AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) 2025 Plan Details for Los Alamos County, New Mexico Residents
AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) 2025 Plan Details for Los Alamos County, New Mexico Residents
Choosing the right Medicare Advantage plan in Los Alamos County is crucial for your healthcare needs in 2025. With AARP Medicare Advantage Patriot No Rx NM-MA01 (PPO) 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 (May, 2025), there are approximately 740 members enrolled in this plan, 0 in Los Alamos County.
AARP Medicare Advantage Patriot No Rx NM-MA01 Overview
| Plan ID H2406-080-0 Overview | |
|---|---|
| Health Plan ID: | H2406-080-0 |
| Medicare Advantage Plan Type: | PPO |
| Plan Year: | 2025 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $6,700.00 (In-Network) |
| Part B Give Back: | $0.00/mo |
| Part D Drug Plan Benefit: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Los Alamos County, NM |
| Insured By: | UnitedHealthcare® |
Explore the Benefits of AARP Medicare Advantage Patriot No Rx NM-MA01
As a Medicare Advantage PPO plan, AARP Medicare Advantage Patriot No Rx NM-MA01 offers coverage for all Medicare Part A and Part B services while giving you the flexibility to choose your providers. With a monthly premium of $0.00, you can visit any Medicare-approved doctor or facility — and you'll typically save more when using in-network providers.
Primary care visits have a $0 copay, specialist visits come with a $55 copay, lab services cost $0 copay, urgent care services carry a $55 copay, and ambulance transportation is $290 copay. All of these expenses count toward your annual maximum out-of-pocket (MOOP) limit of $6,700.00 . Once that threshold is met, your in-network care is fully covered.
Registered with CMS under plan ID H2406-080-0, AARP Medicare Advantage Patriot No Rx NM-MA01 is a dependable choice for people who want flexible access to care with protection against unexpected medical expenses. Cost-sharing details are outlined below. Still have questions? Check the FAQ section for more info.
| We're Here to Help You Enroll |
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Cost-Sharing Overview
AARP Medicare Advantage Patriot No Rx NM-MA01 has cost-sharing, meaning you'll have out-of-pocket costs when using approved healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H2406-080-0.
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: | $0 Copay |
| Specialist: | $55 Copay Prior Authorization Required |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $125 Copay |
| Urgent care: | $55 Copay |
| Ground ambulance: | $290 Copay |
| Inpatient hospital care: | $425.00 per day for days 1 through 7 $0.00 per day for days 8 and beyond |
| Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $203.00 per day for days 21 and beyond |
This section covers Medicare-approved foot care services, including exams and routine foot care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | $45 Copay Prior Authorization Required |
| Routine Foot Care: | $45 Copay Prior Authorization Required |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | $20 Copay Prior Authorization Required |
| Routine chiropractic: | Not Covered |
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: | $25 Copay |
| Outpatient group therapy: | $15 Copay |
| Inpatient psychiatric hospital care: | $425.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
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: | $45 Copay Prior Authorization Required |
| Occupational therapy: | $45 Copay Prior Authorization Required |
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: | $0 Copay Prior Authorization Required |
| Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
| Prosthetics: | 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: | $250 Copay Prior Authorization Required |
| Lab services: | $0 Copay Prior Authorization Required |
| Outpatient x-rays: | $25 Copay Prior Authorization Required |
| Diagnostic tests and procedures: | $50 Copay Prior Authorization Required |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | 20% Coinsurance |
| Other Part B drugs (Medicare-covered): | 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) |
|---|---|
| Medicare Covered Preventive Dental | 20% Coinsurance Prior Authorization Required |
| Oral exam | $0 Copay |
| Dental x-rays | $0 Copay |
| Cleaning | $0 Copay |
| Periodontics | Not Covered |
| Endodontics | Not Covered |
| Restorative Services | Not Covered |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | Covered Limits may apply |
| Hearing aids | Covered Limits may apply |
| Hearing exam | Not Covered |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam (in-network) | $0 Copay |
| Routine eye exam (in-network) | $0 Copay Prior Authorization Required, 1 Every year |
| Eyewear benefits | Eyeglasses: No Contact Lenses: Yes Eyeglass Lenses: Yes Eyeglass Frames: Yes Eyewear Upgrades: Yes |
Maximum eyewear benefit: | $200.00 Every two years |
Certain preventive services are covered 100% by AARP Medicare Advantage Patriot No Rx NM-MA01 as a Part B benefit.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
How CMS Star Ratings Guide Your Choice
The Centers for Medicare & Medicaid Services (CMS) reviews and rates Medicare Advantage (Part C) and drug plans (Part D) annually, using a 5-star system to measure aspects such as member satisfaction, preventive services, and management of chronic conditions.
Higher star ratings generally indicate better plan performance, which can be a useful factor to consider when deciding on a plan that aligns with your healthcare goals and preferences.
| CMS Measure | Star Rating |
|---|---|
| 2025 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 NM-MA01 ?
To qualify for enrollment in AARP Medicare Advantage Patriot No Rx NM-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 NM-MA01 and enjoy the extensive healthcare benefits it offers.
When Can I Enroll in AARP Medicare Advantage Patriot No Rx NM-MA01 ?
Understanding the right time to enroll in AARP Medicare Advantage Patriot No Rx NM-MA01 is crucial. Here are the key enrollment periods:
- Initial Enrollment Period (IEP): Your first opportunity to enroll in Medicare starts three months before your 65th birthday and lasts until three months after your birthday month.
- Annual Enrollment Period (AEP): Occurring annually from October 15 to December 7, the AEP allows you to enroll in, switch, or drop a Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31 each year, the MA OEP gives you the chance to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing other coverage, may make you eligible for a SEP, allowing you to adjust your plan outside the usual periods.
Not sure when to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to speak with a licensed insurance agent who can guide you through your options.
Steps to Enroll in AARP Medicare Advantage Patriot No Rx NM-MA01
Getting started with AARP Medicare Advantage Patriot No Rx NM-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 NM-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 H2406-080-0:
How much does H2406-080-0 cost per month?
Members pay their Part B premium and the plan's of $0.00 per month to be in this 2025 plan.
How high can my costs go in a worst-case year?
Your costs top out at $6,700.00 (for in-network services) in 2025; after that the plan pays 100% of covered services.
What’s the CMS star score for AARP Medicare Advantage Patriot No Rx NM-MA01 ?
The latest CMS score is ★4.0 out of 5 stars; anything 4 or higher earns quality bonuses.
How many members does AARP Medicare Advantage Patriot No Rx NM-MA01 have?
Enrollment stands at roughly 740 members.
Contact UnitedHealthcare®
| Website: | UnitedHealthcare® Plan Page |
|---|---|
| Providers: | UnitedHealthcare® Providers Page |
| New Member Health Plan Help: | (800)555-5757 |
| New Member Health Plan TTY: | 711 |
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.
- UnitedHealthcare®, http://AARPMedicarePlans.com, Last Accessed June 1, 2025
- CMS.gov, "Medicare Advantage Plan Fact Sheet", Last Accessed 25 May, 2025
- AARP.org, "The Big Choice: Original Medicare vs. Medicare Advantage", Last Accessed 25 May, 2025
- Medicare.gov, "Explore your Medicare coverage options", Last Accessed 25 May, 2025
- CMS.gov, Landscape Source Files, Last Accessed October 15, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed October 15, 2024
- CMS.gov, Plan Benefits Package, Last Accessed October 15, 2024
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County, Last Accessed June 6, 2025
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