Coverage and benefits

The Medicare plans with more benefits and personalized care

Important Information about your Part D Vaccine and Insulin Coverage

What You Pay for Vaccines – Our plan covers most adult Part D vaccines at no cost to you.

What You Pay for Insulin – You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan. Refer to your plan materials.

AT&T Group Medicare Advantage (PPO) Plans

Get information about your plan options and what you can expect next – click on the links below that apply to you.

2024 materials

When you choose one of the AT&T Group Medicare Advantage (PPO) Plans, you’re selecting a plan you can’t get anywhere else. These plans have an exclusive combination of benefits designed to help you get the most from your retirement, including:

A $900 annual out-of-pocket maximum for medical, which may be lower than your current plan.
In-home wellness visits with UnitedHealthcare® HouseCalls
Anytime medical advice through 24/7 Nurse Support
A free gym membership at a fitness location you select from a nationwide network, including many premium gyms. Visit UHCRenewActive.com to find a fitness location near you.
Rewards for certain health care activities
Discounts on hearing aids through UnitedHealthcare® Hearing
Post-discharge meals and post-discharge transportation
8 hours of free in-home care support each month from a network of pre-screened, professional caregivers through CareLinx
Special programs for chronic conditions like diabetes or heart disease
Routine chiropractic and acupuncture services
Virtual doctor and behavioral health visits

Benefits and costs

Plan options and costs
Benefits	AT&T Group Medicare Advantage (PPO) Plan	AT&T Group Medicare Advantage (PPO) Plus Plan
AT&T Group Medicare Advantage (PPO) Plan	AT&T Group Medicare Advantage (PPO) Plus Plan
Annual medical deductible	None	None
Annual medical deductible
None	None
Annual out-of-pocket maximum	$900	$900
Annual out-of-pocket maximum
$900	$900
Office and clinic visits	$0 copay primary care $30 copay specialist visit $0 copay virtual doctor visit	$0 copay primary care $30 copay specialist visit $0 copay virtual doctor visit
Office and clinic visits
$0 copay primary care $30 copay specialist visit $0 copay virtual doctor visit	$0 copay primary care $30 copay specialist visit $0 copay virtual doctor visit
Hospital services (inpatient)	$100 copay per admit	$100 copay per admit
Hospital services (inpatient)
$100 copay per admit	$100 copay per admit
Hospital services (outpatient)	$200 copay	$200 copay
Hospital services (outpatient)
$200 copay	$200 copay
Prescription drug coverage	Tier 1: $0 copay Tier 2: $10 copay Tier 3: $40 copay Tier 4: $125 copay Tier 5: 33% coinsurance $6,500 Rx Max out of pocket Estimate Drug Cost	Tier 1: $0 copay Tier 2: $10 copay Tier 3: $40 copay Tier 4: $125 copay Tier 5: 33% coinsurance $6,500 Rx Max out of pocket Estimate Drug Cost
Prescription drug coverage
Tier 1: $0 copay Tier 2: $10 copay Tier 3: $40 copay Tier 4: $125 copay Tier 5: 33% coinsurance $6,500 Rx Max out of pocket Estimate Drug Cost	Tier 1: $0 copay Tier 2: $10 copay Tier 3: $40 copay Tier 4: $125 copay Tier 5: 33% coinsurance $6,500 Rx Max out of pocket Estimate Drug Cost
Dental	NA	100% coverage for preventive care 80% coverage for basic dental services 50% coverage for major dental services $50 deductible**, $1,000 plan year maximum
Dental
NA	100% coverage for preventive care 80% coverage for basic dental services 50% coverage for major dental services $50 deductible**, $1,000 plan year maximum
Vision	$0 copay for routine vision 1 exam every 12 months	$0 for 1 routine exam every 12 months $150 Eyeglasses or Contact Lenses Allowance annually
Vision
$0 copay for routine vision 1 exam every 12 months	$0 for 1 routine exam every 12 months $150 Eyeglasses or Contact Lenses Allowance annually
Hearing Aid	$0 copay for routine hearing exam every 12 months	$4,000 Hearing Aid Allowance every 3 years
Hearing Aid
$0 copay for routine hearing exam every 12 months	$4,000 Hearing Aid Allowance every 3 years

**Preventive and diagnostic services are not included in the deductible.

Preventive services

The following preventive services are covered under your plan for a $0 copay when you visit your primary care provider:

Annual Wellness Exam
Annual Routine Physical
Screenings for certain Cancers (prostate, colorectal, breast cancer)
Screening for Diabetes
Smoking and Tobacco Use Cessation

For more information about these preventive services, please call the Customer Service number on your member ID card.

Disclaimer

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the costsharing that applies to out-of-network services.