AARP Medicare Advantage Patriot No Rx ID-MA01 (HMO-POS) 2026 Plan Details for Nez Perce County, Idaho Residents
AARP Medicare Advantage Patriot No Rx ID-MA01 (HMO-POS) 2026 Plan Details for Nez Perce County, Idaho Residents
Choosing the right Medicare Advantage plan in Nez Perce County is crucial for your healthcare needs in 2026. With AARP Medicare Advantage Patriot No Rx ID-MA01 (HMO-POS) as one of the options, you can compare it side-by-side with other available plans to find the best fit for you. Whether you prefer enrolling online or seeking advice from a licensed agent, we’ve made the process simple and straightforward.
According to CMS enrollment data, there are approximately 4,192 members enrolled in this plan, 88 in Nez Perce County.
AARP Medicare Advantage Patriot No Rx ID-MA01 Overview
| Plan ID H4604-019-0 Overview | |
|---|---|
| Health Plan ID: | H4604-019-0 |
| Medicare Advantage Plan Type: | HMO-POS |
| Plan Year: | 2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $6700.00 (In-Network) |
| Part B Give Back: | −$90.00 reduction |
| Part D Drug Plan Benefit: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Nez Perce County, ID |
| Insured By: | UnitedHealthcare |
Why Choose AARP Medicare Advantage Patriot No Rx ID-MA01?
This Medicare Advantage HMO-POS plan gives you structured benefits with added flexibility. With a monthly premium of $0.00, AARP Medicare Advantage Patriot No Rx ID-MA01 covers all the essentials of Medicare Part A and Part B, while giving you the option to see out-of-network providers in certain situations. You’ll typically pay less when staying in-network, but have the freedom to go outside when needed — a nice middle ground for those who want more control over their care.
Primary care visits have a $0 copay, specialist visits come with a $0-$55 copay, urgent care services carry a $0-$50 copay, and ambulance transportation is $290 copay. These costs all apply toward the plan’s annual maximum out-of-pocket (MOOP) limit of $6700.00. Once you reach that cap, your in-network services are covered at 100% for the rest of the year. It’s a dependable option if you’re looking for predictable costs and the flexibility to step outside the network when needed.
This plan is registered with CMS under ID H4604-019-0. You’ll find a summary of its cost sharing below, including what you can expect to pay for primary care, specialists, urgent care, and more. Still have questions? Check the FAQ section for more details.
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Out-of-Pocket Expenses
With AARP Medicare Advantage Patriot No Rx ID-MA01, you'll have cost-sharing expenses, which are the out-of-pocket costs for approved healthcare services. The table below provides a summary of the typical in-network out-of-pocket costs associated with plan H4604-019-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | In-network: $0 copay |
| Specialist: | In-network: $0-$55 copay |
Medicare Advantage plans often include preventive and wellness benefits designed to help members stay healthy, identify risks early, and maintain an active lifestyle.
| Service | Enrollee Cost (in-network) |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | Not covered |
| Fitness benefits: | In-network: $0 copay |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over the counter drug benefits: | In-network: $0 copay |
| Health transportation (non-emergency): | Not covered |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $130 copay |
| Wordwide 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 |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $218 per day for days 21-100 |
| Ground ambulance: | In-network: $290 copay |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | In-network: $0-$25 copay |
| Outpatient group therapy: | In-network: $15 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 |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $55 copay |
| Occupational therapy: | In-network: $50 copay |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | In-network: $0 copay |
| Durable medical equipment: | In-network: 20% coinsurance |
| Prosthetics: | In-network: 20% coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | In-network: $0-$260 copay |
| Lab services: | In-network: $0 copay |
| Outpatient x-rays: | In-network: $30 copay |
| Diagnostic tests and procedures: | In-network: $50 copay |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance |
This section details the dental services covered under your plan including Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| 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 the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Hearing exam: | In-network: $0 copay |
| Fitting/evaluation: | Not covered |
| Prescription hearing aids: | In-network: $199-$1249 copay |
| OTC hearing aids: | In-network: $199-$829 copay |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Routine eye exam: | In-network: $0 copay |
| Contact lenses: | In-network: $0 copay |
| Eyeglass frames only: | In-network: $0 copay |
| Eyeglass lenses only: | In-network: $0-$153 copay |
| Eyeglasses (frames & lenses): | Not covered |
| Upgrades: | Not covered |
Medicare Advantage plans may include extra benefits and special needs services designed to support members with chronic conditions, mobility limitations, or other complex health needs.
