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UHC Complete Care NC-27 (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-27 (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-27 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care NC-27 (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 2026.
It's important to know that UHC Complete Care NC-27 (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-27 (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-27 (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-27 (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 $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 UHC Complete Care NC-27 (HMO-POS C-SNP) plan features an annual prescription drug deductible of $440. For Tier 1 preferred generic drugs, members pay no copay for 1-month and 3-month supplies at standard pharmacies and through mail order. Tier 2 generic drugs cost a $5 copay for a 1-month supply at standard pharmacies, but are available with no copay for a 3-month supply through preferred mail order. For higher-tier medications, Tier 3 preferred brand drugs require a 21% coinsurance for both standard pharmacy and mail-order fills. Tier 4 non-preferred drugs carry a 45% coinsurance for a 1-month supply, while Tier 5 specialty drugs require a 28% coinsurance for a 1-month supply across standard pharmacies and mail-order options.
Additional Benefits
The UHC Complete Care NC-27 (HMO-POS C-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care, telehealth, and routine preventive services. For inpatient hospital stays, members pay a $395 daily copay for the first six days and no copay thereafter, while specialist visits require copays ranging from $0 to $35 with no coinsurance. Emergency care is available with a $130 copay, which is waived upon hospital admission, and worldwide emergency services have no copay or coinsurance. This plan also features valuable daily benefits, including routine hearing and vision exams with no copay, along with prescription eyewear and hearing aid coverage with no coinsurance. Preventive dental services, home health care, and over-the-counter items are covered with no copay, while durable medical equipment and Medicare-covered dental care require a 20% coinsurance. These balanced cost-sharing features make the plan an attractive option for individuals seeking predictable health care expenses.
Inpatient Hospital See details
UHC Complete Care NC-27 (HMO-POS C-SNP) covers inpatient hospital-acute stays with no coinsurance, requiring a $395 daily copay for days 1 through 6 and no copay for days 7 and beyond. 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, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Complete Care NC-27 (HMO-POS C-SNP) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital copays range from $0 to $395, observation services carry a $395 daily copay, and outpatient substance abuse sessions require copays between no copay and $25.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Complete Care NC-27 (HMO-POS C-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
UHC Complete Care NC-27 (HMO-POS C-SNP) partially covers ambulance and transportation services, offering ground and air ambulance services with a $290 copay, no coinsurance, and prior authorization required. Transportation services to plan-approved or any health-related locations are not covered under this plan.
Emergency Services See details
UHC Complete Care NC-27 (HMO-POS C-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Complete Care NC-27 (HMO-POS C-SNP) offers primary care, telehealth, and opioid treatment services with no copay and no coinsurance. Specialist visits, mental health, and therapy services are covered with no coinsurance and copays ranging from $0 to $35, while some chiropractic services are covered but routine and other chiropractic services are not.
Preventive Services See details
UHC Complete Care NC-27 (HMO-POS C-SNP) covers preventive services, including annual physical exams, kidney disease education, and select screenings, with no copay and no coinsurance. Additional preventive benefits are partially covered with no copay or coinsurance for fitness benefits and home safety devices; however, health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Complete Care NC-27 (HMO-POS C-SNP), offering one routine hearing exam per year with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids are covered with a copay of $199 to $1,249 and no coinsurance (excluding inner ear, outer ear, and over the ear types), while OTC hearing aids have a copay of $199 to $829 and no coinsurance.
Vision Services See details
Vision services are covered by UHC Complete Care NC-27 (HMO-POS C-SNP) with no coinsurance, featuring no copay for one routine eye exam per year, while other eye exam services are not covered. Eyewear is partially covered up to a $300 limit every two years with no coinsurance, offering no copay for contact lenses or frames and a $0 to $153 copay for eyeglass lenses, though eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are partially covered by UHC Complete Care NC-27 (HMO-POS C-SNP), offering Medicare-covered dental care with no copay and 20% coinsurance, as well as preventive services with no copay and no coinsurance. Major services not covered under this plan include restorative, endodontics, periodontics, prosthodontics, implants, oral and maxillofacial surgery, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Complete Care NC-27 (HMO-POS C-SNP) with no copay, although prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance, while insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by UHC Complete Care NC-27 (HMO-POS C-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered under the UHC Complete Care NC-27 (HMO-POS C-SNP) plan, offering durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies and therapeutic shoes or inserts are also covered with no copays and no coinsurance, though prior authorization is required and manufacturer limits apply.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Complete Care NC-27 (HMO-POS C-SNP) with prior authorization required. There is no copay or coinsurance for lab and diagnostic radiological services, while diagnostic tests require a $50 copay (no coinsurance), outpatient X-rays require a $25 copay plus coinsurance, and therapeutic radiological services require a copay and 20% coinsurance.
Home Health Services See details
UHC Complete Care NC-27 (HMO-POS C-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Complete Care NC-27 (HMO-POS C-SNP) covers some cardiac rehabilitation services with no copay and no coinsurance, although prior authorization is required. 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) care is covered by UHC Complete Care NC-27 (HMO-POS C-SNP) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UHC Complete Care NC-27 (HMO-POS C-SNP) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and other miscellaneous services are not covered under this benefit, and prior authorization is required for meals.
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