A non-government entity
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 2026, 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 4.5 out of 5 stars in 2026.
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 $13900.00 (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 $13900.00 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)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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 provides excellent coverage for everyday healthcare needs, featuring no copays and no coinsurance for primary care visits, telehealth, preventive services, and home health care. Routine vision and hearing exams are also available with no copay, and the plan includes a $150 eyewear allowance alongside coverage for hearing aids. Specialist visits and diagnostic lab tests are highly affordable, requiring no coinsurance and low copays. For emergency care and hospital stays, members pay a $115 copay for emergency room visits and a $475 daily copay for days 1 through 5 of inpatient hospital stays, with no copay for subsequent days. Skilled nursing facility care is covered with no copay for the first 20 days. Other essential medical services, such as dialysis, durable medical equipment, and Medicare Part B drugs, are covered with no copay and up to 20% coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) covers inpatient hospital services with no coinsurance, requiring a $475 daily copay for days 1 through 5 of acute stays (with no copay for days 6 and beyond) and days 1 through 4 of psychiatric stays (with no copay for days 5 through 90). Prior authorization is required, and certain services such as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay ranging from $0 to $475 (including a $475 daily copay for observation services), while outpatient substance abuse sessions carry a copay of $0 to $25, with prior authorization required for most services.
Partial Hospitalization See details
AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this covered benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) covers ground and air ambulance services with a $290 copay and no coinsurance, though prior authorization is required. For transportation services, some services are covered, but trips to plan-approved health-related locations or any other health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours. Urgently needed services require a copay ranging from no copay to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits under the AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) include primary care and telehealth visits with no copay and no coinsurance, while chiropractic services are not covered. Other covered services, such as specialist visits, therapy, and mental health care, require no coinsurance and copays ranging from $0 to $55.
Preventive Services See details
AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) covers preventive services, including annual physical exams, kidney disease education, and diabetes self-management training, with no copays and no coinsurance. Additional preventive benefits are partially covered, offering a fitness benefit with no copay, while services such as health education, weight management, nutritional counseling, and in-home safety assessments are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO), which features one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. The plan also covers up to two prescription hearing aids per year with copays ranging from $199 to $1,249 and up to two OTC hearing aids per year with copays from $199 to $829, both with no coinsurance. However, prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision Services are partially covered by AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO), offering no copays and no coinsurance for routine eye exams (one per year, prior authorization required) and select eyewear, with no plan deductible. Covered eyewear features a $150 combined maximum benefit every two years with no coinsurance, covering contact lenses and frames with no copay, and lenses with a copay of $0 to $153. Other eye exams, upgrades, and package eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services are partially covered by the AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) plan, which features Medicare-covered dental services with no copay and a 20% coinsurance, as well as preventive care with no copay and no coinsurance. However, several services are not covered, including restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics.
Home Infusion bundled Services See details
AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy and radiation, carry a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance. Prior authorization is required for these equipment and supply benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) plan, with prior authorization required. Diagnostic tests have a $50 copay and no coinsurance, lab and diagnostic radiological services have no copay, while outpatient X-rays require a $30 copay and therapeutic radiology has a 20% coinsurance.
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, although prior authorization is required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) provides cardiac rehabilitation coverage with no copay and no coinsurance, though only some services are covered. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered, and prior authorization is required.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior 3-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage Patriot No Rx NC-MA01 (PPO) partially covers other services, 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 plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved