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AARP Medicare Advantage CareFlex from UHC MA-9 (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 MA-9 (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 MA-9 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage CareFlex from UHC MA-9 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select counties in Massachusetts. 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 MA-9 (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 MA-9 (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 MA-9 (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:
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Drug Coverage
The AARP Medicare Advantage CareFlex from UHC MA-9 (HMO-POS) plan has an enhanced alternative drug benefit. The plan has a $495 deductible. In the initial coverage phase, after the deductible, you'll pay a copay for your prescriptions. For example, Tier 1 (Preferred Generic) drugs have a $12 copay at a standard pharmacy. Tier 3 (Preferred Brand) drugs have a $100 copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage CareFlex plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services and primary care visits have no copay. Emergency services and ambulance services have copays, while preventive services, vision services, and dental services are covered with no copay or coinsurance. This plan provides coverage for hearing, home health, and skilled nursing facility services, along with medical equipment and diagnostic services, with varying cost-sharing. Additionally, the plan offers coverage for home infusion services and dialysis services, both with coinsurance. The plan also offers a meal benefit and over-the-counter items with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $495 copay for days 1-5, and no copay for days 6-90; additional days have no copay. For Inpatient Hospital Psychiatric services, you will pay a $495 copay for days 1-4, and no copay for days 5-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days, and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay ranging from $0 to $495, and observation services with a $495 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, while Outpatient Substance Abuse Services, including individual and group sessions, have copays ranging from $0 to $55.
Partial Hospitalization See details
Partial Hospitalization is covered with a $105 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage CareFlex from UHC MA-9 (HMO-POS) plan. Both ground and air ambulance services have a $275 copay and no coinsurance, while transportation services to health-related locations 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 MA-9 (HMO-POS) plan. Emergency Services have a $90 copay and no coinsurance, while Urgently Needed Services have a copay of $0-$30 and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage CareFlex from UHC MA-9 (HMO-POS) covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a copay between $0 and $45, and physician specialist services with a copay between $0 and $50. Mental health specialty services, podiatry services, other health care professional, psychiatric services, and opioid treatment program services have varying copays depending on the service. Physical therapy and speech-language pathology services have a copay between $0 and $50, and additional telehealth benefits have no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other preventive services, including Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, are covered with no copay. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services are not covered.
Hearing Services See details
The AARP Medicare Advantage CareFlex from UHC MA-9 (HMO-POS) plan covers hearing exams with a $50 copay, and OTC hearing aids with a copay between $99 and $829. Prescription Hearing Aids are covered, with a copay between $199 and $1249 for all types, but 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 eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, with contact lenses having no copay, eyeglass lenses having a copay of $0.00 - $153.00, and eyeglass frames having no copay; eyeglass lenses and frames are covered every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with 20% coinsurance. Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services are covered with no copay, while other services like Orthodontic, Restorative, and Endodontic services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the AARP Medicare Advantage CareFlex from UHC MA-9 (HMO-POS) plan, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, both with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage CareFlex from UHC MA-9 (HMO-POS) plan, but require prior authorization. The plan has a coinsurance of 20% for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 50% coinsurance and requires prior authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 50% coinsurance, and Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 50% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $25 copay, and lab services with no copay. Radiological services include diagnostic radiological services with a maximum copay of $200, therapeutic radiological services with a 20% coinsurance, and outpatient X-ray services with a $50 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage CareFlex from UHC MA-9 (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 the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required, and copay information is available in the plan details.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage CareFlex from UHC MA-9 (HMO-POS) plan, but require prior authorization. You will pay no copay for days 1-20, and a $203 copay for days 21-100. 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 plan covers Over-the-Counter (OTC) Items with no copay, and a meal benefit with no copay, though prior authorization is required. 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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