AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) 2025 Plan Details for Caldwell County, North Carolina Residents
AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) 2025 Plan Details for Caldwell County, North Carolina Residents
When selecting a Medicare Advantage plan in Caldwell County for 2025, it's important to compare all your options. AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) is among the plans you can review side-by-side with others, ensuring you find the coverage that suits your needs. You can easily enroll online or reach out to a licensed agent for personalized guidance.
AARP Medicare Advantage Patriot No Rx NC-MA02 Overview
Plan ID H5253-040-0 Overview | |
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Health Plan ID: | H5253-040-0 |
Medicare Advantage Plan Type: | Local HMO |
Plan Year: | 2024 |
Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Annual Out-of-Pocket Maximum: | $6,900 |
Part B Give Back: | $100.00/mo |
Part D Drug Plan Benefit: | Not Included |
Part D Gap Coverage: | No |
Supplemental Benefits: | Vision, Hearing |
Availability: | Caldwell County, NC |
Insured By: | UnitedHealthcare |
Why Consider AARP Medicare Advantage Patriot No Rx NC-MA02?
AARP Medicare Advantage Patriot No Rx NC-MA02 is a Medicare Advantage Health Maintenance Organization - Point of Service (HMO-POS) plan that offers comprehensive and flexible healthcare coverage. With a monthly premium of $0.00, this plan includes all the benefits of Medicare Part A and Part B, ensuring you have access to essential medical care. As an HMO-POS plan, AARP Medicare Advantage Patriot No Rx NC-MA02 gives you the freedom to seek care both in and out of the plan’s network, with the advantage of lower costs when staying in-network.
Note that AARP Medicare Advantage Patriot No Rx NC-MA02 does not include Medicare drug coverage. For prescription drug needs, explore standalone Part D plans. A key benefit of AARP Medicare Advantage Patriot No Rx NC-MA02 is its financial protection through an annual maximum out-of-pocket (MOOP) limit of $6,900. Once you reach this limit, the plan covers 100% of your in-network healthcare costs for the remainder of the year. This makes AARP Medicare Advantage Patriot No Rx NC-MA02 an ideal choice for those who seek both flexibility and comprehensive healthcare coverage.
We're Here to Help You Enroll |
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Out-of-Pocket Costs
AARP Medicare Advantage Patriot No Rx NC-MA02 has cost-sharing, meaning you'll have out-of-pocket costs when using approved healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H5253-040-0.
Service | Enrollee Cost |
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Doctor's Office Visit (In-Network) | |
Primary: | $0 Copay |
Specialist: | $40 Copay Prior Authorization Required |
Wellness & Preventive Programs: | None |
Preventive care: | $0 Copay |
Foot Care (In-Network) | |
Foot Exams and Treatments (Medicare-covered): | $40 Copay Prior Authorization Required |
Routine Foot Care: | $40 Copay Prior Authorization Required |
Chiropractic Treatment (In-Network) | |
Medicare-covered chiropractic: | $15 Copay Prior Authorization Required |
Routine chiropractic: | Not Covered |
Emergency and Urgent Care | |
Emergency room care: | $100 Copay |
Urgent care: | $40 Copay |
Ground ambulance: | $0 |
Inpatient hospital care: | $375.00 per day for days 1 through 6 $0.00 per day for days 7 and beyond |
Outpatient hospital care: | $275 Copay Prior Authorization Required |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $203.00 per day for days 21 and beyond |
Optional supplemental benefits: | |
Mental Health Services (In-Network) | |
Outpatient individual therapy: | $25 Copay |
Outpatient group therapy: | $15 Copay |
Inpatient psychiatric hospital care: | $375.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Outpatient group therapy: | $15 Copay |
Outpatient individual therapy: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy: | $40 Copay Prior Authorization Required |
Occupational therapy: | $40 Copay Prior Authorization Required |
Medical Equipment and Supplies (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 (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 (In-Network) | |
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered) | 20% Coinsurance |
Most preventive services are covered 100% by AARP Medicare Advantage Patriot No Rx NC-MA02 as a Part B benefit.
Supplemental Benefits
Here’s an overview of the additional benefits that UnitedHealthcare offers with this plan:
Supplemental Healthcare Service | Member Cost |
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Preventive Dental | |
Oral exam (In-Network) | Not Covered |
Fluoride treatment (In-Network) | Not Covered |
Dental x-ray(s) (In-Network) | Not Covered |
Cleaning (In-Network) | Not Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Not Covered |
Non-routine services (In-Network) | Not Covered |
Diagnostic services (In-Network) | Not Covered |
Extractions (In-Network) | Not Covered |
Endodontics (In-Network) | Not Covered |
Restorative services (In-Network) | Not Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Not Covered |
Hearing Aids | |
Fitting/evaluation (In-Network) | Covered Limits may apply |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | Not Covered |
Vision | Maximum vision benefit: | $300.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | $0 Copay |
Routine eye exam (In-Network) | $0 Copay Prior Authorization Required |
Contact lenses (In-Network) | $0 Copay |
Additional Benefits
None specified.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
How CMS Star Ratings Guide Your Choice
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
CMS Measure | Star Rating |
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2024 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 |
Who Can Enroll in AARP Medicare Advantage Patriot No Rx NC-MA02?
To qualify for enrollment in AARP Medicare Advantage Patriot No Rx NC-MA02, you must:
- Be entitled to Medicare Part A and enrolled in Medicare Part B.
- Live within the plan’s designated service area.
- Not have End-Stage Renal Disease (ESRD), except under certain conditions.
If you fulfill these criteria, you can enroll in AARP Medicare Advantage Patriot No Rx NC-MA02 and enjoy the extensive healthcare benefits it offers.
Enrollment Periods for AARP Medicare Advantage Patriot No Rx NC-MA02
Knowing when you can enroll in AARP Medicare Advantage Patriot No Rx NC-MA02 is essential. Here are the main enrollment periods:
- Initial Enrollment Period (IEP): Your IEP starts three months before your 65th birthday and ends three months after, giving you a seven-month window to enroll in Medicare.
- Annual Enrollment Period (AEP): The AEP, from October 15 to December 7, allows you to make changes to your Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): Running from January 1 to March 31, the MA OEP lets you switch plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Life events such as moving or losing coverage may qualify you for a SEP, enabling you to enroll or make changes outside the usual periods.
If you're uncertain about the right time to enroll, Call HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711) for expert guidance from a licensed insurance agent.
Steps to Enroll in AARP Medicare Advantage Patriot No Rx NC-MA02
Enrolling in AARP Medicare Advantage Patriot No Rx NC-MA02 is easy. Choose the option that works best for you:
- Online through MedicareEnrollment.com: Visit the enrollment page and complete your enrollment through their Secure Online Enrollment Form.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711). A licensed insurance agent can assist you with the enrollment process and provide answers to any questions.
- Through Medicare.gov: Go to Medicare.gov, log in or create an account, and follow the instructions to join AARP Medicare Advantage Patriot No Rx NC-MA02 through the official Medicare website.
- Directly with AARP Medicare Advantage Patriot No Rx NC-MA02: You can also enroll directly with the plan. The necessary contact details are provided below in the "Contact" section.
Remember to enroll during the correct enrollment period to ensure your coverage starts on time.
Contact UnitedHealthcare
Website: | http://AARPMedicarePlans.com |
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Formulary: | http://AARPMedicarePlans.com |
Pharmacy: | UnitedHealthcare Pharmacy Page |
New Members: | (800)555-5757 |
TTY Users: | 711 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, you can do so on the Social Security Administration website. For more information about the Medicare Part C program, visit the official Medicare website or call 1-800-MEDICARE.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
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