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AARP Medicare Advantage from UHC NC-0012 (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-0012 (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-0012 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC NC-0012 (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 from UHC NC-0012 (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-0012 (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-0012 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $49.00. 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 $5400.00 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-0012 (HMO-POS) plan has a $340 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy used. For tier 1 preferred generic drugs, you'll pay an $8 copay at standard pharmacies. Tier 3 preferred brand drugs have a $100 copay, regardless of the pharmacy. Non-preferred drugs have a 29% coinsurance.
Additional Benefits
The AARP Medicare Advantage from UHC NC-0012 (HMO-POS) plan offers comprehensive coverage with a variety of benefits. This plan includes coverage for inpatient and outpatient services, with varying copays depending on the specific service, such as a $385 copay for inpatient hospital stays and copays between $0 and $385 for outpatient hospital services. Many services have no copay, including primary care visits, preventive services, and vision exams. Additional benefits include coverage for hearing exams and hearing aids, vision services like eye exams and eyewear, and dental services with no copay for many preventive services. The plan also covers ambulance services, emergency services, and home health services. Other benefits such as medical equipment, home infusion, and dialysis services are available, but may require coinsurance or prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $385 copay for days 1-5, and no copay for days 6-90, with no coinsurance; for Inpatient Hospital Psychiatric, you will pay a $385 copay for days 1-4 and no copay for days 5-90, with no coinsurance. Additional days for Inpatient Hospital-Acute are covered with no copay and no coinsurance. Non-Medicare-covered stay and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $385, Observation Services with a $385 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with individual sessions costing between $0 and $25 and group sessions costing $15, and Outpatient Blood Services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. There is a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by AARP Medicare Advantage from UHC NC-0012 (HMO-POS). This plan covers ground and air ambulance services with a $275 copay, and no coinsurance, but does not cover transportation services to any health-related location.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $55; both have no coinsurance. Worldwide Emergency Services have a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, and no coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have no copay. Chiropractic Services have a $20 copay, Physician Specialist Services have a copay between $0 and $30, and Mental Health Specialty Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Podiatry Services and Other Health Care Professional services have a $30 copay, and Psychiatric Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive services include Medicare-covered services with no copay, an annual physical exam with no copay, and additional preventive services with copays for Fitness Benefit and Home and Bathroom Safety Devices and Modifications. Other services like Health Education, In-Home Safety Assessment, and Personal Emergency Response System are not covered.
Hearing Services See details
Hearing exams are covered with no copay, while routine hearing exams are limited to one per year. Prescription hearing aids are covered, with a copay between $199 and $1249 for all types, limited to two per year, while OTC hearing aids have a copay between $99 and $829, limited to two per year. 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 annually. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, all with no copay, and a combined maximum benefit of $300 every two years; however, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Medicare dental services have a 20% coinsurance, and other dental services are covered up to a $2,000 maximum per year. Orthodontic services are covered, with coverage under diagnostic and preventive dental. Restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery have no copay. Prosthodontics, removable, and prosthodontics, fixed, have a 0% - 50% coinsurance. Implant and orthodontic services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC NC-0012 (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical equipment is covered, including durable medical equipment with a 20% coinsurance and no copay, prosthetics and medical supplies with a 20% coinsurance and no copay, and diabetic equipment. Diabetic supplies have no copay, and diabetic therapeutic shoes/inserts have a 20% coinsurance. Durable medical equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $50 copay, lab services with no copay, all radiological services, diagnostic radiological services with a copay up to $225, therapeutic radiological services with up to 20% coinsurance, and outpatient X-ray services with a $25 copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC NC-0012 (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 there is no cost sharing information available. However, the plan states that 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 are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC NC-0012 (HMO-POS) plan, with a $0 copay for days 1-20 and a $203 copay per day for days 21-100; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and Meal Benefits. Over-the-Counter (OTC) Items have no copay, and Meal Benefits also have no copay and require 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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