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 2026, 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 2026.
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.
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS).
The cost of a Medicare Advantage Plan is made up of four main parts.
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 $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.
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The AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) plan features an annual drug deductible of $600. For prescription drugs, Tier 1 preferred generics have no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generics cost a $10 copay for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay through preferred mail order. For brand-name and specialty medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brands require a 15% coinsurance, while Tier 4 non-preferred drugs carry a 41% coinsurance for a 1-month supply. Tier 5 specialty drugs require a 26% coinsurance for a 1-month supply through standard pharmacies or mail order.
The AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) offers comprehensive medical coverage with predictable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, annual physicals, and home health services. Specialist visits require a copay ranging from no copay to $60, while emergency room visits carry a $130 copay that is waived if you are admitted. For inpatient hospital stays, members pay a $550 daily copay for the first few days of acute or psychiatric stays, with no copay required for the remaining covered days. Routine dental, vision, and hearing exams are highly accessible with no copay or coinsurance, alongside a $150 eyewear allowance every two years and affordable copays for prescription hearing aids. Durable medical equipment and prosthetics require no copay but carry a 50% coinsurance, while diabetic supplies and over-the-counter items are available with no copay. Diagnostic lab services are also covered with no copay, making this plan a robust option for managing routine and preventive health needs.
AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $550 daily copay for days 1-5 of acute stays and days 1-4 of psychiatric stays, with no copay for remaining covered days. Upgrades, non-Medicare-covered stays, and additional psychiatric hospital days are not covered.
AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) covers outpatient services with no coinsurance, featuring copays ranging from no copay to $550 for outpatient hospital and observation services. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while outpatient substance abuse services require no coinsurance and a copay between no copay and $25.
AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) covers partial hospitalization services with a $105.00 copay and no coinsurance. This benefit requires both prior authorization and a referral.
AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) covers ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required. Transportation services to health-related locations are not covered under this plan.
AARP Medicare Advantage CareFlex from UHC TX-47 (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 feature a copay of $0 to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) provides primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $60 copay and no coinsurance. Therapy services range from a $50 to $60 copay with no coinsurance, mental health sessions cost a $0 to $25 copay with no coinsurance, and chiropractic services are not covered in practice.
Preventive Services are partially covered by AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS), offering covered services like annual physicals and fitness benefits with no copay and no coinsurance. However, the plan does not cover several sub-services, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, and adult day health services.
Hearing services are partially covered by AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) with no deductibles and no coinsurance, featuring a $30 copay for exams (no copay for routine exams) and copays ranging from $199 to $1,249 for prescription and OTC hearing aids. Fitting and evaluation services, as well as inner, outer, and over-the-ear prescription hearing aids, are not covered.
Vision services are partially covered by AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS), featuring no deductible and no coinsurance for all services, with no copay for yearly routine exams and frames, and a $0 to $153 copay for lenses. While a $150 combined eyewear allowance is available every two years, other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental services are partially covered by the AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS), featuring no copay and a 20% coinsurance for Medicare-covered dental care. Preventive and diagnostic services like cleanings and exams are available with no copay and no coinsurance, while restorative, endodontic, periodontic, prosthodontic, oral surgery, orthodontic, and implant services are not covered.
AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance up to a 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance up to a 20% coinsurance.
AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) covers dialysis services with no copay and a 20% coinsurance. Both prior authorization and a referral are required to receive these covered services.
AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 50% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 50% coinsurance, with prior authorization required for these benefits.
Diagnostic and radiological services are covered under the AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS), though prior authorization and referrals are required. Lab services and diagnostic radiology feature no copays or coinsurance, while diagnostic tests require a $20 copay with no coinsurance, outpatient X-rays carry a $30 copay plus coinsurance, and therapeutic radiology requires a copay and a minimum 20% coinsurance.
Home health services are covered by AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) with no copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Cardiac Rehabilitation Services are covered with no coinsurance under the AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) plan, but only some services are covered in practice because cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and a referral, but no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare-covered period are not covered.
AARP Medicare Advantage CareFlex from UHC TX-47 (HMO-POS) provides partial coverage for other services, offering over-the-counter (OTC) items with no copay and no coinsurance. However, acupuncture and meal benefits are not covered under this plan.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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