Plan vs plan · Hampden County, MA · 2027 plan year

Medicare PPO Blue ValueRx (PPO) vs AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

Medicare.gov compares Medicare Advantage plans with each other. This page also shows Original Medicare, so you can see the full trade-off: premiums, copays, the yearly limit, extra benefits, and the rules about doctors and approvals.

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Medicare PPO Blue ValueRx (PPO)

Plan premium
$108 a month
Yearly limit, in network
$6,600
2027 star rating
4 of 5
Prior authorization needed for
18 services

AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

Plan premium
$0 a month
Yearly limit, in network
$7,150
2027 star rating
4 of 5
Prior authorization needed for
24 services

In Massachusetts, you can go back to Medigap later

Massachusetts law makes Medigap companies accept you from February 1 to March 31 each year. Your age and health do not change the price. Coverage from that window starts on June 1. The companies also sell Medigap during the rest of the year. So you can try Medicare Advantage and go back to Original Medicare with Medigap later.

Read about Medigap rights on Medicare.gov

Your yearly cost, side by side

Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.

How much care do you expect?

Ongoing specialist care

Medigap plan with Original Medicare

Massachusetts sets its own Medigap plans: Core and Supplement 1A. Supplement 1 is open only to people who were eligible for Medicare before 2020. These plans are not the plans with letters, such as Plan G and Plan N. We have no prices for these plans, so the totals show Original Medicare without Medigap. Without Medigap you pay 20% of most costs, with no yearly limit. Check Medigap plans and prices for ZIP 01034 on Medicare.gov

Want to check your exact drugs? Medicare.gov lets you enter each drug and shows what each plan charges for it. Enter your drugs on Medicare.gov

Original Medicare

With no Medigap and Blue MedicareRx Value Plus (PDP)

$6,139 a year

Premiums
$2,820
Medical costs
$1,616
Drugs
$1,703

No yearly limit on what you pay for medical care.

Medicare PPO Blue ValueRx (PPO)

PPO from Blue Cross Blue Shield of Massachusetts

$6,370 a year

Premiums
$3,810
Medical costs
$840
Drugs
$1,720

Most you can pay in a bad year, before drugs: $10,410.

AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

HMO-POS from UnitedHealthcare

$6,122 a year

Premiums
$2,514
Medical costs
$1,740
Drugs
$1,868

Most you can pay in a bad year, before drugs: $9,664.

With these settings, AARP Medicare Advantage from UHC MA-0003 (HMO-POS) costs about $17 less a year than Original Medicare.

These are estimates, not quotes. Check every number with Medicare (Medicare.gov or 1-800-MEDICARE) and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Drug costs use typical prices for generic and brand-name drugs. Original Medicare amounts are 2027 projections from the 2026 Medicare Trustees Report. CMS sets the final amounts in November.

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What you pay each time you get care

In-network costs for one visit or one stay. The Original Medicare amounts follow your Medigap choice above: no Medigap.

Primary doctor visit

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Medicare PPO Blue ValueRx (PPO)

    $0 copay

  • AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

    $0

Specialist visit

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Medicare PPO Blue ValueRx (PPO)

    $0-$45

    Prior authorization
  • AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

    $0-$60

    Prior authorization

Lab tests

  • Original Medicare, no Medigap

    $0

    most Medicare-covered tests

  • Medicare PPO Blue ValueRx (PPO)

    $0 copay

    Prior authorization
  • AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

    $0

    Prior authorization

MRI or CT scan

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Medicare PPO Blue ValueRx (PPO)

    $250

    Prior authorization
  • AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

    $0-$320

    Prior authorization

Emergency room

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Medicare PPO Blue ValueRx (PPO)

    $130

  • AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

    $130

Urgent care

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Medicare PPO Blue ValueRx (PPO)

    $0-$50

  • AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

    $0-$50

Outpatient surgery

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Medicare PPO Blue ValueRx (PPO)

