AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) Plan Details for Caldwell County, NC
Many of the plans featured here are available through our partner, HealthCompare, who may compensate us when you enroll in a plan. This does not influence our evaluations. Our opinions are our own, based on our independent research. Learn more about how we make money.
*CMS rated this UnitedHealthcare plan (H5253-040-0) 4 (Good) out of 5 stars.
AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) is a Medicare Advantage plan with prescription drug benefits. Eligibility applies. Enroll online today.
See more Medicare Advantage Plans in Caldwell County, North Carolina.
AARP Medicare Advantage Patriot No Rx NC-MA02 Basic Details
Plan Basics | |
---|---|
Plan ID: | H5253-040-0 |
Plan Type: | HMO-POS |
Plan Year: | 2025 |
Premium: | $0.00/mo Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Out-of-Pocket Maximum: | 7,900.00 /yr (in-network) |
Part B Reduction: | $0.00/mo |
Drug Plan Benefit: | Not Included |
Supplemental Benefits: | Vision, Hearing |
Availability: | Caldwell County, NC |
Insured By: | UnitedHealthcare |
Summary of Benefits |
---|
UnitedHealthcare Out-of-Pocket Costs
This UnitedHealthcare Part C plan has cost-sharing. These are costs you pay out-of-pocket when you use approved health services. The following table summarizes the most common in-network out-of-pocket costs in plan H5253-040-0.
NOTE: Certain preventive services are covered 100% by the plan as a Part B benefit.
Doctor's Office Visits
Service | Enrollee Cost (in-network) |
---|---|
Primary: | $0 Copay |
Specialist: | $50 Copay Prior Authorization Required |
Emergency, Urgent, and Inpatient Hospital Coverage
Service | Enrollee Cost |
---|---|
Emergency room care: | $110 Copay |
Urgent care: | $45 Copay |
Ground ambulance: | $290 Copay |
Inpatient hospital care: | $475.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $203.00 per day for days 21 and beyond |
Foot Care
Service | Enrollee Cost (in-network) |
---|---|
Foot Exams and Treatments (Medicare-covered): | $45 Copay Prior Authorization Required |
Routine Foot Care: | $45 Copay Prior Authorization Required |
Chiropractic Care
Service | Enrollee Cost (in-network) |
---|---|
Medicare-covered chiropractic: | $15 Copay Prior Authorization Required |
Routine chiropractic: | Not Covered |
Mental Health Services
Service | Enrollee Cost (in-network) |
---|---|
Outpatient individual therapy: | $25 Copay |
Outpatient group therapy: | $15 Copay |
Inpatient psychiatric hospital care: | $475.00 per day for days 1 through 4 $0.00 per day for days 5 and beyond |
Rehabilitation Services
Service | Enrollee Cost (in-network) |
---|---|
Physical therapy and speech and language therapy: | $50 Copay Prior Authorization Required |
Occupational therapy: | $35 Copay Prior Authorization Required |
Medical Equipment and Supplies
Service | Enrollee Cost (in-network) |
---|---|
Diabetes supplies: | $0 Copay Prior Authorization Required |
Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
Prosthetics: | 20% Coinsurance |
Diagnostics, Lab Services, and Imaging
Service | Enrollee Cost (in-network) |
---|---|
Diagnostic radiology services: | $225 Copay Prior Authorization Required |
Lab services: | $0 Copay Prior Authorization Required |
Outpatient x-rays: | $25 Copay Prior Authorization Required |
Diagnostic tests and procedures: | $45 Copay Prior Authorization Required |
Medicare Part B Drugs
Service | Enrollee Cost (in-network) |
---|---|
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered): | 20% Coinsurance |
Dental Services
Service | Member Cost (in-network) |
---|---|
Medicare Covered Preventive Dental | 20% Coinsurance Prior Authorization Required |
Oral exam | $0 Copay |
Dental x-rays | $0 Copay |
Cleaning | $0 Copay |
Periodontics | Not Covered |
Endodontics | Not Covered |
Restorative Services | Not Covered |
Hearing Aids and Services
Service | Member Cost (in-network) |
---|---|
Fitting/evaluation | Covered Limits may apply |
Hearing aids | Covered Limits may apply |
Hearing exam | Not Covered |
Vision Services
Service | Member Cost (in-network) |
---|---|
Medicare-covered eye exam | $0 Copay |
Routine eye exam | $0 Copay 1 Every year |
Eyewear benefits | Eyeglasses: No Contact Lenses: No Eyeglass Lenses: No Eyeglass Frames: No Eyewear Upgrades: No |
Maximum eyewear benefit: | $2.00 Every three years |
Feel free to download our AARP Medicare Advantage Patriot No Rx NC-MA02 Summary of Benefits information.
Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Rating Marks
Each year the Centers for Medicare & Medicaid Services (CMS) rates health plans (Part C) and drug plans (Part D) in several major categories using a 5-star rating system. These ratings are designed to help you understand the quality of care and service you can expect if you join AARP Medicare Advantage Patriot No Rx NC-MA02 .
CMS Measure | Star Rating |
---|---|
2025 Overall Rating | |
Staying Healthy: Screenings, Tests, Vaccines | |
Managing Chronic (Long Term) Conditions | |
Member Experience with Health Plan | |
Complaints and Changes in Plans Performance | |
Health Plan Customer Service | |
Drug Plan Customer Service | |
Complaints and Changes in the Drug Plan | |
Member Experience with the Drug Plan | |
Drug Safety and Accuracy of Drug Pricing |
Additional Plan Options
The Medicare Part C program offers a myriad of HMO, PPO, and PFFS plan options, including these plans:
- AARP Medicare Advantage Patriot No Rx TC-MA01 (HMO-POS)
- AARP Medicare Advantage from UHC VA-0011 (HMO-POS)
- AARP Medicare Advantage from UHC PA-0003 (HMO-POS)
- AARP Medicare Advantage Extras from UHC OH-11 (HMO-POS)
- AARP Medicare Advantage from UHC PA-0001 (HMO-POS)
- AARP Medicare Advantage from UHC OK-0001 (HMO-POS)
- AARP Medicare Advantage Essentials from UHC OH-5 (HMO-POS)
If you are enrolled in a Part C plan with prescription drug coverage, you cannot be enrolled in a stand-alone Medicare Part D plan, regardless of your chosen insurance company.
You cannot be enrolled in a Part C health plan and simultaneously hold Medicare Supplement Insurance (Medigap). Medicare Supplement plans are only compatible with Medicare Parts A and B.
Contact UnitedHealthcare
Website: | UnitedHealthcare Plan Page |
---|---|
Providers: | UnitedHealthcare Providers Page |
New Member Health Plan Help: | (800)555-5757 |
New Member Health Plan TTY: | 711 |
If you qualify for Medicare benefits but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Part C program on www.medicare.gov or call 1-800-MEDICARE.
Citations & References
- UnitedHealthcare, http://AARPMedicarePlans.com, Last Accessed February 20, 2024
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed January 21, 2024
- Medicare.gov, "Compare Original Medicare & Medicare Advantage", Last Accessed February 19, 2024
- Medicare.gov, "Medicare & You in Different Formats", Last Accessed February 19, 2024
- Medicare.gov, "Your Medicare Coverage", Last Accessed April 11, 2023
- CMS.gov, Landscape Source Files, Last Accessed February 21, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed February 21, 2024
- CMS.gov, Plan Benefits Package, Last Accessed February 21, 2024
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.