Coverage and benefits

Get a quick overview of your plan benefits and costs and find more detailed information about additional benefits and programs.

Important information about your Part D vaccine and insulin coverage

What you pay for vaccines – Our plan covers most adult Part D vaccines at no cost to you.

What you pay for insulin – You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan. Refer to your plan materials.

2026 materials

Duke Energy MAPD Plan 1 (PPO)

Duke Energy MAPD Plan 2 (PPO)

Preventive services

The following preventive services are covered under your plan for a $0 copay when you visit your primary care physician:

Screening and counseling to reduce alcohol misuse
Screening for depression in adults
Screening for Sexually Transmitted Infections (STIs) and high intensity behavioral counseling to prevent STIs
Intensive behavioral therapy to reduce cardiovascular disease risk
Screening and counseling for obesity

For more information about these preventive services, please call the Customer Service number on your plan ID card.

Benefits and costs

For premium information, please contact UnitedHealthcare at 1-844-589-3862, 8 a.m. – 8 p.m. local time, Monday - Friday. TTY users, call 711

Plan options and costs
Benefit	Duke Energy MAPD Plan 1 (PPO)	Duke Energy MAPD Plan 2 (PPO)
Duke Energy MAPD Plan 1 (PPO)	Duke Energy MAPD Plan 2 (PPO)
Annual medical deductible	$0	$50
Annual medical deductible
$0	$50
Annual out-of-pocket maximum	$0	$350 Copays and coinsurance apply to annual medical deductible and out-of-pocket maximum
Annual out-of-pocket maximum
$0	$350 Copays and coinsurance apply to annual medical deductible and out-of-pocket maximum
Office and clinic visits	$0 copay	$35 copay
Office and clinic visits
$0 copay	$35 copay
Hospital services (inpatient)	$0 copay	$50 copay per day, days 1 – 7 $0 copay days 8+
Hospital services (inpatient)
$0 copay	$50 copay per day, days 1 – 7 $0 copay days 8+
Hospital services (outpatient)	$0 copay	20% coinsurance
Hospital services (outpatient)
$0 copay	20% coinsurance
Prescription drug coverage	Tier 1 – Preferred generic: $0 copay Tier 2 – Generic: $8 copay Tier 3 – Preferred brand: $40 copay Tier 4 – Non-preferred drug: $90 copay Tier 5 – Specialty drugs: 29% coinsurance Rx Deductible: $300 (applies to Tiers 3 – 5)	Tier 1 – Preferred generic: $0 copay Tier 2 – Generic: $8 copay Tier 3 – Preferred brand: $40 copay Tier 4 – Non-preferred drug: $90 copay Tier 5 – Specialty drugs: 29% coinsurance Rx Deductible: $300 (applies to Tiers 3 – 5)
Prescription drug coverage
Tier 1 – Preferred generic: $0 copay Tier 2 – Generic: $8 copay Tier 3 – Preferred brand: $40 copay Tier 4 – Non-preferred drug: $90 copay Tier 5 – Specialty drugs: 29% coinsurance Rx Deductible: $300 (applies to Tiers 3 – 5)	Tier 1 – Preferred generic: $0 copay Tier 2 – Generic: $8 copay Tier 3 – Preferred brand: $40 copay Tier 4 – Non-preferred drug: $90 copay Tier 5 – Specialty drugs: 29% coinsurance Rx Deductible: $300 (applies to Tiers 3 – 5)

Disclaimer

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.