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AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in San Antonio Metro Area. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS).
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 AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS), 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 $600.00 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 Maximum Out-Of-Pocket cost of $6700.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) prescription drug plan features an annual drug deductible of $600. For Tier 1 preferred generic drugs, there is no copay for standard pharmacy fills and mail-order deliveries. Tier 2 generic drugs carry a $10 copay for a one-month supply at standard pharmacies, though you can secure a three-month supply with no copay through preferred mail order. For brand-name and specialty medications, costs transition to coinsurance percentages instead of flat copays. Tier 3 preferred brand drugs require a 16% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require 32% and 26% coinsurance respectively. These clear cost-sharing tiers help you easily estimate your out-of-pocket medication expenses with this UHC plan.
Additional Benefits
The AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) offers comprehensive medical coverage with predictable costs, featuring no copay or coinsurance for primary care, telehealth, and preventive services. Specialist visits require a copay of up to $60, while emergency room services carry a $130 copay that is waived if you are admitted. For hospital care, inpatient stays require a $550 daily copay for the first few days, and outpatient hospital services range from no copay up to a $550 copay. In addition to medical care, the plan provides routine dental, vision, and hearing benefits with no copays for annual exams. Dental services are covered up to a $1,000 annual limit with no copay and up to 50% coinsurance for comprehensive care, while select hearing aids and eyewear are available with low to moderate copays. Specialized services like dialysis and durable medical equipment require no copay but carry 20% and 50% coinsurance respectively, while home health and over-the-counter items are fully covered with no copay.
Inpatient Hospital See details
Inpatient hospital services are partially covered by AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) with no coinsurance, requiring a $550 copay for days 1 through 5 of an acute stay and days 1 through 4 of a psychiatric stay, with no copay for subsequent days. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered under this benefit.
Outpatient Services See details
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $550, observation services have a $550 daily copay, and outpatient substance abuse services range from no copay to a $25 copay.
Partial Hospitalization See details
Partial hospitalization is covered under the AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) plan with a $105.00 copay and no coinsurance. Both a referral and prior authorization are required to access these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) partially covers ambulance and transportation services, with ground and air ambulance services requiring a $275 copay and no coinsurance. Prior authorization is required for ambulance transfers, and transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) covers primary care, telehealth, and opioid treatment services with no copay and no coinsurance, while specialist visits require a $0 to $60 copay and no coinsurance. Outpatient therapies, mental health, and podiatry services are also covered with copays ranging up to $60 and no coinsurance, though chiropractic services are not covered.
Preventive Services See details
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) provides partially covered preventive services with no copay and no coinsurance for covered benefits like annual physical exams, fitness benefits, and glaucoma screenings. However, several supplemental benefits, including health education, weight management programs, and personal emergency response systems, are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) with no coinsurance required. Routine hearing exams have no copay, while fitting evaluations and inner, outer, or over-the-ear prescription hearing aids are not covered; other prescription hearing aids carry a $199 to $1,249 copay and OTC hearing aids have a $199 to $829 copay (with a limit of 2 of each aid type per year).
Vision Services See details
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) provides partially covered vision services with no deductible and no coinsurance, including one routine eye exam per year with no copay. Covered eyewear includes contact lenses and frames with no copay, and lenses with a $0 to $153 copay up to a $150 maximum benefit every two years, while other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) up to a $1,000 annual limit, with implants and orthodontics excluded from coverage. Preventive care is offered with no copay and no coinsurance, Medicare-covered services require no copay and 20% coinsurance, and covered comprehensive services have no copay and 50% coinsurance.
Home Infusion bundled Services See details
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Medicare Part B chemotherapy, radiation, and other drugs have a coinsurance ranging from no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) covers dialysis services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and 50% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require 50% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS), with prior authorization and referrals required for care. Lab services and diagnostic radiology have no copay, diagnostic tests require a $50 copay with no coinsurance, outpatient X-rays have a $30 copay with coinsurance, and therapeutic radiology has a 20% coinsurance.
Home Health Services See details
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) covers home health services with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) with no copay and no coinsurance. While some services are covered, specific sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, though prior authorization and a referral are required. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, and a prior 3-day inpatient hospital stay is not required.
Other Services See details
AARP Medicare Advantage CareFlex from UHC TX-45 (HMO-POS) partially covers other services, providing over-the-counter (OTC) items and a meal benefit for chronic illness with no copay and no coinsurance. Acupuncture is not covered under these services, and the meal benefit requires prior authorization.
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