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AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage Giveback from UHC NC-13 (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 Giveback from UHC NC-13 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage Giveback from UHC NC-13 (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 Giveback from UHC NC-13 (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 Giveback from UHC NC-13 (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 Giveback from UHC NC-13 (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 $50.00. 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.
This plan has a $600.00 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 $8900.00 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:
Sign up for AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic medications cost $7 for a 1-month supply at standard pharmacies, but you can save with no copay on a 3-month supply through preferred mail order. Higher-tier medications are subject to coinsurance rather than flat copays, beginning with 18% coinsurance for Tier 3 preferred brand drugs. Tier 4 non-preferred drugs require a 28% coinsurance, while Tier 5 specialty drugs require a 26% coinsurance for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) offers robust medical coverage with no copay or coinsurance for primary care provider visits, telehealth, and annual preventive screenings. For more intensive medical needs, inpatient hospital stays require a $550 daily copay for the first few days with no copay thereafter, while emergency room visits carry a $115 copay that is waived upon admission. Outpatient surgical services and home health visits are also covered with no copay. Additional benefits include routine dental, vision, and hearing exams with no copay, with preventive dental coverage extending up to a $1,000 annual limit. Patients requiring durable medical equipment or dialysis will pay no copay and a 20% coinsurance, while prescription hearing aids range from a $199 to $1,249 copay. Please note that routine transportation, chiropractic care, and cardiac rehabilitation services are not covered under this plan.
Inpatient Hospital See details
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $550 daily copay for days 1-4 of acute stays and days 1-3 of psychiatric stays, with no copay for subsequent covered days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $550 for outpatient hospital services and a $550 daily copay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services require no coinsurance and copays between $0 and $25.
Partial Hospitalization See details
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) covers Medicare-approved ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required. Transportation services, including trips to plan-approved or other health-related locations, are not covered under this plan.
Emergency Services See details
Emergency Services under the AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) are covered with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $0 to $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits under the AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) feature primary care provider visits and telehealth services with no copay and no coinsurance. Specialist visits, physical and occupational therapy, and mental health services are covered with copayments ranging from $0 to $55 and no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) with no copay and no coinsurance for annual physical exams, kidney disease education, and other screenings. Additional preventive benefits are partially covered, offering a fitness benefit with no copay and no coinsurance, but excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, bathroom modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS), offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation services are not covered. Prescription and OTC hearing aids are covered with no coinsurance and copays ranging from $199 to $1,249, but inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) partially covers eye exams, offering one routine eye exam per year with no copay, no coinsurance, and no deductible, while other eye exam services are not covered and prior authorization is required. For eyewear, some services are covered, but contact lenses, eyeglasses, lenses, frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by the AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS), excluding implant services and orthodontics. Preventive services are available with no copay and no coinsurance up to a $1,000 annual limit, while Medicare-covered dental services require no copay and 20% coinsurance, and covered comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance up to 20%, while Medicare Part B insulin drugs have a $35 copay and up to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage Giveback from UHC NC-13 (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 Giveback from UHC NC-13 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) covers diagnostic and radiological services with prior authorization required. Diagnostic tests have a $50 copay and no coinsurance, lab services and diagnostic radiology have no copay, outpatient X-rays require a $30 copay, and therapeutic radiology has a 20% coinsurance.
Home Health Services See details
Home health services are covered under the AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) plan. None of the associated sub-services, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services, are covered under this plan.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) partially covers other services, offering a meal benefit for chronic illnesses with no copay and no coinsurance, although prior authorization is required. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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