting. Rows the filing does not state are left out rather than guessed; an out-of-network dash means the plan files no separate out-of-network cost for that service. Contact the plan for the full Evidence of Coverage.

Drug tiers — preferred pharmacy, initial coverage

TierCost-sharing
Tier 1 · Preferred Generic$0.00
Tier 2 · Generic$4.00
Tier 3 · Preferred Brand21%
Tier 4 · Non-Preferred Drug27%
Tier 5 · Specialty Tier26%

Rx cost-sharing by coverage phase

Tier30-day supply90-day supply
PreferredStandardMail OrderPreferredStandardMail Order
Initial coverage phase
Tier 1: Preferred Generic$0.00$0.00n/a$0.00$0.00$0.00
Tier 2: Generic$4.00$4.00n/a$12.00$12.00$0.00
Tier 3: Preferred Brand21%21%n/a21%21%21%
Tier 4: Non-Preferred Drug27%27%27%n/an/an/a
Tier 5: Specialty Tier26%26%26%n/an/an/a

These are the initial coverage phase amounts, as the plan filed them in its benefit package. The deductible and post-threshold phases are not stated per tier in that filing, so they are not shown here rather than being inferred; the plan's annual out-of-pocket threshold is $2,400.00.

Star rating measures

Each CMS star measure for contract R0759, 2027 against 2026
Measure20272026
Staying Healthy: Screenings, Tests and Vaccines
Breast Cancer Screening · C012 out of 5 stars for Breast Cancer Screening3 out of 5 stars for Breast Cancer Screening
Colorectal Cancer Screening · C023 out of 5 stars for Colorectal Cancer Screening3 out of 5 stars for Colorectal Cancer Screening
Annual Flu Vaccine · C032 out of 5 stars for Annual Flu Vaccine3 out of 5 stars for Annual Flu Vaccine
Improving or Maintaining Physical Health · C044 out of 5 stars for Improving or Maintaining Physical Health4 out of 5 stars for Improving or Maintaining Physical Health
Improving or Maintaining Mental Health · C055 out of 5 stars for Improving or Maintaining Mental Health2 out of 5 stars for Improving or Maintaining Mental Health
Monitoring Physical Activity · C063 out of 5 stars for Monitoring Physical Activity3 out of 5 stars for Monitoring Physical Activity
Managing Chronic (Long Term) Conditions
Special Needs Plan (SNP) Care Management · C071 out of 5 stars for Special Needs Plan (SNP) Care Management2 out of 5 stars for Special Needs Plan (SNP) Care Management
Care for Older Adults – Medication Review · C083 out of 5 stars for Care for Older Adults – Medication Review3 out of 5 stars for Care for Older Adults – Medication Review
Care for Older Adults - Functional Status Assessment · C093 out of 5 stars for Care for Older Adults - Functional Status Assessmentnew measure
Osteoporosis Management in Women who had a Fracture · C103 out of 5 stars for Osteoporosis Management in Women who had a Fracture2 out of 5 stars for Osteoporosis Management in Women who had a Fracture
Diabetes Care – Eye Exam · C112 out of 5 stars for Diabetes Care – Eye Exam3 out of 5 stars for Diabetes Care – Eye Exam
Diabetes Care – Blood Sugar Controlled · C124 out of 5 stars for Diabetes Care – Blood Sugar Controlled4 out of 5 stars for Diabetes Care – Blood Sugar Controlled
Kidney Health Evaluation for Patients with Diabetes · C133 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes3 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes
Controlling High Blood Pressure · C143 out of 5 stars for Controlling High Blood Pressure3 out of 5 stars for Controlling High Blood Pressure
Reducing the Risk of Falling · C152 out of 5 stars for Reducing the Risk of Falling3 out of 5 stars for Reducing the Risk of Falling
Improving Bladder Control · C162 out of 5 stars for Improving Bladder Control4 out of 5 stars for Improving Bladder Control
Plan All-Cause Readmissions · C172 out of 5 stars for Plan All-Cause Readmissions3 out of 5 stars for Plan All-Cause Readmissions
Statin Therapy for Patients with Cardiovascular Disease · C182 out of 5 stars for Statin Therapy for Patients with Cardiovascular Disease2 out of 5 stars for Statin Therapy for Patients with Cardiovascular Disease
Transitions of Care · C192 out of 5 stars for Transitions of Care2 out of 5 stars for Transitions of Care
Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions · C202 out of 5 stars for Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions3 out of 5 stars for Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions
Member Experience with Health Plan
Getting Needed Care · C214 out of 5 stars for Getting Needed Care5 out of 5 stars for Getting Needed Care
Getting Appointments and Care Quickly · C225 out of 5 stars for Getting Appointments and Care Quickly4 out of 5 stars for Getting Appointments and Care Quickly
Rating of Health Care Quality · C244 out of 5 stars for Rating of Health Care Quality4 out of 5 stars for Rating of Health Care Quality