    $150

    Prior authorization
  • AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

    $0-$635

    Prior authorization

Ground ambulance

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Medicare PPO Blue ValueRx (PPO)

    $325

    Prior authorization
  • AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

    $350

    Prior authorization

Hospital stay, 5 days

  • Original Medicare, no Medigap

    $1,788

    Part A deductible each benefit period; $447 a day for days 61-90

  • Medicare PPO Blue ValueRx (PPO)

    $2,165

    for a 5-day stay

    Prior authorization
  • AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

    $2,740

    for a 5-day stay

    Prior authorization
See every cost in one table
What you pay in networkOriginal Medicare, no MedigapMedicare PPO Blue ValueRx (PPO)AARP Medicare Advantage from UHC MA-0003 (HMO-POS)
Monthly premiumPart B $209.50 + drug plan $25.50$108 + Part B $209.50$0 + Part B $209.50
Yearly limit on what you payNo yearly limit$6,600 in network; $10,000 in and out of network$7,150 in network
Medical deductible$292 Part B; $1,788 Part A each benefit period$0$0
Primary doctor visit20%, after the $292 yearly Part B deductible$0 copay$0 copay
Specialist visit20%, after the $292 yearly Part B deductible$0-$45 copayPrior authorization$0-$60 copayPrior authorization
Lab tests$0, most Medicare-covered tests$0 copayPrior authorization$0 copayPrior authorization
MRI or CT scan20%, after the $292 yearly Part B deductible$250 copayPrior authorization$0-$320 copayPrior authorization
X-rays20%, after the $292 yearly Part B deductible$10 copayPrior authorization$30 copayPrior authorization
Emergency room20%, after the $292 yearly Part B deductible$130 copay$130 copay
Urgent care20%, after the $292 yearly Part B deductible$0-$50 copay$0-$50 copay
Outpatient hospital20%, after the $292 yearly Part B deductible$300 copayPrior authorization$0-$685 copayPrior authorization
Surgery center20%, after the $292 yearly Part B deductible$150 copayPrior authorization$0-$635 copayPrior authorization
Ground ambulance20%, after the $292 yearly Part B deductible$325 copayPrior authorization$350 copayPrior authorization
Hospital stay$1,788, Part A deductible each benefit period; $447 a day for days 61-90$433 per day for days 1-7; $0 per day for days 8-90Prior authorization$685 per day for days 1-4; $0 per day for days 5-90Prior authorization
Skilled nursing facility$0, days 1-20, then $223.50 a day for days 21-100$10 per day for days 1-20; $221 per day for days 21-100Prior authorization$0 per day for days 1-20; $221 per day for days 21-100Prior authorization
Mental health visit20%, after the $292 yearly Part B deductible$0-$30 copayPrior authorization$0-$25 copayPrior authorization
Physical therapy20%, after the $292 yearly Part B deductible$30 copayPrior authorization$60 copayPrior authorization
Home health care$0, Medicare-covered home health$0 copay$0 copayPrior authorization
Medical equipment20%, after the $292 yearly Part B deductible20% coinsurancePrior authorization30% coinsurancePrior authorization
Part B drugs20% after the $292 Part B deductible0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization
Drug deductible (Part D)$700 with Blue MedicareRx Value Plus (PDP)$500$685
Drug tiers (one month, retail)Preferred Generic: $0 copayGeneric: $3 copayPreferred Brand: 17% coinsuranceNon-Preferred Drug: 35% coinsuranceSpecialty Tier: 25% coinsurancePreferred Generic: $0 copayGeneric: $6 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 31% coinsuranceSpecialty Tier: 27% coinsurancePreferred Generic: $0 copayGeneric: $8 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 27% coinsuranceSpecialty Tier: 26% coinsurance

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A higher drug plan premium is not, by itself, a reason to switch

With Original Medicare, you buy a separate drug plan. In Massachusetts, 10 drug plans are for sale for 2027, from $13.30 to $284.70 a month. Half of them cost $114.75 a month or less.

