AARP Medicare Advantage Access from UHC NC-23 (PPO)

SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. · 2026 plan year

Plan ID H2001-084-000

Local PPO★ 4.5 CMS Stars
MOOP (in-network)
$3,000
MOOP (combined)
$3,000
Monthly premium
$255/mo
Part C $102 + Part D $153, before Extra Help
Prescription drugs
Included

Plan information

Contract / Plan / Segment
H2001-084-000
Medical deductible
$0 — no deductible
Part D premium
$153/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$600/yr
Also owed
Your Medicare Part B premium, paid separately

More SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. plans in NC

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — AcuteNo charge
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — PsychiatricNo charge
Worldwide Urgent Care CoverageNo charge

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual SessionsNo charge
Mental Health — Group SessionsNo charge
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Hearing — Hearing Aids (All Types)$199-$1,249
Hearing — OTC Hearing Aids$199-$829
Diabetic SuppliesNo charge
Emergency ServicesNo charge
Skilled Nursing Facility (SNF)No charge
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional SessionsNo charge
Intensive Cardiac Rehabilitation — Additional SessionsNo charge
Pulmonary Rehabilitation — Additional SessionsNo charge
Supervised Exercise Therapy (SET)No charge
Urgently Needed ServicesNo charge
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency CoverageNo charge
Worldwide Emergency TransportationNo charge
Partial Hospitalization ProgramNo charge
Intensive Outpatient Program (IOP)No charge
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic ServicesNo charge
Occupational Therapy ServicesNo charge
Physician Specialist ServicesNo charge
Podiatry ServicesNo charge
Podiatry ServicesNo charge
Other Health Care Professional ServicesNo charge
Psychiatric ServicesSee plan details
Psychiatric Services — Individual SessionsNo charge
Psychiatric Services — Group SessionsNo charge
Physical Therapy & Speech-Language PathologyNo charge
Additional Telehealth Services (Part B)No charge
Opioid Treatment Program ServicesNo charge
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & TestsNo charge
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Diagnostic RadiologyNo charge
Therapeutic RadiologyNo charge
X-Ray ServicesNo charge
Outpatient Hospital ServicesNo charge
Hospital Observation ServicesNo charge
Ambulatory Surgical Center (ASC)No charge
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual SessionsNo charge
Substance Abuse — Group SessionsNo charge
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground AmbulanceNo charge
Air AmbulanceNo charge
Durable Medical Equipment (DME)No charge
Prosthetics & OrthoticsSee plan details
Prosthetic DevicesNo charge
Medical SuppliesNo charge
Diabetic Supplies & ServicesSee plan details
Diabetic Therapeutic Shoes & InsertsNo charge
Dialysis Services20% coinsurance
Meal BenefitNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Fitness BenefitNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)0%-20% coinsurance (max $35)
Dental — Medicare-Covered ServicesNo charge
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Hearing — Prescription Hearing AidsSee plan details
Dental — Other Preventive ServicesNo charge
Dental — ComprehensiveSee plan details
Dental — Restorative Services50% coinsurance
Dental — Endodontics (Root Canal)50% coinsurance
Dental — Periodontics (Gum Care)50% coinsurance
Dental — Removable Prosthodontics (Dentures)50% coinsurance
Dental — Maxillofacial Prosthetics50% coinsurance
Dental — Fixed Prosthodontics (Bridges)50% coinsurance
Dental — Oral & Maxillofacial Surgery50% coinsurance
Dental — Adjunctive General Services50% coinsurance
Vision — Eye ExamsNo charge
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglass Lenses$0-$153
Vision — Eyeglass FramesNo charge
Hearing — ExamsNo charge
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge

Service area

  • NC: 99 counties

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