Yes. AARP Medicare Advantage plans from UnitedHealthcare cover physical therapy, and so do AARP Medicare Supplement (Medigap) plans insured by UnitedHealthcare. What you pay and how much paperwork sits between you and your first appointment depends on which type of plan you have. On an Advantage plan, expect a flat copay per visit and a prior authorization requirement once treatment extends past the initial stretch. On a Supplement plan, your costs are typically limited to the annual Part B deductible, after which the plan covers the coinsurance Original Medicare leaves behind.
Both types of coverage rest on the same Medicare rule: Part B covers outpatient physical therapy that is medically necessary to restore or improve movement after an injury, illness, or surgery, or to maintain function and slow decline.1Medicare.gov. Physical Therapy Services A doctor, nurse practitioner, clinical nurse specialist, or physician assistant must certify the plan of care, usually within 30 days of the first visit. You do not need a physician referral to start therapy; that requirement went away in 2005.2APTA. Direct Access and Medicare
There is no annual dollar cap on medically necessary therapy. Congress repealed the old therapy caps in the Bipartisan Budget Act of 2018.3CMS. Therapy Services A spending threshold still exists, but it only triggers extra documentation: in 2026, once combined physical therapy and speech-language pathology charges hit $2,480, the provider has to attach a KX modifier to attest continued necessity.4APTA. Therapy Cap Charges above $3,000 may be selected for targeted medical review.
What You Pay Under AARP Medicare Advantage
AARP Medicare Advantage plans administered by UnitedHealthcare replace Original Medicare and must cover everything Original Medicare covers, including outpatient physical, occupational, and speech-language therapy.5UHC. Medicare Coverage for Outpatient Rehabilitation Therapy Instead of the 20% coinsurance you’d pay under Original Medicare, these plans charge a flat copay per visit.
The exact copay varies by plan and location. A 2025 AARP Medicare Advantage PPO plan in Oregon lists $30 per in-network visit and $55 out-of-network.6UHC. AARP Medicare Advantage From UHC OR-0001 (PPO) Summary of Benefits An AARP Medicare Advantage HMO-POS plan in New York charges $25 per visit.7MedicareAdvantage.com. AARP Medicare Advantage From UHC NY-0028 (HMO-POS) Summary of Benefits Some group retiree Medicare Advantage plans from UnitedHealthcare cover outpatient rehabilitation at a $0 copay.8St. Petersburg School District. UHC Summary of Benefits for Retirees With Medicare Your Summary of Benefits is the only reliable source for your own number.
Every Advantage plan also has an annual maximum out-of-pocket limit. For 2026, the CMS ceiling is $9,250, and individual plans can set theirs lower.9Medicare Interactive. Maximum Out-of-Pocket Limit Physical therapy copays count toward it, so a long course of therapy has a hard annual ceiling.
Referrals and Prior Authorization
You do not need a referral to see a physical therapist. UnitedHealthcare carves physical, occupational, and speech therapy out of its referral requirement even on HMO plans that otherwise require a primary care referral for specialists.10UHC Provider. Medicare Advantage Referrals That exemption was reaffirmed when UnitedHealthcare rolled out broader HMO referral requirements starting January 1, 2026.11UHC Provider. Referral Requirements for Specialist Services
Prior authorization is a separate matter and does apply. The initial evaluation visit does not require authorization. After that, up to six follow-up visits over eight weeks are covered without a clinical review, provided you are new to the provider, have a new condition, or have had a gap of 90 or more days since previous therapy.12APTA. UHC Continues Refinement of Prior Authorization Policy A shortened form in the provider portal gives real-time confirmation for these initial requests.
Anything beyond six visits or eight weeks triggers a medical necessity review. If your therapist requests more than six visits upfront, the first six are approved automatically and the rest go to review.12APTA. UHC Continues Refinement of Prior Authorization Policy The request must be submitted within 10 business days of starting treatment, or the claim can be denied.13UHC Provider. Outpatient Therapy and Chiropractic Prior Authorization Your therapist handles the paperwork, but it is worth confirming at your first visit that they intend to submit it on time.
