A non-government entity
UHC Complete Care NC-28 (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-28 (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-28 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care NC-28 (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-28 (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-28 (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-28 (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-28 (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 $355.00 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:
Sign up for UHC Complete Care NC-28 (HMO-POS C-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Complete Care NC-28 (HMO-POS C-SNP) prescription drug plan has an annual drug deductible of $355. Tier 1 preferred generic drugs feature no copay for 1-month or 3-month fills at standard pharmacies, as well as 3-month mail orders. Tier 2 generic drugs have a $5 copay for a 1-month supply at standard pharmacies, but you can save with no copay on a 3-month supply through preferred mail order. Higher-tier prescription medications under this plan require coinsurance instead of flat copays. Tier 3 preferred brand drugs carry a 22% coinsurance for both 1-month and 3-month supplies. Non-preferred drugs in Tier 4 require a 46% coinsurance, while Tier 5 specialty drugs have a 29% coinsurance for a 1-month supply.
Additional Benefits
The UHC Complete Care NC-28 (HMO-POS C-SNP) plan offers affordable access to essential medical care, featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. For specialized care, specialist visits range from no copay to $25, while acute inpatient hospital stays require a $455 daily copay for the first six days. Emergency room visits carry a $150 copay, which is waived upon admission, while urgently needed services range from no copay to $65. Routine dental, hearing, and vision exams are covered with no copay and no coinsurance, though advanced services like prescription hearing aids and eyewear require copays. Durable medical equipment, dialysis, and Medicare-covered dental services require a 20% coinsurance with no copay. Additionally, members benefit from over-the-counter items and home-delivered meals with no copay, although cardiac rehabilitation is not covered.
Inpatient Hospital See details
UHC Complete Care NC-28 (HMO-POS C-SNP) covers inpatient hospital services with no coinsurance, requiring a $455 copay for days 1 to 6 of acute stays (no copay for days 7 and beyond) and a $455 copay for days 1 to 5 of psychiatric stays (no copay for days 6 to 90). Prior authorization is required, and the benefit is partially covered as upgrades, psychiatric additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Complete Care NC-28 (HMO-POS C-SNP) covers outpatient services with no coinsurance, though copays vary by service and prior authorization is generally required. Outpatient hospital services have a copay of up to $455, while ambulatory surgical center and blood services feature no copay, and outpatient substance abuse sessions range from no copay up to $25.
Partial Hospitalization See details
UHC Complete Care NC-28 (HMO-POS C-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Complete Care NC-28 (HMO-POS C-SNP), featuring a $275.00 copay and no coinsurance for ground and air ambulance services, which require prior authorization. For transportation benefits, some services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by UHC Complete Care NC-28 (HMO-POS C-SNP) with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay ranging from no copay to $65 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-28 (HMO-POS C-SNP) covers primary care and telehealth services with no copay and no coinsurance. Specialist visits, mental health sessions, and physical therapy are also covered with copays ranging from $0 to $25 and no coinsurance, though routine chiropractic care is not covered.
Preventive Services See details
Preventive services are covered by UHC Complete Care NC-28 (HMO-POS C-SNP) 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, as the plan excludes health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge 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.
Hearing Services See details
Hearing services are partially covered by UHC Complete Care NC-28 (HMO-POS C-SNP), offering annual routine exams with no copay, no coinsurance, and no deductible, though fittings and inner, outer, or over-the-ear prescription aids are not covered. Covered prescription hearing aids require a $199 to $1,249 copay and OTC hearing aids require a $199 to $829 copay, both with no coinsurance for up to two devices per year.
Vision Services See details
Vision services are partially covered by UHC Complete Care NC-28 (HMO-POS C-SNP) with no deductible and no coinsurance. Covered benefits include one routine eye exam annually with no copay, as well as a $150 eyewear allowance every two years for contact lenses and eyeglass frames with no copay, and eyeglass lenses with a $0 to $153 copay, while other eye exams, combined eyeglasses, and upgrades are not covered.
Dental Services See details
UHC Complete Care NC-28 (HMO-POS C-SNP) partially covers dental services, providing Medicare-covered dental care with no copay and a 20% coinsurance, as well as preventive services with no copay and no coinsurance. However, several sub-services are not covered, including restorative, endodontic, periodontic, prosthodontic, oral surgery, orthodontic, and implant services.
Home Infusion bundled Services See details
UHC Complete Care NC-28 (HMO-POS C-SNP) covers home infusion bundled services with no copay and no coinsurance, though prior authorization and step therapy are required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the UHC Complete Care NC-28 (HMO-POS C-SNP) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
UHC Complete Care NC-28 (HMO-POS C-SNP) covers 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 copay and no coinsurance, though prior authorization is required and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under UHC Complete Care NC-28 (HMO-POS C-SNP), requiring prior authorization for all services. Diagnostic tests carry a $50 copay with no coinsurance, lab services and diagnostic radiology feature no copay, outpatient X-rays require a $20 copay, and therapeutic radiology services incur a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by UHC Complete Care NC-28 (HMO-POS C-SNP) with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are not covered under the UHC Complete Care NC-28 (HMO-POS C-SNP) plan because all sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Complete Care NC-28 (HMO-POS C-SNP) with no coinsurance and no prior three-day hospital stay requirement. Prior authorization is required, with no copay for days 1 to 20, a $218 daily copay for days 21 to 100, and no coverage for additional days.
Other Services See details
UHC Complete Care NC-28 (HMO-POS C-SNP) partially covers other services, offering over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and other additional services are not covered, and prior authorization is required for the meal benefit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved