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AARP Medicare Advantage from UHC NC-26 (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-26 (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-26 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC NC-26 (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-26 (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-26 (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-26 (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 Maximum Out-Of-Pocket cost of $5400.00 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-26 (HMO-POS) plan has an annual drug deductible of $440. For Tier 1 preferred generic drugs, there is no copay for 1-month or 3-month supplies at standard pharmacies, or for 3-month supplies filled via mail order. Tier 2 generic drugs carry a $5 copay for a 1-month supply at standard pharmacies, though you can save with no copay on a 3-month supply through preferred mail order. Higher-tier medications transition to coinsurance costs instead of flat copayments. Tier 3 preferred brand drugs require an 18% coinsurance for 1-month and 3-month supplies across standard pharmacies and mail-order options. For Tier 4 non-preferred drugs and Tier 5 specialty drugs, you will pay a 39% and 28% coinsurance respectively for a 1-month supply.
Additional Benefits
The AARP Medicare Advantage from UHC NC-26 (HMO-POS) plan offers comprehensive coverage with no copays for primary care visits, telehealth services, and preventive care like annual physical exams. For more intensive care, inpatient hospital stays require a $395 daily copay for the first six days and no copay thereafter, while emergency room visits have a $130 copay that is waived if you are admitted. Outpatient hospital services and specialist visits are also covered, with specialist copays ranging from no copay to $40. This plan features valuable routine benefits, including no copays for annual routine vision and hearing exams, plus no copays for preventive dental care up to a $1,000 annual limit. Additionally, home health services, cardiac rehabilitation, and the first 20 days of skilled nursing facility stays are available with no copay. For medical equipment, dialysis, and comprehensive dental services, members will generally pay no copay and a 20% to 50% coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC NC-26 (HMO-POS) covers inpatient acute hospital stays with no coinsurance, a $395 daily copay for days 1 through 6, and no copay for days 7 and beyond, though upgrades and non-Medicare-covered stays are not covered. Inpatient psychiatric hospital stays are also covered with no coinsurance, requiring a $395 daily copay for days 1 through 5 and no copay for days 6 through 90, while additional psychiatric days and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC NC-26 (HMO-POS) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services require a copay of up to $395, while outpatient substance abuse services have a copay of up to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
Partial hospitalization is covered by the AARP Medicare Advantage from UHC NC-26 (HMO-POS) plan with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC NC-26 (HMO-POS) covers Medicare-approved ground and air ambulance services with a $290.00 copay and no coinsurance, subject to prior authorization. For transportation, some services are covered, but transportation to plan-approved health-related locations and any other health-related locations is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC NC-26 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed care has a copay of $0 to $50 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 from the AARP Medicare Advantage from UHC NC-26 (HMO-POS) feature primary care and telehealth services with no copay and no coinsurance, while specialist visits range from a $0 to $40 copay with no coinsurance. Physical and occupational therapies require a $30 copay, podiatry costs a $40 copay, both with no coinsurance, and chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage from UHC NC-26 (HMO-POS) with no copay and no coinsurance for annual physical exams, kidney disease education, and fitness benefits. The benefit is partially covered because several sub-services—including 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/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, home safety modifications, and counseling—are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC NC-26 (HMO-POS), offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation services are not covered. The plan covers up to two prescription hearing aids per year with a $199.00 to $1,249.00 copay and no coinsurance, and up to two OTC hearing aids with a $199.00 to $829.00 copay and no coinsurance, but inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC NC-26 (HMO-POS) with no coinsurance, offering no copay for annual routine eye exams and eyewear copays ranging from $0 to $153 up to a $300 limit every two years. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered under this plan.
Dental Services See details
Dental Services are partially covered under the AARP Medicare Advantage from UHC NC-26 (HMO-POS) plan, excluding implant services and orthodontics. Preventive dental care features no copay and no coinsurance up to a $1,000 annual limit, while Medicare-covered services require no copay and a 20% coinsurance, and other 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-26 (HMO-POS) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and other drugs, have coinsurance ranging from no coinsurance up to 20%, while Part B insulin is covered with a $35 copay and coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
AARP Medicare Advantage from UHC NC-26 (HMO-POS) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Medical Equipment See details
AARP Medicare Advantage from UHC NC-26 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay from specified manufacturers, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC NC-26 (HMO-POS) with prior authorization required. Diagnostic tests require a $50 copay and no coinsurance, lab and diagnostic radiological services have no copay and no coinsurance, outpatient X-rays carry a $25 copay and coinsurance, and therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
The AARP Medicare Advantage from UHC NC-26 (HMO-POS) plan covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered with no copay and no coinsurance under AARP Medicare Advantage from UHC NC-26 (HMO-POS), though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC NC-26 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance and does not require a prior three-day inpatient hospital stay, though prior authorization is needed. There is no copay for days 1 through 20, while days 21 through 100 require a $218 daily copay, with no coverage provided for additional days.
Other Services See details
AARP Medicare Advantage from UHC NC-26 (HMO-POS) partially covers other services, providing a chronic illness meal benefit with no copay and no coinsurance, although prior authorization is required. Acupuncture, over-the-counter (OTC) items, and Dual Eligible SNPs with Highly Integrated Services are not covered.
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