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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 2025, 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 2025.
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 $340.00 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 $5900.00 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 has a $340 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, standard generic drugs have a $10 copay, while preferred brand drugs have a $100 copay. If you qualify for the low-income subsidy (LIS), you may have reduced costs for your prescriptions. After 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-0007 (HMO-POS) plan offers a variety of benefits with varying costs. This plan covers inpatient hospital stays with a copay, and outpatient services with copays ranging from $0 to $415. Emergency services have a $125 copay, and primary care visits have no copay. Additional benefits include coverage for preventive services with no copay, hearing and vision services with no copays for exams, and dental services with no copays for many services. The plan also covers home health services and skilled nursing facilities, both with copays, and provides coverage for durable medical equipment and diabetic supplies with coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits for AARP Medicare Advantage from UHC NC-0007 (HMO-POS) include coverage for Inpatient Hospital-Acute, with a copay of $415 for days 1-4, and no copay for days 5-90. Additional days for Inpatient Hospital-Acute have no copay for days 91-999. Inpatient Hospital Psychiatric has a copay of $415 for days 1-3 and no copay for days 4-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services for AARP Medicare Advantage from UHC NC-0007 (HMO-POS) includes coverage for all outpatient hospital services with a copay ranging from $0 to $415, observation services with a $415 copay, and no copay for ambulatory surgical center services and outpatient blood services. Individual sessions for outpatient substance abuse have a copay between $0 and $25, and group sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC NC-0007 (HMO-POS) plan, but requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC NC-0007 (HMO-POS) plan, with prior authorization required for all ambulance services. Ground and Air Ambulance Services have a copay of $275, but there is no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55; there is no coinsurance for either. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
The AARP Medicare Advantage from UHC NC-0007 (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a copay between $0 and $30, and specialist services with a copay between $0 and $35. Mental health specialty services, podiatry services, other health care professional services, psychiatric services, and physical therapy and speech-language pathology services also have copays, and additional telehealth benefits have no copay. Opioid treatment program services have no copay.
Preventive Services See details
Preventive services, including annual physical exams, are covered. Annual physical exams have no copay, and additional preventive services, including Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, also have no copay.
Hearing Services See details
Hearing exams are covered with no copay. Prescription hearing aids are covered, with a copay between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Vision services include eye exams, eyewear, contact lenses, eyeglass lenses, and eyeglass frames. Eye exams and eyewear have no copay, and eyewear has a combined maximum benefit of $300 every two years. Contact lenses have no copay, eyeglass lenses have a copay of $0 - $153, and eyeglass frames have no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a 20% coinsurance, and other dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventative dental services with no copay. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, removable, maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay; however, implants and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay with coinsurance between 0-20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC NC-0007 (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay. Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $50 copay, and lab services with no copay. Radiological services include diagnostic radiological services with a copay of at most $225, therapeutic radiological services with 20% coinsurance, and outpatient X-ray services with a $25 copay.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC NC-0007 (HMO-POS) 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 any of the sub-services, which include Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation 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-0007 (HMO-POS) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
Other Services includes Over-the-Counter (OTC) Items and a Meal Benefit. Over-the-Counter (OTC) Items have no copay. The Meal Benefit also has no copay and requires prior authorization. Acupuncture, 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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