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AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Patriot No Rx NC-MA02 (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 Patriot No Rx NC-MA02 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) is a HMO-POS 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-MA02 (HMO-POS) 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-MA02 (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 Patriot No Rx NC-MA02 (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. Additionally, this plan comes with a Part B Premium reduction of $160.00. 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 $7900.00 (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 $7900.00 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
Prescription drugs are not covered by AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS).
Additional Benefits
The AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) plan provides coverage for a wide range of healthcare services. This plan offers no copay for many services, including primary care visits, preventive services such as annual physical exams, hearing exams, vision eye exams, home health services, and meal benefits. Inpatient hospital stays have a copay, as do outpatient services, emergency services, and ambulance services. The plan also includes benefits for hearing aids, dental, and medical equipment, with varying copays and coinsurance amounts. Additionally, the plan covers services like partial hospitalization, dialysis, and skilled nursing facilities, with some services requiring prior authorization. This plan offers a comprehensive approach to healthcare coverage, focusing on preventive care while also providing support for more specialized medical needs.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for 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 psychiatric care, non-Medicare-covered stays, and upgrades for acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient services are covered by the AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) plan. Outpatient Hospital Services have a copay between $0 and $475, Observation Services have a $475 copay, Ambulatory Surgical Center (ASC) Services have no copay, Outpatient Substance Abuse Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial hospitalization is covered under this plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) plan. Ground and Air Ambulance Services have a $290 copay with no coinsurance, while 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 by the AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) plan. Emergency Services have a $110 copay with no coinsurance, while Urgently Needed Services have a copay between $0 and $45 with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
The AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) plan covers Primary Care Physician Services with no copay, Chiropractic Services with a $15 copay, Occupational Therapy Services with a copay between $0 and $35, and Physician Specialist Services with a copay between $0 and $50. Mental Health Specialty Services and Psychiatric Services have a $0-$25 copay for individual sessions and a $15 copay for group sessions. The plan also covers Podiatry Services with a $45 copay, Other Health Care Professional services with a copay between $0 and $50, Physical Therapy and Speech-Language Pathology Services with a copay between $0 and $50, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
Preventive services are covered, including an annual physical exam with no copay. Additional preventive services and kidney disease education services are covered with no copay, while health education, in-home safety assessments, and other services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year. Prescription hearing aids (all types) 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 aids, 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 coverage for eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear has no copay for contact lenses, and eyeglass frames, but there is a copay between $0 - $153 for eyeglass lenses, with a combined maximum of $250 every two years, and eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered by the AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) plan, with 20% coinsurance for Medicare Dental Services. Oral exams, dental X-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services are covered with no copay. Orthodontic services, restorative services, and many other services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%, and for Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
The AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) plan covers medical equipment, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $45 copay, and lab services with no copay. Radiological services include coverage for diagnostic radiological services with a copay up to $225, therapeutic radiological services with a coinsurance of at least 20%, and outpatient X-ray services with a $25 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) 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. 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 Patriot No Rx NC-MA02 (HMO-POS) plan, but require prior authorization. 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 stays for SNF are not covered.
Other Services See details
The "Other Services" benefit for AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) covers meal benefits 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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