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AARP Medicare Advantage from UHC NC-0017 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NC-0017 (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-0017 (PPO) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC NC-0017 (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 2026.
It's important to know that AARP Medicare Advantage from UHC NC-0017 (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-0017 (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-0017 (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 $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 $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-0017 (PPO) plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, there is no copay for 1-month or 3-month supplies at standard pharmacies, as well as for 3-month mail-order fills. Tier 2 generic drugs cost a $10 copay for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay through preferred mail order. Higher-tier medications transition to coinsurance costs during the initial coverage phase. Tier 3 preferred brand drugs require a 16% coinsurance for both 1-month and 3-month supplies across standard pharmacies and mail-order options. Tier 4 non-preferred drugs carry a 39% coinsurance, while Tier 5 specialty drugs require a 26% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC NC-0017 (PPO) plan offers comprehensive coverage with no copay and no coinsurance for primary care visits, telehealth services, annual physical exams, and routine eye exams. For hospital stays, there is no coinsurance, but members pay a $550 daily copay for the first five days of acute inpatient stays and up to a $550 copay for outpatient hospital services. Specialty care is highly accessible, featuring specialist visits with no copay to a $45 copay and no coinsurance. Routine preventive dental care and home health services are available with no copay and no coinsurance, while Medicare-covered dental, dialysis, and durable medical equipment require a 20% coinsurance. Vision and hearing benefits include no copay for routine exams, alongside coverage for corrective eyewear and prescription hearing aids. Although some services like routine transportation and cardiac rehabilitation are not covered, the plan provides robust protection with a $130 copay for emergency room visits and no copay for worldwide emergency care.
Inpatient Hospital See details
Inpatient hospital services are covered by the AARP Medicare Advantage from UHC NC-0017 (PPO) with no coinsurance, featuring a $550 daily copay for days 1 to 5 of acute stays and days 1 to 4 of psychiatric stays, followed by no copay for remaining covered days. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC NC-0017 (PPO) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services range from no copay to a $550 copay, observation services require a $550 daily copay, and outpatient substance abuse services carry a copay of up to $25.
Partial Hospitalization See details
Partial hospitalization services are covered by AARP Medicare Advantage from UHC NC-0017 (PPO) with a $55.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC NC-0017 (PPO) covers Medicare-approved ground and air ambulance services with a $275 copay and no coinsurance, with prior authorization required. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage from UHC NC-0017 (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 require a copay of $0 to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC NC-0017 (PPO) features primary care and telehealth services with no copay and no coinsurance. Specialist visits ($0 to $45 copay), physical therapy ($35 copay), and mental health services ($0 to $25 copay) require no coinsurance, though chiropractic services are only partially covered because routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage from UHC NC-0017 (PPO) with no copay and no coinsurance for annual physical exams, fitness benefits, kidney disease education, and screenings such as glaucoma and diabetes self-management. However, additional preventive benefits are only partially covered, excluding services like health education, in-home safety assessments, nutritional benefits, and weight management programs.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC NC-0017 (PPO), featuring one annual routine hearing exam with no copay and no coinsurance, though hearing aid fitting and evaluation is not covered. Up to two prescription hearing aids (copays of $199 to $1,249) and two OTC hearing aids (copays of $199 to $829) are covered annually with no coinsurance, but 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-0017 (PPO) with no deductible, no coinsurance, and no copay for annual routine eye exams, contact lenses, and eyeglass frames. Eyeglass lenses are covered with a copay of $0 to $153 up to a $300 combined eyewear allowance every two years, while other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC NC-0017 (PPO), which features Medicare-covered dental with no copay and 20% coinsurance, and preventive care with no copay and no coinsurance. Sub-services not covered include restorative, adjunctive general, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC NC-0017 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs require no copay and a 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by AARP Medicare Advantage from UHC NC-0017 (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC NC-0017 (PPO) and requires prior authorization for most items. Durable medical equipment, prosthetics, and medical supplies are available with no copay and a 20% coinsurance, while diabetic supplies feature no copay and diabetic therapeutic shoes or inserts carry a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC NC-0017 (PPO), with prior authorization required for these services. Lab services have no copay and no coinsurance, diagnostic tests require a $50 copay, diagnostic radiology starts at no copay, outpatient X-rays require a $30 copay plus coinsurance, and therapeutic radiology has a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage from UHC NC-0017 (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage from UHC NC-0017 (PPO) plan, as none of the sub-services—including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation—are covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC NC-0017 (PPO) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by the AARP Medicare Advantage from UHC NC-0017 (PPO) plan, which offers a chronic illness meal benefit with no copay, no coinsurance, and prior authorization required. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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