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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 2026, 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 2026.
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 $54.00. 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 $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-0012 (HMO-POS) plan features an annual prescription drug deductible of $520. Under this plan, Tier 1 preferred generic drugs have no copay for 1-month and 3-month supplies at standard pharmacies and mail-order services. Tier 2 generic drugs carry an $8 copay for a 1-month supply at standard pharmacies, though you can secure a 3-month supply with no copay when using preferred mail order. For higher-tier medications, your costs are based on coinsurance rather than flat copays. Tier 3 preferred brand-name drugs require a 16% coinsurance for both 1-month and 3-month fills. Tier 4 non-preferred drugs carry a 40% coinsurance, while Tier 5 specialty medications require a 27% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC NC-0012 (HMO-POS) plan offers robust healthcare coverage with no copay and no coinsurance for primary care, telehealth, and preventive services like annual physicals. If you require hospital care, inpatient stays feature a $495 daily copay for the first few days and no copay thereafter, while emergency room visits have a $130 copay that is waived if you are admitted. Outpatient surgery and lab services are also highly accessible with no copay, though specialist visits require a small copay of up to $40. For ancillary care, this plan provides valuable dental, vision, and hearing benefits to keep out-of-pocket costs low. Routine eye and hearing exams feature no copay, and dental care is covered with no copay for preventive services up to a $1,250 annual limit. Additionally, medical equipment, dialysis, and home health services are covered, with many items requiring no copay and a standard 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by AARP Medicare Advantage from UHC NC-0012 (HMO-POS) with no coinsurance, requiring a $495 daily copay for days 1 to 5 of acute stays and days 1 to 4 of psychiatric stays, with no copay for subsequent covered days. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under AARP Medicare Advantage from UHC NC-0012 (HMO-POS) are covered with no coinsurance, though prior authorization is required for most services. There is no copay for ambulatory surgical center and outpatient blood services, while outpatient hospital services require a copay of $0 to $495 (including $495 per day for observation services) and substance abuse sessions require copays ranging from $0 to $25.
Partial Hospitalization See details
Partial hospitalization services are covered by AARP Medicare Advantage from UHC NC-0012 (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by AARP Medicare Advantage from UHC NC-0012 (HMO-POS), featuring a $275.00 copay and no coinsurance for both ground and air ambulance services. While some transportation services are covered, transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC NC-0012 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $0 to $50 copay and no coinsurance, while worldwide emergency, urgent care, and emergency transportation are covered with no copays and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC NC-0012 (HMO-POS) covers primary care and telehealth services with no copay and no coinsurance. Specialty care, physical and occupational therapies, and mental health services require copays ranging from $0 to $40 with no coinsurance, though routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered under the AARP Medicare Advantage from UHC NC-0012 (HMO-POS) plan with no copay and no coinsurance for covered services like annual physical exams, fitness benefits, kidney disease education, and diabetes training. However, the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, home safety modifications, or counseling.
Hearing Services See details
AARP Medicare Advantage from UHC NC-0012 (HMO-POS) provides partially covered hearing services, featuring routine hearing exams with no copay and no coinsurance, while fitting and evaluation exams are not covered. Prescription hearing aids are also partially covered with a copay of $199.00 to $1,249.00 and no coinsurance, excluding inner ear, outer ear, and over the ear types. OTC hearing aids are covered with a copay ranging from $199.00 to $829.00 and no coinsurance.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC NC-0012 (HMO-POS), featuring no coinsurance for all covered services, no copay for annual routine eye exams, and a $300 combined limit every two years for eyewear. Covered eyewear includes contact lenses and frames with no copay, and eyeglass lenses with a copay of up to $153, though other eye exams, bundled eyeglasses, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC NC-0012 (HMO-POS), with implant services and orthodontics not covered. Preventive dental care has no copay and no coinsurance up to a $1,250 annual limit, while Medicare-covered dental has no copay and a 20% coinsurance, and covered comprehensive services have no copay and a 50% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC NC-0012 (HMO-POS) with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC NC-0012 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered under AARP Medicare Advantage from UHC NC-0012 (HMO-POS) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay, and prior authorization is required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC NC-0012 (HMO-POS) with prior authorization required. Diagnostic tests and procedures have a $50 copay with no coinsurance, lab services and diagnostic radiology have no copay, outpatient x-rays require a $30 copay, and therapeutic radiology has a 20% minimum coinsurance.
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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage from UHC NC-0012 (HMO-POS) with no copay and no coinsurance, but some services are covered while cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC NC-0012 (HMO-POS) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring prior authorization but no prior three-day inpatient 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 AARP Medicare Advantage from UHC NC-0012 (HMO-POS), which offers a chronic illness meal benefit with no copay and no coinsurance, subject to prior authorization. Acupuncture, over-the-counter (OTC) items, and other supplemental services are not covered under this plan.
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