2027 Medicare plan code

H2406-075

Medicare Plan

AARP Medicare Advantage from UHC DE-0001 (PPO) · UnitedHealthcare · Local PPO · State of Delaware

Full CMS plan ID: H2406-075-000

H2406-075-000 is the full CMS identifier for the H2406-075 Medicare plan. Common searches include H2406 075 and H2406075.

2027

Spaces or dashes work: H5216-435-002 · S2135 802

● CMS 2027 plan record

AARP Medicare Advantage from UHC DE-0001 (PPO)

H2406-075-000 State of Delaware Local PPO

At-a-glance

Quick view

01

In-network

Inpatient hospital

Days 1–4 $685 / day
Days 5–90 $0 / day
Total of listed copays · 4 charged days $2,740
Out-of-network

Tier 1: 40% coinsurance

Point of service

Not separately reported

02

Emergency transport

Ambulance

Ground · in-network$275 copay
Air · in-network$275 copay
03

Emergency services

Emergency room

$130 copay

Waived if admitted within 24 hours

04

Medical maximum

Maximum out-of-pocket

In-network$7,150
Combined in + out$10,750
05

Skilled care at home

Home health

In-network$0 copay
Out-of-network50% coinsurance
06

Monthly cost

Premium & giveback

Part C premium$0 / month
Consolidated C + D$23 / month

CMS reports no Part B premium reduction for this plan.

Plan details

All plan benefits

Medical care3 benefits

Primary care physician

In-networkPrimary Care Physician Services: $0 copay
Out-of-network7a: $45 copay

Specialist

In-networkPhysician Specialist Services: $0–$60 copay
Out-of-network7d: $105 copay

Preventive care

In-networkAnnual Physical Exam: $0 copay; Kidney Disease Education Services: $0 copay; Glaucoma Screening: $0 copay; Diabetes Self-Management Training: $0 copay; Digital Rectal Exams: $0 copay; EKG following Welcome Visit: $0 copay
Out-of-network14b: 40% coinsurance; 14d: 40% coinsurance; 14e1: $105 copay; 14e2: 40% coinsurance; 14e4: 40% coinsurance; 14e5: 40% coinsurance; 14a: 0%–40% coinsurance
Diagnostics & imaging4 benefits

Diagnostic procedures & tests

In-networkDiagnostic Procedures/Tests: $5 copay
Out-of-network8a1: 40% coinsurance

Laboratory services

In-networkLab Services: $0 copay
Out-of-network8a2: $0 copay

X-rays & standard imaging

In-networkOutpatient X-Ray Services: $5 copay
Out-of-network8b3: $55 copay

MRI, CT & PET imaging

In-networkDiagnostic Radiological Services: $0–$320 copay
Out-of-network8b1: 40% coinsurance
Urgent & hospital care6 benefits

Urgent care

In-networkUrgently Needed Services: $0–$50 copay
Out-of-networkNot separately reported

Emergency room

In-network$130 copay
Out-of-networkNot separately reported

Ground ambulance

In-network$275 copay
Out-of-network$275 copay

Air ambulance

In-network$275 copay
Out-of-network$275 copay

Outpatient hospital

In-networkOutpatient Hospital Services: $0–$685 copay; Observation Services: $685 copay
Out-of-network9a1: 40% coinsurance; 9a2: 40% coinsurance

Outpatient surgery / ASC

In-networkAmbulatory Surgical Center (ASC) Services: $0–$635 copay
Out-of-network9b: 40% coinsurance
Recovery & therapy5 benefits

Home health

In-network$0 copay
Out-of-network50% coinsurance

Skilled nursing facility

In-networkSkilled nursing facility: Tier 1: $0 / day for days 1–20; $221 / day for days 21–100
Out-of-networkSkilled nursing facility: Tier 1: $250 / day for days 1–100; $0 per stay

Cardiac & pulmonary rehabilitation

In-networkCardiac Rehabilitation Services: $0 copay; Intensive Cardiac Rehabilitation Services: $0 copay; Pulmonary Rehabilitation Services: $0 copay; SET for PAD Services: $0 copay; 3-1(NMC): Not applicable; 3-2(NMC): Not applicable; 3-3(NMC): Not applicable; 3-4(NMC): Not applicable
Out-of-network3-1: 40% coinsurance; 3-2: 40% coinsurance; 3-3: 40% coinsurance; 3-4: 40% coinsurance

Occupational therapy

In-networkOccupational Therapy Services: $50 copay
Out-of-network7c: $105 copay

Physical & speech therapy

In-networkPhysical Therapy and Speech-Language Pathology Services: $60 copay
Out-of-network7i: $105 copay
Behavioral health2 benefits

