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AARP Medicare Advantage CareFlex from UHC ST-6 (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 ST-6 (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 ST-6 (HMO-POS) in 2025, please refer to our full plan details page.

AARP Medicare Advantage CareFlex from UHC ST-6 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Missouri and Illinois. This plan received an overall rating of 4 out of 5 stars in 2025.

It's important to know that AARP Medicare Advantage CareFlex from UHC ST-6 (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Overview IconKey Plan Facts

Below are a few key facts and commonly-asked questions about AARP Medicare Advantage CareFlex from UHC ST-6 (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 ST-6 (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 $495.00 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:

Regular visits to your primary care doctor are covered and will have a copay of $0.00 and coinsurance of 0% (no coinsurance).

Specialist Visits:

Visits to specialists are covered and will have a copay of $0.00 - $50.00 and coinsurance of 0% (no coinsurance). Specialist visits may require a referral from your primary care doctor or prior authorization.

Emergency Room:

Trips to the Emergency Room are covered, and will have a copay of $125.00 and coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Urgent Care:

Trips to Urgent Care arecovered and will have a copay of $0.00 - $55.00 and coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Sign up for AARP Medicare Advantage CareFlex from UHC ST-6 (HMO-POS)

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Drug Coverage IconDrug Coverage

The AARP Medicare Advantage CareFlex from UHC ST-6 (HMO-POS) plan has an enhanced alternative drug benefit. The plan has a deductible of $495. During the initial coverage phase, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy used. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, you may have a reduced premium.

Additional Benefits IconAdditional Benefits

The AARP Medicare Advantage CareFlex from UHC ST-6 (HMO-POS) plan offers comprehensive coverage with a variety of benefits. The plan includes inpatient hospital stays with a copay, outpatient services with copays varying by service, and emergency services with a $125 copay. Primary care, preventive services, and vision services, including eye exams and eyewear, are covered with no copay. Additional benefits include coverage for hearing exams, dental services, home health services with no copay, and medical equipment with coinsurance. The plan also covers ambulance services with a $275 copay, and offers coverage for home infusion and dialysis services with coinsurance. Additionally, the plan provides coverage for skilled nursing facility stays with a copay, and covers over-the-counter items and meal benefits.

Inpatient Hospital See details

Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization. For Inpatient Hospital-Acute, you'll pay a $495 copay for days 1-5, and no copay for days 6-90, with no coinsurance. For Inpatient Hospital Psychiatric, the copay is $495 for days 1-4, and no copay for days 5-90, with no coinsurance. Additional days for Inpatient Hospital-Acute are covered with no copay or coinsurance, while Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered.

Outpatient Services See details

Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $495, observation services with a $495 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay between $0 and $50 for individual sessions and a $50 copay for group sessions, and outpatient blood services with no copay. Prior authorization is required for all services.

Partial Hospitalization See details

Partial Hospitalization is covered, but requires prior authorization. You will pay a $105 copay for this benefit.

Ambulance and Transportation Services See details

Ambulance and Transportation Services are covered by the AARP Medicare Advantage CareFlex from UHC ST-6 (HMO-POS) plan. Ground and air ambulance services have a $275 copay, with no coinsurance. Transportation services to any health-related location are not covered.

Emergency Services See details

Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the AARP Medicare Advantage CareFlex from UHC ST-6 (HMO-POS) plan. Emergency Services have a $125 copay with no coinsurance, while Urgently Needed Services have a copay between $0 and $55 with no coinsurance. Worldwide Emergency Services has a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation with no coinsurance.

Primary Care See details

The AARP Medicare Advantage CareFlex from UHC ST-6 (HMO-POS) plan offers primary care benefits including no copay for primary care physician services, a $20 copay for chiropractic services, and a copay ranging from $0 to $35 for occupational therapy services. The plan also covers physician specialist services with a copay from $0 to $50, and mental health and psychiatric services with a copay that can range from $0 to $50. Other covered services include podiatry, with a $45 copay, other health care professional services with a copay from $0 to $50, physical therapy and speech-language pathology services with a copay from $0 to $50, additional telehealth benefits with no copay, and opioid treatment program services with no copay.

Preventive Services See details

Preventive services include an annual physical exam with no copay, and other preventive services like glaucoma screening, diabetes self-management training, and more with no copay. Additional preventive services such as health education, in-home safety assessment, and others are not covered.

Hearing Services See details

Hearing exams are covered with a $50 copay, while routine hearing exams have no copay. Prescription hearing aids are covered with a copay between $199 and $1249, depending on the type of hearing aid, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.

Vision Services See details

Vision Services include coverage for eye exams and eyewear. Eye exams have no copay, while routine eye exams are limited to one per year. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames with no copay, and a combined maximum benefit of $300 every two years; however, eyeglasses (lenses and frames) and upgrades are not covered.

Dental Services See details

Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Other Dental Services are covered, with a $1,000 maximum plan benefit coverage every year.

Home Infusion bundled Services See details

Home Infusion bundled Services are covered, but prior authorization is required. For Medicare Part B insulin drugs, you will pay a $35 copay and 0-20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay 0-20% coinsurance.

Dialysis Services See details

Dialysis Services are covered by the AARP Medicare Advantage CareFlex from UHC ST-6 (HMO-POS) plan, but require prior authorization. You are responsible for 20% coinsurance.

Medical Equipment See details

Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 50% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a 50% coinsurance, and Diabetic Supplies have no copay. Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.

Diagnostic and Radiological Services See details

Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a $75 copay, and Lab Services with no copay. Diagnostic Radiological Services have a copay up to $190, and Outpatient X-Ray Services have a $50 copay. Therapeutic Radiological Services have a 20% coinsurance.

Home Health Services See details

Home Health Services are covered by the AARP Medicare Advantage CareFlex from UHC ST-6 (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.

Cardiac Rehabilitation Services See details

Cardiac Rehabilitation Services are covered with prior authorization, but none of the sub-services are covered. There is a copay for the sub-services, but the amount is not specified in this summary.

Skilled Nursing Facility (SNF) See details

Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.

Other Services See details

The AARP Medicare Advantage CareFlex from UHC ST-6 (HMO-POS) plan's other services include Over-the-Counter (OTC) items and meal benefits. OTC items have no copay, and meal benefits also have no copay and require prior authorization. Acupuncture, Dual Eligible SNPs, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.

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