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AARP Medicare Advantage from UHC NC-0001 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NC-0001 (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 from UHC NC-0001 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC NC-0001 (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 from UHC NC-0001 (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 from UHC NC-0001 (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 from UHC NC-0001 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $440.00 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 $10100.00 (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 $10100.00 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 from UHC NC-0001 (PPO) plan features an annual prescription drug deductible of $440. Under this plan, Tier 1 preferred generic drugs are highly affordable, offering no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic drugs have a $10 copay for a 1-month supply at standard pharmacies, but you can save by choosing a 3-month supply with no copay through preferred mail order. For brand-name and specialty prescriptions, the plan transitions to a coinsurance structure. Tier 3 preferred brand drugs require a 16% coinsurance for both 1-month and 3-month supplies, whether filled at a standard pharmacy or via mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 39% coinsurance and 28% coinsurance, respectively, for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC NC-0001 (PPO) plan offers affordable coverage with no copay for primary care visits, telehealth services, and annual preventive exams. Routine dental cleanings, annual vision exams, and yearly hearing exams are also available with no copay or coinsurance, though comprehensive dental services are not covered. If you require inpatient hospital care, you will pay a $450 daily copay for the first few days of your stay with no coinsurance. Specialist visits and outpatient therapies feature low copays ranging from $0 to $50, while emergency room visits carry a $130 copay that is waived upon admission. For medical supplies, dialysis, and durable medical equipment, the plan requires a 20% coinsurance and no copay. Skilled nursing facility stays are covered with no copay for the first 20 days and a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
AARP Medicare Advantage from UHC NC-0001 (PPO) covers inpatient hospital services with no coinsurance, requiring a $450 daily copay for days 1 to 6 of acute stays (with no copay for days 7 and beyond) and a $450 daily copay for days 1 to 5 of psychiatric stays (with no copay for days 6 to 90). This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC NC-0001 (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services at no copay. Outpatient hospital services require a $0 to $450 copay, observation services carry a $450 daily copay, and outpatient substance abuse sessions have a copay of $0 to $25.
Partial Hospitalization See details
AARP Medicare Advantage from UHC NC-0001 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC NC-0001 (PPO) covers ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. Some transportation services are covered, but trips to plan-approved health-related locations or any health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC NC-0001 (PPO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC NC-0001 (PPO) offers primary care and telehealth services with no copay and no coinsurance, while specialist, therapy, and mental health visits require copays ranging from $0 to $50 with no coinsurance. For chiropractic benefits, some services are covered but routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage from UHC NC-0001 (PPO) with no copay and no coinsurance, including annual physical exams, kidney disease education, fitness benefits, glaucoma screenings, diabetes self-management, digital rectal exams, and EKGs. However, additional preventive services are only partially covered, as health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, bathroom safety, and counseling are not covered.
Hearing Services See details
AARP Medicare Advantage from UHC NC-0001 (PPO) provides partially covered hearing services with no deductible, including one annual routine hearing exam with no copay or coinsurance, while fitting and evaluation services are not covered. The plan also covers up to two prescription hearing aids (with copays from $199 to $1,249) and two OTC hearing aids (with copays from $199 to $829) yearly with no coinsurance, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC NC-0001 (PPO), featuring no coinsurance and no copay for annual routine eye exams, contact lenses, and frames, though eyeglass lenses require a $0 to $153 copay. A $300 combined eyewear allowance is offered every two years, while other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered under the AARP Medicare Advantage from UHC NC-0001 (PPO) plan, featuring no copay and no coinsurance for preventive care like cleanings, exams, and X-rays, while Medicare-covered dental services require a 20% coinsurance and no copay. Comprehensive services including restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC NC-0001 (PPO) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while covered Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC NC-0001 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for this covered benefit.
Medical Equipment See details
AARP Medicare Advantage from UHC NC-0001 (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are also covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for most equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC NC-0001 (PPO), with prior authorization required for all services. Diagnostic tests carry a $45 copay and no coinsurance, lab services and diagnostic radiology have no copay, outpatient X-rays require a $30 copay, and therapeutic radiology services have a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by the AARP Medicare Advantage from UHC NC-0001 (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 covered with no copay and no coinsurance under the AARP Medicare Advantage from UHC NC-0001 (PPO) plan, although only some services are covered in practice. Specifically, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC NC-0001 (PPO) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Additional days beyond the standard Medicare-covered limit are not covered, and prior authorization is required.
Other Services See details
Other Services under the AARP Medicare Advantage from UHC NC-0001 (PPO) plan are partially covered, featuring a meal benefit for chronic illnesses with no copay and no coinsurance, though prior authorization is required. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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