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AARP Medicare Advantage CareFlex from UHC TX-47 (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-47 (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-47 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Texas. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage CareFlex from UHC TX-47 (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-47 (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-47 (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:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS)
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Drug Coverage
The AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) plan has a $495 deductible for prescription drugs. Once the deductible is met, you will pay a copay for your prescriptions. The copay for preferred generic drugs at a standard pharmacy is $10.00, while standard generic drugs have a $47 copay. For preferred brand drugs, the copay is $100.00, regardless of the pharmacy. Non-preferred drugs have a 27% coinsurance. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage CareFlex plan offers comprehensive coverage with a focus on outpatient and preventive services. You'll find no copay for primary care visits, routine hearing exams, eye exams, and many preventive services, including annual physical exams. The plan also covers inpatient hospital stays, outpatient services, and emergency services with varying copays. This plan provides coverage for hearing aids, vision services, and dental services. Dental coverage includes preventive services with no copay, while hearing services include routine hearing exams with no copay. The plan also covers ambulance, home health, and skilled nursing facility services.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you pay a $495 copay for days 1-5, and no copay for days 6-90, with no coinsurance. For Inpatient Hospital Psychiatric, you pay a $495 copay for days 1-4 and no copay for days 5-90, with no coinsurance. Additional days for Inpatient Hospital Psychiatric and Non-Medicare-covered stays for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, Outpatient Substance Abuse Services, and Outpatient Blood Services, are covered. Outpatient Hospital Services have a copay between $0 and $495, Observation Services have a $495 copay, Ambulatory Surgical Center (ASC) Services have no copay, Individual Sessions for Outpatient Substance Abuse have a copay between $0 and $25, Group Sessions for Outpatient Substance Abuse have a $15 copay, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) plan, and requires prior authorization and a doctor referral. There is no copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) plan. Ground and Air Ambulance Services have a $275 copay, with no coinsurance, while 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. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55, and Worldwide Emergency Services have a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The AARP Medicare Advantage CareFlex plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy with a copay ranging from $0 to $45, and specialist services with a copay between $0 and $50. Mental health specialty services, psychiatric services, and other health care professionals have varying copays depending on the service, and physical therapy and speech-language pathology services have a copay between $0 and $50. Additional telehealth benefits have no copay, and opioid treatment program services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, annual physical exams, and additional services, with no copay for the annual physical exam. Additional services, including Health Education, In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, and others are not covered. Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with no copay.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and OTC hearing aids. Routine hearing exams have no copay, while prescription hearing aids have a copay between $199 and $1249, and OTC hearing aids have a copay between $99 and $829. Fitting/evaluation for hearing aids, 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 eye exams and eyewear. Eye exams have no copay. Eyewear is partially covered, with contact lenses, eyeglass lenses, and eyeglass frames covered, but eyeglass frames are not covered.
Dental Services See details
Dental services include Medicare dental services with 20% coinsurance, oral exams, dental X-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and between 0% and 20% coinsurance, as well as Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with between 0% and 20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME) with 50% coinsurance, and Prosthetics/Medical Supplies with 50% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 50% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a $45 copay, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $150, Therapeutic Radiological Services with a 20% coinsurance, and Outpatient X-Ray Services with a $40 copay. Prior authorization and a doctor referral are required for all services.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) plan with no copay and no coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not in practice because the sub-services are not covered. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) plan, but require prior authorization and a doctor's referral. There is no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
The AARP Medicare Advantage CareFlex plan covers Over-the-Counter (OTC) Items with no copay. However, acupuncture, meal benefits, Dual Eligible SNPs with Highly Integrated Services, 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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