Mental health services

In-networkPartial Hospitalization Program: $55 copay; Individual Sessions for Mental Health Specialty Services: $0–$25 copay; Group Sessions for Mental Health Specialty Services: $15 copay; Individual Sessions for Psychiatric Services: $0–$25 copay; Group Sessions for Psychiatric Services: $15 copay; Inpatient psychiatric hospital: Tier 1: $685 / day for days 1–3; $0 / day for days 4–90
Out-of-network5a: $75 copay; 7e1: $40 copay; 7e2: $30 copay; 7h1: $40 copay; 7h2: $30 copay; Inpatient psychiatric hospital: Tier 1: 40% coinsurance

Substance use treatment

In-networkIntensive Outpatient Program Services: $55 copay; Individual Sessions for Outpatient Substance Abuse: $0–$25 copay; Group Sessions for Outpatient Substance Abuse: $15 copay
Out-of-network5b: $75 copay; 9c1: $40 copay; 9c2: $30 copay
Specialty care2 benefits

Podiatry

In-networkPodiatry Services: $45 copay; 7f(NMC): $45 copay
Out-of-network7f: $105 copay; 7f_2: $105 copay

Chiropractic

In-networkChiropractic Services: $15 copay
Out-of-network7b: $105 copay
Supplemental benefits7 benefits

Dental

In-networkMedicare Dental Services: 20% coinsurance; Diagnostic and Preventive Dental: $0 cost share; Oral Exams: $0 copay; Dental X-Rays: $0 copay; Prophylaxis (Cleaning): $0 copay; Fluoride Treatment: $0 copay; Other Preventive Dental Services: $0 copay
Out-of-network16a: 40% coinsurance; 16b1: $0 copay; 16b2: $0 copay; 16b4: $0 copay; 16b5: $0 copay; 16b6: $0 copay

Vision

In-networkEye Exams: $0 copay; Routine Eye Exams: $0 copay; Other Eye Exam Services: Not applicable; Eyewear: $0 copay; Contact Lenses: $0 copay; Eyeglasses (lenses and frames): $0 copay; Eyeglass lenses: Not applicable; Eyeglass frames: Not applicable; Upgrades: Not applicable
Out-of-network17a: $105 copay; 17a1: $105 copay; 17b: 40% coinsurance; 17b1: 90% coinsurance; 17b2: 90% coinsurance

Hearing

In-networkHearing Exams: $0 copay; Routine Hearing Exams: $0 copay; Fitting/Evaluation for Hearing Aid: Not applicable; Prescription Hearing Aids (all types): $0 copay; Prescription Hearing Aids - Inner Ear: Not applicable; Prescription Hearing Aids - Outer Ear: Not applicable; Prescription Hearing Aids - Over the Ear: Not applicable
Out-of-network18a: $105 copay; 18a1: $105 copay; 18b1: 90% coinsurance

Transportation

Not applicable
In-network10b(NMC): Not applicable
Out-of-networkNot separately reported

Fitness & wellness

Not applicable
In-networkFitness Benefit: Not applicable
Out-of-networkNot separately reported

Over-the-counter allowance

Not applicable
In-networkOver-the-Counter (OTC) Items: Not applicable
Out-of-networkNot separately reported

Meals

Not applicable
In-networkMeal Benefit: Not applicable
Out-of-networkNot separately reported
Plan costs & rulesCoverage overview

Premium & Part B giveback

$0 Part C premium / month · CMS reports no Part B premium reduction for this plan.

Maximum out-of-pocket (MOOP)

In-network$7,150
Combined in + out$10,750

Medical deductibles

In-networkNot reported
Out-of-networkNot reported

Annual health deductible

$1,000

Combined network deductible

Not separately reported

Part D premium

$23 / month

Network & referrals

Local PPO · Referrals: Not required · Out-of-network coverage: Yes

Prescription drugs5 tiers

Part D deductible

$685 / year

Drug tier 1

Standard retail: $0 copay · Preferred retail: $0 copay · 30-day supply

Drug tier 2

Standard retail: $6 copay · Preferred retail: $6 copay · 30-day supply

Drug tier 3

Standard retail: 21% coinsurance · Preferred retail: 21% coinsurance · 30-day supply

Drug tier 4

Standard retail: 27% coinsurance · Preferred retail: 27% coinsurance · 30-day supply

Drug tier 5

Standard retail: 26% coinsurance · Preferred retail: 26% coinsurance · 30-day supply

Using this plan

Understand H2406-075-000

Plain-language context built from this plan’s 2027 CMS record. It is a guide to the reported benefits, not a personalized cost estimate.

Plan at a glance

A quick read on this plan

AARP Medicare Advantage from UHC DE-0001 (PPO) is a 2027 Local PPO offered by UnitedHealthcare in State of Delaware. The CMS record indicates out-of-network coverage, although member costs may differ from in-network care. The plan record does not require referrals. Its listed inpatient copay stages total $2,740 across 4 charged days.

Common benefit costs

What you may pay

These are individual in-network benefit amounts. A real visit may involve more than one separately billed service.

Routine care

Primary care physician
Primary Care Physician Services: $0 copay
Specialist
Physician Specialist Services: $0–$60 copay
Laboratory services
Lab Services: $0 copay

Separate visits or services; costs are not added together.