| Service | Enrollee Cost (in-network) |
|---|---|
| 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 hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | In-network: $0 copay |
Certain preventive services are covered 100% by AARP Medicare Advantage Patriot No Rx ID-MA01 as a Part B benefit.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
Understanding CMS Star Ratings
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
| 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 |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Am I Eligible for AARP Medicare Advantage Patriot No Rx ID-MA01?
To qualify for enrollment in AARP Medicare Advantage Patriot No Rx ID-MA01, you must:
- Be entitled to Medicare Part A and enrolled in Medicare Part B.
- Live within the plan’s designated service area.
If you fulfill these criteria, you can enroll in AARP Medicare Advantage Patriot No Rx ID-MA01 and enjoy the extensive healthcare benefits it offers.
Enrollment Periods for AARP Medicare Advantage Patriot No Rx ID-MA01
Knowing when you can enroll in AARP Medicare Advantage Patriot No Rx ID-MA01 is essential. Here are the main enrollment periods:
- Initial Enrollment Period (IEP): Your IEP starts three months before your 65th birthday and ends three months after, giving you a seven-month window to enroll in Medicare.
- Annual Enrollment Period (AEP): The AEP, from October 15 to December 7, allows you to make changes to your Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): Running from January 1 to March 31, the MA OEP lets you switch plans or return to Original Medicare if you are currently enrolled in a Medicare Advantage plan.
- Special Enrollment Periods (SEPs): Life events such as moving or losing coverage may qualify you for a SEP, enabling you to enroll or make changes outside the usual periods.
If you're uncertain about the right time to enroll, Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) for guidance from a licensed insurance agent.
How to Enroll in AARP Medicare Advantage Patriot No Rx ID-MA01
Getting started with AARP Medicare Advantage Patriot No Rx ID-MA01 is simple. Here are your options:
- Online Enrollment: Easily enroll online using a secure form. Visit the MedicareEnrollment.com enrollment page and follow the steps to complete your enrollment.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will guide you through the process and answer any questions.
- Through Medicare.gov: Enroll through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the instructions to join a Medicare Advantage plan.
- Directly with the Plan: You can also enroll directly with AARP Medicare Advantage Patriot No Rx ID-MA01. The plan's contact information is available below in the "Contact" section.
Be sure to enroll during the appropriate period to ensure your coverage begins without delay.
Here are some of the most frequently asked questions people have about plan ID H4604-019-0:
Is there a premium for this plan in 2026?
For 2026, the monthly premium is $0.00, and you still pay your Part B premium to Medicare.
What is the annual out-of-pocket maximum on this plan?
The annual in-network MOOP is $6700.00, protecting you from larger bills once you hit that limit.
Is this a 4-star or 5-star plan?
CMS rates it ★4.0 out of 5 stars for 2026.
How many people are enrolled in this plan?
Enrollment stands at roughly 4,192 members.
Contact UnitedHealthcare
| Contact Type | Details |
|---|---|
| Website: | UnitedHealthcare Plan Page |
| New Members: | 1-800-555-5757 |
| Existing Members: | 1-844-876-6176 |
| Plan Address: | P.O. Box 30770 | Salt Lake City, UT 84130 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 14, 2025
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed October 13, 2025
Learn more about how we use CMS data.
- UnitedHealthcare, http://AARPMedicarePlans.com — Last accessed October 13, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content managed by David Bynon, Medicare Analyst.
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