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AARP Medicare Advantage Access from UHC NC-23 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Access from UHC NC-23 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on AARP Medicare Advantage Access from UHC NC-23 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Access from UHC NC-23 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in North Carolina. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage Access from UHC NC-23 (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage Access from UHC NC-23 (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For AARP Medicare Advantage Access from UHC NC-23 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $255.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $600.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $3000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $3000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The AARP Medicare Advantage Access from UHC NC-23 (PPO) plan features an Enhanced Alternative drug benefit with a $600.00 prescription drug deductible and a standard Part D premium of $153.00, which can be reduced to $116.80 for individuals who qualify for Extra Help. After meeting the deductible, the initial coverage phase requires an $8.00 copay for Tier 1 preferred generics at standard pharmacies. Tier 2 standard generics carry a 16% coinsurance, while Tier 3 preferred brands and Tier 4 non-preferred drugs require a 42% and 26% coinsurance, respectively. These initial rates apply until total drug expenses trigger the next coverage phase. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage Access from UHC NC-23 (PPO) offers exceptionally robust medical coverage with no copays and no coinsurance for a wide range of essential services. This comprehensive coverage includes inpatient and outpatient hospital stays, emergency care, primary and specialist doctor visits, diagnostic tests, and medical equipment. Additionally, home health care and skilled nursing facility stays for up to 100 days are covered with no copay or coinsurance. For specialty care, members benefit from routine vision and hearing exams with no copay, as well as dental preventive services. However, some out-of-pocket costs apply, such as a 50% coinsurance for comprehensive dental care up to $1,500, a 20% coinsurance for dialysis, and copays ranging from $199 to $1,249 for hearing aids. Note that certain services, including routine transportation, cardiac rehabilitation, and over-the-counter items, are not covered by this plan.
Inpatient Hospital See details
AARP Medicare Advantage Access from UHC NC-23 (PPO) partially covers inpatient hospital services, offering Medicare-covered acute and psychiatric stays with no copay and no coinsurance. However, upgrades, non-Medicare-covered stays, and additional days for psychiatric care are not covered.
Outpatient Services See details
AARP Medicare Advantage Access from UHC NC-23 (PPO) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and no coinsurance. Prior authorization is required for these covered benefits.
Partial Hospitalization See details
Partial hospitalization benefits are covered by AARP Medicare Advantage Access from UHC NC-23 (PPO) with no copay and no coinsurance. Prior authorization is required for this covered service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by AARP Medicare Advantage Access from UHC NC-23 (PPO), with ground and air ambulance services requiring prior authorization but featuring no copay and no coinsurance. However, transportation services to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage Access from UHC NC-23 (PPO) covers emergency and urgently needed services with no copay and no coinsurance. Worldwide emergency coverage, urgent care, and emergency transportation are also covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage Access from UHC NC-23 (PPO) covers primary care, specialist, mental health, physical therapy, and podiatry services with no copays or coinsurance. Chiropractic services are partially covered, as routine chiropractic care is not covered.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage Access from UHC NC-23 (PPO) with no copay and no coinsurance, including annual physical exams, kidney disease education, and glaucoma screenings. Additional preventive services are only partially covered; the fitness benefit is included with no copay or coinsurance, but sub-services such as health education, weight management, alternative therapies, and in-home support are not covered.
Hearing Services See details
Hearing services are partially covered by the AARP Medicare Advantage Access from UHC NC-23 (PPO), featuring no copay or coinsurance for one routine hearing exam per year, while fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered for up to two devices per year with no coinsurance and copays ranging from $199 to $1,249, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by AARP Medicare Advantage Access from UHC NC-23 (PPO), featuring no copay and no coinsurance for routine eye exams, contact lenses, and eyeglass frames, and a $0 to $153 copay with no coinsurance for eyeglass lenses. There is no deductible and a combined $200 eyewear limit every two years, though upgrades and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage Access from UHC NC-23 (PPO), excluding implant services and orthodontics. Preventive care is available with no copay and no coinsurance, while covered comprehensive dental services require a 50% coinsurance and no copay, up to a $1,500 annual maximum.
Home Infusion bundled Services See details
AARP Medicare Advantage Access from UHC NC-23 (PPO) covers home infusion bundled services with prior authorization, featuring no copay and 0% to 20% coinsurance for chemotherapy, radiation, and other Part B drugs. Medicare Part B insulin drugs are also covered under this benefit with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage Access from UHC NC-23 (PPO) covers Dialysis Services with a 20% coinsurance and no copay. Prior authorization is required to receive these covered services.
Medical Equipment See details
AARP Medicare Advantage Access from UHC NC-23 (PPO) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and no coinsurance. Prior authorization is required for these covered services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage Access from UHC NC-23 (PPO) with no copay and no coinsurance. These covered benefits include lab services, diagnostic procedures, therapeutic radiological services, and outpatient x-rays, all of which require prior authorization.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Access from UHC NC-23 (PPO) plan with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under AARP Medicare Advantage Access from UHC NC-23 (PPO), meaning there is no coverage, copay, or coinsurance for cardiac, intensive cardiac, pulmonary, or SET for PAD rehabilitation services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by AARP Medicare Advantage Access from UHC NC-23 (PPO) with no copay and no coinsurance for days 1 through 100, though prior authorization is required. Additional days beyond the Medicare-covered limit are not covered, but the plan does allow admission without a prior three-day inpatient hospital stay.
Other Services See details
AARP Medicare Advantage Access from UHC NC-23 (PPO) partially covers Other Services, offering a meal benefit for chronic illnesses with no copay and no coinsurance. Other sub-services under this benefit, including acupuncture, over-the-counter (OTC) items, and dual eligible SNPs with highly integrated services, are not covered.
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