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AARP Medicare Advantage from UHC NC-0007 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NC-0007 (HMO-POS). 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-0007 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Durham and Wake Counties. 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-0007 (HMO-POS) 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-0007 (HMO-POS).
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-0007 (HMO-POS), 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 $520.00 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 Maximum Out-Of-Pocket cost of $6200.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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-0007 (HMO-POS) plan features an annual prescription drug deductible of $520. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic drugs carry a $10 copay for a 1-month supply at standard pharmacies, but you can enjoy no copay for a 3-month supply when using preferred mail order. Higher-tier medications on this plan require coinsurance instead of flat copayments. Tier 3 preferred brand drugs carry a 16% coinsurance for standard pharmacy and mail order options. Tier 4 non-preferred drugs require 37% coinsurance, and Tier 5 specialty drugs require 27% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC NC-0007 (HMO-POS) plan offers robust medical coverage featuring no copay and no coinsurance for primary care visits, telehealth, annual physicals, and home health services. For inpatient hospital stays, you will pay a daily copay of $550 for days one through five and no copay for subsequent days, while emergency room visits require a $130 copay that is waived if you are admitted. Specialist visits are also highly affordable, ranging from no copay to a $45 copay with no coinsurance. Routine dental cleanings, annual eye exams, and yearly hearing tests are covered with no copay and no coinsurance, helping you easily maintain your everyday health. If you need prescription hearing aids or corrective lenses, the plan covers these with set copays and no coinsurance, while durable medical equipment and dialysis services require a 20% coinsurance and no copay. Additionally, skilled nursing facility care is covered with no copay for the first 20 days and no coinsurance throughout your stay.
Inpatient Hospital See details
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) covers inpatient acute hospital stays with no coinsurance and a $550 daily copay for days 1 to 5, and no copay for days 6 and beyond. Inpatient psychiatric stays are also covered with no coinsurance and a $550 daily copay for days 1 to 4, and no copay for days 5 to 90, though upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) covers outpatient services with no coinsurance, featuring copays of $0 to $550 for outpatient hospital services and $550 per day for observation services. Ambulatory surgical center and outpatient blood services are offered with no copay and no coinsurance, while outpatient substance abuse services require copays between $0 and $25 with no coinsurance.
Partial Hospitalization See details
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by AARP Medicare Advantage from UHC NC-0007 (HMO-POS), offering ground and air ambulance services for a $275 copay and no coinsurance. However, transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage from UHC NC-0007 (HMO-POS) with a $130 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature a copay ranging from $0 to $50 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 through the AARP Medicare Advantage from UHC NC-0007 (HMO-POS) plan include primary care visits and telehealth with no copay and no coinsurance, while specialist visits range from a $0 to $45 copay with no coinsurance. Other covered services, such as physical therapy ($35 copay) and mental health sessions (up to a $25 copay), also feature no coinsurance, though chiropractic services are only partially covered with routine and other chiropractic services not covered.
Preventive Services See details
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) provides partially covered preventive services with no copay and no coinsurance for covered options like annual physicals, kidney education, and fitness benefits. Several sub-services are not covered, including health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, home modifications, and counseling.
Hearing Services See details
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) provides partially covered hearing services, featuring one annual routine hearing exam with no copay and no coinsurance, while fitting and evaluation exams are not covered. Prescription hearing aids are also partially covered with a $199 to $1,249 copay and no coinsurance (excluding inner, outer, and over-the-ear models), and OTC hearing aids are covered with a $199 to $829 copay and no coinsurance.
Vision Services See details
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) provides partially covered vision services with no deductible and no coinsurance, though other eye exam services, upgrades, and packaged eyeglasses (lenses and frames) are not covered. Routine eye exams, contact lenses, and eyeglass frames are offered with no copay, while eyeglass lenses have a copay of $0 to $153, up to a $300 maximum eyewear limit every two years.
Dental Services See details
Dental Services are partially covered under the AARP Medicare Advantage from UHC NC-0007 (HMO-POS) plan, offering preventive care like exams and cleanings with no copay and no coinsurance. Medicare-covered dental services require no copay and a 20% coinsurance, but comprehensive options such as restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) covers durable medical equipment, prosthetic devices, 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, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC NC-0007 (HMO-POS), with prior authorization required for all services. Lab services and diagnostic radiology services have no copay, diagnostic tests require a $50 copay with no coinsurance, outpatient x-rays have a $25 copay, and therapeutic radiology services require a minimum 20% coinsurance.
Home Health Services See details
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) covers Home Health Services with no copay and no coinsurance. Prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage from UHC NC-0007 (HMO-POS) plan, as standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by AARP Medicare Advantage from UHC NC-0007 (HMO-POS) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. You will pay no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by AARP Medicare Advantage from UHC NC-0007 (HMO-POS), featuring a chronic illness meal benefit 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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