Tests & outpatient care

Diagnostic procedures & tests
Diagnostic Procedures/Tests: $5 copay
MRI, CT & PET imaging
Diagnostic Radiological Services: $0–$320 copay
Outpatient hospital
Outpatient Hospital Services: $0–$685 copay; Observation Services: $685 copay

The service setting and billing details can change what you pay.

Emergency & hospital care

Emergency room
$130 copay
Listed inpatient stages
$2,740 total

4 charged inpatient days are included in the calculated total. Actual costs depend on the care received and plan rules.

Helpful context

Terms worth knowing

Maximum out-of-pocket (MOOP)

This is the most you generally pay during the plan year for covered Part A and Part B medical services under the applicable network limit. Premiums and prescription drug costs generally do not count toward it.

Part B premium reduction (“giveback”)

A giveback may reduce the amount you pay toward Medicare Part B; it is not usually paid to you as cash. The CMS record notes: CMS reports no Part B premium reduction for this plan.

Availability

Who can enroll

Service area
State of Delaware (DE)
Plan type
Local PPO
Contract / plan
H2406-075
Coverage year
2027

Enrollment generally requires Medicare eligibility and residence in the plan's service area. Confirm eligibility and the exact service area with the plan before enrolling.

Supplemental coverage

Extra benefits reported

Availability is summarized here; allowances, frequency limits, networks, and prior-authorization rules may apply.

DentalMedicare Dental Services: 20% coinsurance; Diagnostic and Preventive Dental: $0 cost share; Oral Exams: $0 copay; Dental X-Rays: $0 copay; Prophylaxis (Cleaning): $0 copay; Fluoride Treatment: $0 copay; Other Preventive Dental Services: $0 copay
VisionEye Exams: $0 copay; Routine Eye Exams: $0 copay; Other Eye Exam Services: Not applicable; Eyewear: $0 copay; Contact Lenses: $0 copay; Eyeglasses (lenses and frames): $0 copay; Eyeglass lenses: Not applicable; Eyeglass frames: Not applicable; Upgrades: Not applicable
HearingHearing Exams: $0 copay; Routine Hearing Exams: $0 copay; Fitting/Evaluation for Hearing Aid: Not applicable; Prescription Hearing Aids (all types): $0 copay; Prescription Hearing Aids - Inner Ear: Not applicable; Prescription Hearing Aids - Outer Ear: Not applicable; Prescription Hearing Aids - Over the Ear: Not applicable

Plan-specific answers

Frequently asked questions

Where is H2406-075-000 available?

AARP Medicare Advantage from UHC DE-0001 (PPO) is listed for State of Delaware (DE). Enrollment generally requires Medicare eligibility and residence in the plan's service area.

What is the in-network maximum out-of-pocket limit for H2406-075-000?

The 2027 CMS record lists an in-network medical maximum out-of-pocket limit of $7,150. Prescription drug spending generally does not count toward this medical limit.

What is the monthly plan premium for H2406-075-000?

The listed consolidated Part C and Part D premium is $23 per month. This does not replace the standard Medicare Part B premium.

What does an emergency room visit cost on H2406-075-000?

The plan record lists $130 copay, waived when an admission meets the plan's stated timing rule.

Does H2406-075-000 report extra benefits?

Yes. CMS reports dental, vision, hearing. See the detailed benefit rows and official plan documents for limits and conditions.

Source trail

Official CMS, Contract Year 2027

Plan identity and benefits come from CMS PBP data. Benefits and drug cost sharing come from the approved annual PBP tabular extract and its CMS dictionary. Premiums and drug deductibles are cross-checked with the annual Landscape. Geography comes from annual PlanArea and PlanRegionArea records, including exact segments and partial-county or employer/group qualifiers. Quick-reference values should be confirmed in current official plan documents.

Plan context

Where H2406-075-000 fits

Full CMS plan ID
H2406-075-000
Contract
H2406
Base plan code
H2406-075
Segment
000
Carrier
UnitedHealthcare
Plan type
Local PPO
Service area
State of Delaware (DE)

County/service-area foundation

CMS service-area entries

Service areas come from the annual CMS PlanArea and PlanRegionArea tables for this exact contract, plan, and segment. Partial-county and employer/group qualifiers remain part of the coverage area. Regional PPO county entries use the matching annual Landscape expansion of the CMS region.

  • Kent, DE
  • New Castle, DE
  • Sussex, DE

About this code

What H2406-075-000 identifies

H2406-075-000 is a Contract Year 2027 Medicare plan segment code. Searches written as H2406-075, H2406 075, or the compact full CMS ID H2406075000 refer to this plan or its base plan code.

Medicare Plan Lookup uses official CMS data as a quick reference. Benefit details, eligibility, service-area rules, and cost sharing should be confirmed in the current Summary of Benefits or Evidence of Coverage.