  • Every 2027 drug plan limits what you pay for covered drugs to $2,400 a year. The drug coverage in Medicare Advantage plans has the same limit.
  • The premium is one part of your yearly cost. The calculator above adds premiums, medical costs, and drug costs, so you can see the whole year.
  • A Medicare Advantage plan can cost less in a light year. But you also take on its network and prior authorization rules.
  • If your income is limited, Extra Help can pay most of your drug plan premium and drug costs. Check Extra Help at SSA.gov

Doctors, referrals, and prior authorization

Cost is one side. The other side is how you get care. These rules come from the CMS plan files. Prior authorization means the plan must approve a service before you get it.

Original Medicare

  • Any doctor or hospital in the U.S. that takes Medicare
  • No referrals
  • Prior authorization only for a short list of services

Medicare PPO Blue ValueRx (PPO)

PPO

  • The plan has a network. You can go outside it, but you pay more.
  • No referral needed to see a specialist.

Prior authorization for 18 services

Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Partial hospitalization, Medical equipment, Diabetic supplies, Substance use care, Hospital stay, Skilled nursing, Part B drugs

AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

HMO-POS

  • You use the plan network. Some care outside the network is covered at a higher cost.
  • You need a referral to see a specialist.

Prior authorization for 24 services

Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

Extra benefits

Extra benefitOriginal MedicareMedicare PPO Blue ValueRx (PPO)AARP Medicare Advantage from UHC MA-0003 (HMO-POS)
DentalNoComprehensive, up to $575 a yearPreventive only
Eye examNoYesYes
Glasses or contactsNoYes, $200 allowanceNo
Hearing aidsNoYes, up to $1,700Yes, up to $1,000
Over-the-counter allowanceNoNo$100 a year
Fitness benefitNoYesYes
Rides to careNoNoNo
Meals after a hospital stayNoYesYes
Emergency care abroadNo, unless your Medigap plan pays for itYesNo
Part B premium givebackNoNoNo

What changed for 2027

Medicare PPO Blue ValueRx (PPO)

Renewal Plan with SAR · New for 2027

No change found in the fields we track.

AARP Medicare Advantage from UHC MA-0003 (HMO-POS)

Renewal Plan · 2026 plan H5253-157-1

  • In-network out-of-pocket maximum up from $5,900 to $7,150
  • Drug deductible up from $520 to $685
  • Specialist visit: $0-$45 copay to $0-$60 copay
  • Diagnostic radiology (MRI, CT): $0-$260 copay to $0-$320 copay
  • Outpatient hospital: $0-$450 copay to $0-$685 copay
  • Ground ambulance: $275 copay to $350 copay
  • Inpatient hospital: $450 per day for days 1-6; $0 per day for days 7-90 to $685 per day for days 1-4; $0 per day for days 5-90
  • Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
  • Yearly OTC allowance down from $240 to $100
  • Eyewear removed
  • Worldwide emergency coverage removed

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Sources and method

Plan data comes from the CMS 2027 Plan Benefit Package and landscape files. The data is from 2026-10-10. We checked a sample of plans field by field against Medicare.gov. Original Medicare amounts are the 2027 projections in the 2026 Medicare Trustees Report (Tables V.E1 and V.E2). CMS sets the final amounts in November. Massachusetts sets its own Medigap plans: Core and Supplement 1A. Supplement 1 is open only to people who were eligible for Medicare before 2020. These plans are not the plans with letters, such as Plan G and Plan N. We have no prices or cost model for these plans, so the totals show Original Medicare without Medigap. You can look up Medigap plans and prices for ZIP 01034 on Medicare.gov. Totals use typical Medicare-allowed amounts for each service and typical drug prices.

These are estimates, not quotes, and they are for education only. Check every number with Medicare and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Plans can change their benefits, premiums, drug lists, and networks each year.

Pinnie is not an insurance agent or broker and does not sell Medicare plans. Pinnie is not connected with or endorsed by the U.S. government or the federal Medicare program. For all your options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

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