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AARP Medicare Advantage from UHC NC-0015 (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-0015 (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-0015 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC NC-0015 (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-0015 (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-0015 (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-0015 (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 $255.00 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 combined Maximum Out-Of-Pocket cost of $3900.00 (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 $3900.00 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
The AARP Medicare Advantage from UHC NC-0015 (HMO-POS) plan has a $255 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For preferred generic drugs, you will pay a $5 copay at standard pharmacies. Standard generic drugs have a $47 copay. Preferred and standard brand drugs have a $100 copay. Non-preferred drugs have 30% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC NC-0015 (HMO-POS) plan offers a variety of benefits with varying cost-sharing. It covers inpatient hospital stays with a copay for the first few days, and outpatient services with copays ranging from $0 to $295. Emergency, primary care, and preventive services often have no copay, and hearing, vision, and dental services are also covered with some cost-sharing. This plan includes coverage for ambulance services with a copay, as well as skilled nursing facility stays with a copay after the first 20 days. Additionally, the plan offers benefits for medical equipment, home health services, and diagnostic services, with some services requiring coinsurance or copays. Other services include OTC items and meal benefits, with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For days 1-5 of an inpatient stay, the copay is $295, and for days 6-90, there is no copay. Additional days for Inpatient Hospital-Acute are covered with no copay for days 91-999, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay ranging from $0 to $295, observation services with a $295 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the AARP Medicare Advantage from UHC NC-0015 (HMO-POS) plan. This benefit has a $55 copay, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by AARP Medicare Advantage from UHC NC-0015 (HMO-POS). Ground and air ambulance services have a $275 copay, and 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 by the AARP Medicare Advantage from UHC NC-0015 (HMO-POS) plan. Emergency Services have a $140 copay, Urgently Needed Services have a copay between $0 and $65, and Worldwide Emergency Services have a $0 copay.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services are covered with a $20 copay. Occupational Therapy Services are covered with a copay between $0 and $20. Physician Specialist Services and Physical Therapy and Speech-Language Pathology Services are covered with a copay between $0 and $20. Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, and Opioid Treatment Program Services are covered with a copay between $0 and $25. Additional Telehealth Benefits are covered with no copay.
Preventive Services See details
The AARP Medicare Advantage from UHC NC-0015 (HMO-POS) plan covers preventive services, including an annual physical exam with no copay. Other preventive services, such as glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, are covered with no copay. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered for one visit per year with no copay. Prescription hearing aids are partially covered with a copay between $199 and $1249 for all types, but inner ear, outer ear, and over the ear hearing aids are not covered, and OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, while routine eye exams are limited to one per year. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, all with no copay, and eyeglass lenses are limited to one pair every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC NC-0015 (HMO-POS) plan covers dental services with 20% coinsurance for Medicare dental services, while other dental services are covered with a maximum plan benefit of $2000 every year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay, and Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Maxillofacial Prosthetics, and Oral and Maxillofacial Surgery have no copay, but Prosthodontics (removable and fixed) have 0-50% coinsurance. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, the plan has a $35 copay and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC NC-0015 (HMO-POS) plan. There is a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics, Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires authorization. Prosthetic Devices have a 20% coinsurance, while Medical Supplies also have a 20% coinsurance. 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 $40 copay, lab services with no copay, and all radiological services. Diagnostic Radiological Services have a maximum copay of $110, while Therapeutic Radiological Services have a 20% coinsurance, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC NC-0015 (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 Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the AARP Medicare Advantage from UHC NC-0015 (HMO-POS) plan. There is no copay for days 1-20, but a $203 copay applies for days 21-100; there is no coinsurance.
Other Services See details
Other Services for AARP Medicare Advantage from UHC NC-0015 (HMO-POS) includes Over-the-Counter (OTC) Items and Meal Benefit coverage. OTC Items have no copay, while Meal Benefit requires prior authorization and has no copay. 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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