Rating of Health Plan · C253 out of 5 stars for Rating of Health Plan3 out of 5 stars for Rating of Health Plan
Care Coordination · C264 out of 5 stars for Care Coordinationnot enough data
Member Complaints and Changes in the Health Plan's Performance
Complaints about the Health Plan · C274 out of 5 stars for Complaints about the Health Plan5 out of 5 stars for Complaints about the Health Plan
Members Choosing to Leave the Plan · C283 out of 5 stars for Members Choosing to Leave the Plan3 out of 5 stars for Members Choosing to Leave the Plan
Health Plan Quality Improvement · C294 out of 5 stars for Health Plan Quality Improvement3 out of 5 stars for Health Plan Quality Improvement
Health Plan Customer Service
Plan Makes Timely Decisions about Appeals · C305 out of 5 stars for Plan Makes Timely Decisions about Appeals5 out of 5 stars for Plan Makes Timely Decisions about Appeals
Reviewing Appeals Decisions · C314 out of 5 stars for Reviewing Appeals Decisions4 out of 5 stars for Reviewing Appeals Decisions
Call Center – Foreign Language Interpreter and TTY Availability · C325 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability5 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability
DD1: Drug Plan Customer Service
Call Center – Foreign Language Interpreter and TTY Availability · D015 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability5 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability
DD2: Member Complaints and Changes in the Drug Plan’s Performance
Complaints about the Drug Plan · D024 out of 5 stars for Complaints about the Drug Plan5 out of 5 stars for Complaints about the Drug Plan
Members Choosing to Leave the Plan · D033 out of 5 stars for Members Choosing to Leave the Plan3 out of 5 stars for Members Choosing to Leave the Plan
Drug Plan Quality Improvement · D043 out of 5 stars for Drug Plan Quality Improvement3 out of 5 stars for Drug Plan Quality Improvement
DD3: Member Experience with the Drug Plan
Rating of Drug Plan · D054 out of 5 stars for Rating of Drug Plan4 out of 5 stars for Rating of Drug Plan
Getting Needed Prescription Drugs · D064 out of 5 stars for Getting Needed Prescription Drugsnot enough data
DD4: Drug Safety and Accuracy of Drug Pricing
MPF Price Accuracy · D075 out of 5 stars for MPF Price Accuracy5 out of 5 stars for MPF Price Accuracy
Medication Adherence for Diabetes Medications · D082 out of 5 stars for Medication Adherence for Diabetes Medications3 out of 5 stars for Medication Adherence for Diabetes Medications
Medication Adherence for Hypertension (RAS antagonists) · D094 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists)3 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists)
Medication Adherence for Cholesterol (Statins) · D103 out of 5 stars for Medication Adherence for Cholesterol (Statins)3 out of 5 stars for Medication Adherence for Cholesterol (Statins)
Statin Use in Persons with Diabetes (SUPD) · D112 out of 5 stars for Statin Use in Persons with Diabetes (SUPD)2 out of 5 stars for Statin Use in Persons with Diabetes (SUPD)
Concurrent Use of Opioids and Benzodiazepines (COB) · D121 out of 5 stars for Concurrent Use of Opioids and Benzodiazepines (COB)new measure
Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) · D133 out of 5 stars for Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)new measure

Measures are paired between the two years by name, not by the C/D number: CMS reuses those numbers, and in 2027 nineteen of them refer to a different measure than they did in 2026. A measure introduced for 2027 has no 2026 score to show. Published per contract — every plan under R0759 shares it.

Also available in 66 other FL counties

Benefits in plain text

AARP Medicare Advantage from UHC FL-0031 (Regional PPO) (R0759-001-0) is a 2027 Regional PPO Medicare Advantage plan offered by UnitedHealthcare, available to residents of Escambia County, FL.

The monthly premium is $127.00.

With full Extra Help (the Low-Income Subsidy), the total monthly premium is $119.70.

Its in-network out-of-pocket maximum is $9,850.00.

The combined in- and out-of-network out-of-pocket maximum is $14,800.00.

The drug deductible is $685.00. Tier 1 and 2 exempt.

At a preferred pharmacy in the initial coverage phase, a 30-day supply costs tier 1 (Preferred Generic): $0.00; tier 2 (Generic): $4.00; tier 3 (Preferred Brand): 21%; tier 4 (Non-Preferred Drug): 27%; tier 5 (Specialty Tier): 26%.

CMS gives the plan's contract (R0759) an overall rating of 3.5 out of 5 stars.

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Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.