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AARP Medicare Advantage CareFlex from UHC RI-5 (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 RI-5 (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 RI-5 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Rhode Island. 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 RI-5 (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 RI-5 (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 RI-5 (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 RI-5 (HMO-POS) plan has a $495 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance for your prescriptions. For standard generic drugs, the copay is $0.00. For standard generic drugs, the copay is $47.00. For preferred brand drugs, the copay is $100.00. 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 from UHC RI-5 (HMO-POS) plan offers a range of benefits, including coverage for inpatient and outpatient hospital services, with varying copays depending on the specific service. Emergency and primary care services often have low or no copays. There are also additional benefits such as hearing, vision, and dental services, with specific copays and limitations on coverage, as well as home health and preventive services with no copay. This plan also covers ambulance services, with a copay, and offers additional services such as partial hospitalization, home infusion, and dialysis, with associated costs. However, certain services, like some dental, vision, and hearing services, may not be covered. The plan also offers coverage for medical equipment and diagnostic services, with associated copays and coinsurance.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you pay a $495 copay for days 1-5, and no copay for days 6-90. For Inpatient Hospital Psychiatric, you pay a $495 copay for days 1-4, and no copay for days 5-90. The plan does not cover Non-Medicare-covered Stay or Upgrades for Inpatient Hospital-Acute, nor does it cover Additional Days or Non-Medicare-covered Stay for Inpatient Hospital Psychiatric.
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 (ASC) services with no copay, and outpatient substance abuse services with a copay between $0 and $55 for individual sessions and a $55 copay for group sessions. Outpatient blood services are also covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) plan, with a $105 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. 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, including Urgently Needed Services and Worldwide Emergency Services, are covered under the AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55; both have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
The AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) plan 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. The plan also covers mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, and an annual physical exam with no copay. Additional 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. Some services are not covered, including 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.
Hearing Services See details
Hearing Services includes hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have a $50 copay, and routine hearing exams have no copay, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids have a copay between $199 and $1249 depending on the type of hearing aid, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids have a copay between $99 and $829.
Vision Services See details
The AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) plan covers vision services, including eye exams with no copay, and eyewear with a combined maximum benefit of $200 every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services offer coverage for Medicare dental services with 20% coinsurance, and other services, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services, are covered 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, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay, with a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) plan, and require prior authorization. The coinsurance is between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 50% coinsurance, Prosthetics/Medical Supplies with 50% coinsurance, and Diabetic Equipment, including Diabetic Supplies with no copay and Diabetic Therapeutic Shoes/Inserts with 50% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a $45 copay for diagnostic procedures and tests, and no copay for lab services. Diagnostic Radiological Services have a copay of up to $250, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a $50 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage CareFlex from UHC RI-5 (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 by the AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) plan, but the plan does not cover any of the sub-services including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage CareFlex from UHC RI-5 (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 and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) items and Meal Benefits, with no copay for OTC items, and no copay for meal benefits, but acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered. The plan offers nicotine replacement therapy (NRT) as a Part C OTC benefit.
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