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AARP Medicare Advantage from UHC NC-0002 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NC-0002 (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-0002 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC NC-0002 (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 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC NC-0002 (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-0002 (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-0002 (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. Additionally, this plan comes with a Part B Premium reduction of $13.00. You must continue to pay paying your reduced 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 $495.00 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 $14000.00 (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 $14000.00 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-0002 (PPO) plan has a $495 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, in the initial coverage phase, you will pay a $14 copay for standard generic drugs at a standard pharmacy, and a $100 copay for preferred brand drugs. Non-preferred drugs have a 27% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC NC-0002 (PPO) plan offers a wide range of benefits, including coverage for inpatient and outpatient services, with varying copays depending on the service. Preventative services, such as annual checkups, have no copay. The plan also covers hearing, vision, and dental services, with no copays for routine eye exams and preventive dental services, but copays for hearing aids and other dental services. Additional benefits include ambulance services, with a $290 copay, and home health services with no copay. The plan also covers services like primary care, diagnostic tests, and skilled nursing facilities, each with its own copay or coinsurance structure. This plan provides comprehensive coverage with a focus on both preventative and specialized care.
Inpatient Hospital See details
Inpatient Hospital coverage, including acute and psychiatric care, is covered with prior authorization. For acute care, you will pay a $395 copay for days 1-5, and no copay for days 6-90; additional days 91-999 have no copay. For psychiatric care, you will pay a $395 copay for days 1-4, and no copay for days 5-90. Non-Medicare-covered stays and upgrades for acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered. Outpatient Hospital Services have a copay between $0 and $395, Observation Services have a $395 copay, Ambulatory Surgical Center (ASC) Services have no copay, and Outpatient Blood Services have no copay. Individual sessions for Outpatient Substance Abuse have a copay between $0 and $25, while group sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC NC-0002 (PPO) plan, including both ground and air ambulance services, each with a $290 copay and no coinsurance. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered. Emergency services have a $110 copay, while urgently needed services have a copay between $0 and $45; worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation have no copay.
Primary Care See details
The AARP Medicare Advantage from UHC NC-0002 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, and occupational therapy services with a copay of $0-$20. The plan also covers physician specialist services with a copay of $0-$45 and mental health specialty services with a copay of $0-$25 for individual sessions and $15 for group sessions. Podiatry services have a $35 copay, other health care professional services have a copay of $0-$45, and psychiatric services have a copay of $0-$25 for individual sessions and $15 for group sessions. Physical therapy and speech-language pathology services have a copay of $0-$35, additional telehealth benefits have no copay, and opioid treatment program services have no copay.
Preventive Services See details
Preventive services, including annual physical exams, are covered with no copay. Additional preventive services, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visits are covered with no copay. However, Health Education, In-Home Safety Assessments, Personal Emergency Response Systems (PERS), Medical Nutrition Therapy (MNT), Post-discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefits, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have no copay for routine hearing exams, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids have a copay between $199 and $1249 for all types of hearing aids, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids have a copay between $99 and $829.
Vision Services See details
The AARP Medicare Advantage from UHC NC-0002 (PPO) plan covers vision services, including routine eye exams with no copay, and eyewear. Eyewear coverage includes contact lenses with no copay, eyeglass lenses with a copay between $0 and $153, and eyeglass frames with no copay; however, eyeglass frames and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay, while orthodontic services, restorative services, and other services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay, and the coinsurance ranges from 0% to 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC NC-0002 (PPO) plan. The plan requires prior authorization and has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics and Medical Supplies with 20% coinsurance, and Diabetic Equipment, including Diabetic Supplies with no copay and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by AARP Medicare Advantage from UHC NC-0002 (PPO). Diagnostic Procedures/Tests have a copay of $25, while Lab Services have no copay. Diagnostic Radiological Services have a maximum copay of $225, Therapeutic Radiological Services have a minimum copay of $80, and Outpatient X-Ray Services have a copay of $15.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage from UHC NC-0002 (PPO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC NC-0002 (PPO) plan. There is no copay for days 1-20, but there is a $203 copay for days 21-100; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include meal benefits with no copay, but acupuncture, over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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