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AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx NC-MA01 (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 Patriot No Rx NC-MA01 (PPO) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx NC-MA01 (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 Patriot No Rx NC-MA01 (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage Patriot No Rx NC-MA01 (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 Patriot No Rx NC-MA01 (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 $75.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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:
Sign up for AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO)
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Drug Coverage
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) plan offers a wide range of benefits with varying costs. You'll find no copays for primary care, preventive services like exams and screenings, and many dental services. The plan also includes coverage for inpatient and outpatient hospital services, with copays ranging from $0 to $475 depending on the service. Additional benefits of this plan include coverage for hearing and vision services, such as hearing exams, eye exams, and eyewear. This plan also covers ambulance services with a $290 copay, and emergency services with a $100 copay. Other services like home health, skilled nursing facility, and cardiac rehabilitation services have varying copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care, with a copay of $475 for days 1-5 and no copay for days 6-90 for acute care, and a copay of $475 for days 1-4 and no copay for days 5-90 for psychiatric care. Additional days for inpatient hospital psychiatric are not covered.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services, with a copay ranging from $0 to $475, observation services with a $475 copay, Ambulatory Surgical Center (ASC) services with no copay, outpatient substance abuse services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) plan. Both ground and air ambulance services have a $290 copay, with no coinsurance, while transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) plan. Emergency Services have a $100 copay, and Urgently Needed Services have a copay between $0 and $45; Worldwide Emergency Services have a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, and occupational therapy services with a copay between $0 and $35. The plan also covers physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services with varying copays.
Preventive Services See details
Preventive services include no copay for annual physical exams, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. Fitness benefits, including memory fitness and activity trackers, are also covered with no copay. However, health education, in-home safety assessments, and other services are not covered.
Hearing Services See details
The AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) plan covers hearing exams with no copay, and routine hearing exams with no copay. This plan also covers OTC hearing aids with a copay between $99 and $829, but does not cover fitting/evaluation for hearing aids, or prescription hearing aids - inner ear, outer ear, or over the ear.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered annually. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames with a combined maximum of $250 every two years, and contact lenses have no copay. Eyeglasses and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) plan covers dental services, including oral exams, dental x-rays, other diagnostic services, cleanings, fluoride treatments, other preventive services, restorative services, and adjunctive general services with no copay. The plan has a 20% coinsurance for Medicare dental services and a maximum benefit of $1,500 per year for other dental services. Prosthodontics, removable and fixed, have a coinsurance between 0% and 50%. The plan does not cover implant services or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) plan, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires authorization, while DME for use outside the home is not covered. Prosthetic devices have a 20% coinsurance, and medical supplies have a 20% coinsurance. Diabetic supplies have no copay, and diabetic therapeutic shoes/inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a $15 copay, lab services with no copay, diagnostic radiological services with a copay up to $225, therapeutic radiological services with a copay up to $60, and outpatient X-ray services with a $5 copay.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage Patriot No Rx NC-MA01 (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 Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. A copay applies, but the specific amount is not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization required. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services offered by the AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) plan include a meal benefit 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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