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UHC Complete Care NC-25 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care NC-25 (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Complete Care NC-25 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care NC-25 (HMO-POS C-SNP) is a HMO-POS C-SNP 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 UHC Complete Care NC-25 (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Complete Care NC-25 (HMO-POS C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UHC Complete Care NC-25 (HMO-POS C-SNP).
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 UHC Complete Care NC-25 (HMO-POS C-SNP), 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 $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 $4900.00 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 UHC Complete Care NC-25 (HMO-POS C-SNP) plan has a $340 deductible for prescription drugs. After you meet your deductible, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy you use. For example, if you use a standard pharmacy, you will pay a $10 copay for preferred generic drugs, a $47 copay for standard generic drugs, and a $100 copay for preferred brand drugs. After your total drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Complete Care NC-25 (HMO-POS C-SNP) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays depending on the specific service. Emergency services have a $125 copay, while primary care visits are available with no copay. The plan also provides coverage for preventive, hearing, vision, and dental services. This plan includes additional benefits such as home health services with no copay, and coverage for ambulance, and diagnostic services. Prescription hearing aids and diabetic supplies are available with a copay. The plan also covers Skilled Nursing Facility (SNF) services with no copay for the first 20 days, and offers other services such as Home Infusion, Dialysis, and Cardiac Rehabilitation, with some services requiring coinsurance or copays.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered. For Inpatient Hospital-Acute, you will pay a $345 copay for days 1-5, and no copay for days 6-90, with additional days 91-999 covered with no copay, and Inpatient Hospital Psychiatric has a $345 copay for days 1-4, and no copay for days 5-90. Non-Medicare-covered stays 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 $345, Observation Services with a $345 copay, Ambulatory Surgical Center (ASC) 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. Prior authorization is required for some services.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Complete Care NC-25 (HMO-POS C-SNP) plan. Ground and Air Ambulance Services have a $290 copay, and there is no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency services are covered under the UHC Complete Care NC-25 (HMO-POS C-SNP) plan, with a $125 copay. Urgently needed services have a copay between $0 and $55, and worldwide emergency services are covered with no copay for worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation.
Primary Care See details
The UHC Complete Care NC-25 (HMO-POS C-SNP) plan covers primary care physician services with no copay, and chiropractic services with a $20 copay. Occupational therapy services have a copay between $0 and $20, and physician specialist services have a copay between $0 and $20. Mental health specialty services, including individual sessions (between $0 and $25 copay) and group sessions ($15 copay), are covered. Podiatry services and other health care professional services have a $20 copay. Psychiatric services, including individual sessions (between $0 and $25 copay) and group sessions ($15 copay), are covered. Physical therapy and speech-language pathology services have a copay between $0 and $20. Additional telehealth benefits have no copay, and Opioid Treatment Program Services has no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, and an annual physical exam with no copay. Other preventive services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), and more are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year with no copay. Prescription hearing aids are covered with a copay between $199 and $1249 for all types, though inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
The UHC Complete Care NC-25 (HMO-POS C-SNP) plan covers vision services including eye exams and eyewear. Routine eye exams, contact lenses, and eyeglass frames have no copay, while eyeglass lenses have a copay between $0 and $153. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Complete Care NC-25 (HMO-POS C-SNP) plan covers Medicare Dental Services with 20% coinsurance, as well as oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services with no copay. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, and Oral and Maxillofacial Surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay, with a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Complete Care NC-25 (HMO-POS C-SNP) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a 20% coinsurance, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a $50 copay for diagnostic procedures/tests, and lab services with no copay. Diagnostic radiological services have a copay of at most $225, while therapeutic radiological services have a coinsurance of at least 20%. Outpatient X-ray services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care NC-25 (HMO-POS C-SNP) plan 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 specific services Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. A copay applies for some cardiac and pulmonary rehabilitation services, but the specific cost is not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Complete Care NC-25 (HMO-POS C-SNP) plan. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
The UHC Complete Care NC-25 (HMO-POS C-SNP) plan covers Over-the-Counter (OTC) Items and Meal Benefits. Over-the-counter items have no copay, and Meal Benefits also have no copay, but 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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