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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 2026, 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 2026.
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 $440.00 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 $4200.00 (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 $4200.00 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 features an annual drug deductible of $440. For Tier 1 preferred generic drugs, members enjoy no copay for both 1-month and 3-month supplies at standard pharmacies and mail-order services. Tier 2 generic drugs cost a $5 copay for a 1-month standard pharmacy supply, or no copay for a 3-month supply when using preferred mail order. Brand-name and specialty medications under this plan transition to coinsurance percentages rather than flat copays. Tier 3 preferred brand drugs require an 18% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs incur 42% and 28% coinsurance respectively for a 1-month supply. These details help you easily estimate your out-of-pocket prescription costs with this Medicare Advantage plan.
Additional Benefits
The AARP Medicare Advantage from UHC NC-0015 (HMO-POS) plan offers comprehensive coverage with no copay and no coinsurance for primary care visits, telehealth, and routine preventive care. Specialist visits feature copays ranging from no copay to $35 with no coinsurance, while emergency room visits require a $150 copay that is waived if admitted. Inpatient hospital stays require a $455 daily copay for the first few days and no copay for subsequent days, with no coinsurance overall. Routine dental, vision, and hearing exams are covered with no copay and no coinsurance, although prescription hearing aids require copays ranging from $199.00 to $1,249.00. Home health services and skilled nursing facility stays for the first 20 days also carry no copay, while durable medical equipment and dialysis services require a 20% coinsurance with no copay. Members also benefit from over-the-counter items and chronic illness meal benefits with no copay and no coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $455 copay for days 1 through 6 of acute stays and days 1 through 5 of psychiatric stays, with no copay for subsequent days. Prior authorization is required, and some services such as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $455 for outpatient hospital and daily observation services. Ambulatory surgical center and outpatient blood services require no copay and no coinsurance, while outpatient substance abuse sessions have copays up to $25 with no coinsurance.
Partial Hospitalization See details
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) covers partial hospitalization benefits with a $55.00 copay and no coinsurance. Prior authorization is required to access these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) partially covers ambulance and transportation services, with Medicare-covered ground and air ambulance services requiring prior authorization, a $275 copay, and no coinsurance. Transportation services to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Emergency services are covered by AARP Medicare Advantage from UHC NC-0015 (HMO-POS) with a $150 copay, which is waived if you are admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a copay of up to $65 with no coinsurance, while worldwide emergency, urgent, and transportation services are fully covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits under AARP Medicare Advantage from UHC NC-0015 (HMO-POS) feature no copay and no coinsurance for primary care physician visits and telehealth services. Specialist visits, physical and occupational therapy, and mental health services are covered with copays ranging from $0 to $35 and no coinsurance, while chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, fitness benefits, and home safety devices. However, additional preventive services are only partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy 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, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC NC-0015 (HMO-POS), which offers routine hearing exams with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no coinsurance and copays ranging from $199.00 to $1,249.00, although inner, outer, and over-the-ear prescription models are not covered.
Vision Services See details
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) offers partially covered vision services with no deductible and no coinsurance, featuring one routine eye exam per year and eyeglass frames or contact lenses with no copay. Eyeglass lenses are covered with a copay of $0 to $153 up to a $200 combined maximum benefit every two years, while other eye exams, upgrades, and combined eyeglass packages are not covered.
Dental Services See details
Dental services are partially covered under the AARP Medicare Advantage from UHC NC-0015 (HMO-POS) plan, with implant services and orthodontics excluded from coverage. Preventive care is offered with no copay and no coinsurance up to a $2,000 annual maximum, while Medicare-covered services carry no copay and 20% coinsurance, and comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs carry no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC NC-0015 (HMO-POS) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC NC-0015 (HMO-POS) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies feature no copay and a 20% coinsurance, while diabetic therapeutic shoes and inserts carry a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) covers diagnostic and radiological services, requiring prior authorization for all services. Diagnostic tests 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 carries a 20% coinsurance.
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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by AARP Medicare Advantage from UHC NC-0015 (HMO-POS) with no copay, no coinsurance, and prior authorization required. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by AARP Medicare Advantage from UHC NC-0015 (HMO-POS) with no coinsurance and no prior three-day inpatient hospital stay required. There is no copay for days 1 through 20 and a $218 copay per day for days 21 through 100, though prior authorization is required and additional days are not covered.
Other Services See details
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under these services, and prior authorization is required for the meal benefit.
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