Telehealth Visits
UnitedHealthcare says virtual care under its Medicare Advantage plans “may include” physical therapy, and physical therapists are listed among providers who can offer e-visits through patient portals.14UHC. What Telehealth Services Does Medicare Offer Whether virtual therapy is covered under your plan, and at what copay, varies. Check your plan documents or call the number on your member ID card.15UHC. Telehealth and Virtual Care
What You Pay Under AARP Medicare Supplement
AARP Medicare Supplement plans (Medigap), insured by UnitedHealthcare, do not replace Original Medicare. They pay what Original Medicare leaves behind, which for outpatient physical therapy is the 20% Part B coinsurance.
Plan G is a common choice. With Plan G, you pay the annual Part B deductible ($283 for 2026); after that, the plan covers 100% of the remaining Part B coinsurance for the rest of the year.16Boomer Benefits. Medicare Supplement Plan G Once your deductible is met, outpatient physical therapy costs you $0 per session. Plan F works the same way and also covers the Part B deductible itself, but it is only available to people who became eligible for Medicare before January 1, 2020.
Because you remain on Original Medicare, there is no network and no prior authorization. You can see any physical therapist who accepts Medicare. The therapist bills Medicare, Medicare pays 80%, and your Supplement plan pays the 20%. Medicare’s medical necessity rules and the KX modifier threshold still apply, since those are Medicare rules rather than plan rules.
Physical Therapy in Other Settings
The outpatient clinic is the most common setting, but therapy can be covered in a skilled nursing facility or at home under both types of AARP plans.
Skilled nursing facility. Medicare Part A covers therapy in a skilled nursing facility for up to 100 days per benefit period after a qualifying inpatient hospital stay of at least three consecutive days. For 2026, days 1–20 have no daily copay (after the $1,736 hospital deductible); days 21–100 carry a $217 daily coinsurance. Coverage ends after day 100.17Medicare.gov. Skilled Nursing Facility Care AARP Medicare Supplement plans help cover the day 21–100 coinsurance. Medicare Advantage plans may waive the three-day hospital stay requirement, which matters if you need SNF therapy after a short hospitalization.18Medicare Advocacy. Skilled Nursing Facility Services
Home health. Medicare covers physical therapy at home through the home health benefit when a doctor certifies you are homebound, meaning leaving home requires considerable effort or special assistance. Under this benefit, Medicare generally covers the full cost of therapy sessions with no coinsurance.19UHC. Home Health Care for Those on Medicare Who Can’t Leave Home
If Your Therapy Is Denied
Medicare Advantage members have the right to appeal. File within 65 calendar days of the denial notice, in writing or by calling UnitedHealthcare Customer Service, and include supporting documentation such as medical records or a letter from your treating provider.20UHC. Medicare Appeal
UnitedHealthcare reviews the appeal internally. If it upholds the denial, the case is automatically forwarded to an independent review entity contracted by CMS. From there you can appeal to an administrative law judge.21Medicare Advocacy. Medicare Coverage Appeals Standard appeals are decided within 30 calendar days. If waiting could seriously harm your health or recovery, you or your doctor can request an expedited review, which must be decided within 72 hours.20UHC. Medicare Appeal
Written appeals go to the UnitedHealthcare Appeals and Grievances Department, P.O. Box 6106, Cypress, CA 90630.22UHC. Member Rights
Finding an In-Network Physical Therapist
For Advantage members, using an in-network therapist means the lower copay. UnitedHealthcare’s network includes more than 1.7 million physicians and care professionals.23UHC. Find a Doctor You can search by signing in at member.uhc.com or using the UnitedHealthcare mobile app; a guest search tool lets non-members browse by plan type. Call the therapist’s office before scheduling to confirm they still participate in your specific plan, since provider contracts change.24UHOne. Find a Doctor