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 2026, 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 2026.
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.
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS).
The cost of a Medicare Advantage Plan is made up of four main parts.
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 $520.00 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 RI-5 (HMO-POS) has an annual prescription drug deductible of $520. Beneficiaries pay no copay for Tier 1 preferred generic and Tier 2 generic medications for both 1-month and 3-month supplies at standard pharmacies and standard mail order. This ensures affordable access to common maintenance medications. For higher-tier prescriptions, cost-sharing is based on coinsurance percentages at standard pharmacies and standard mail order. You will pay a 16% coinsurance for Tier 3 preferred brand drugs and a 39% coinsurance for Tier 4 non-preferred drugs. Tier 5 specialty medications require a 27% coinsurance for a 1-month supply.
The AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) offers robust coverage for essential medical needs with predictable out-of-pocket costs. Members benefit from no copays and no coinsurance for primary care doctor visits, telehealth, and routine preventive services, while specialist visits feature low copays ranging from $0 to $60. For hospital care, inpatient stays require a $550 daily copay for the first few days with no copay thereafter, and emergency room visits have a $130 copay that is waived if you are admitted. This plan also includes valuable everyday wellness benefits, featuring no copays for routine dental, vision, and hearing exams. Vision benefits include a $300 eyewear allowance, while hearing aids are available with copays ranging from $199 to $1,249. Additionally, services like home health care, over-the-counter items, and post-discharge meals are covered with no copay, helping you manage your health and budget effectively.
AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $550 daily copay for days 1-5 for acute stays and days 1-4 for psychiatric stays, with no copay for subsequent days. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, and prior authorization is required.
AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $550 (including $550 per day for observation), and outpatient substance abuse sessions have copays up to $55.
AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required for this covered benefit.
AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) covers ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required. Routine transportation services to health-related locations are not covered under this plan.
Emergency services are covered by AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) with a $130 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature a $0 to $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) covers primary care doctor visits and telehealth services with no copay and no coinsurance. Specialist visits and therapy services have copays ranging from $0 to $60 with no coinsurance, though routine and other chiropractic services are not covered.
AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management. However, additional preventive services are only partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing services are partially covered by AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS), which offers routine hearing exams with no copay and no coinsurance, and hearing aids with copays ranging from $199 to $1,249 and no coinsurance. Fitting and evaluation for hearing aids, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision services are partially covered by AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS), offering no copay and no coinsurance for one routine eye exam annually and contact lenses, with a $300 combined eyewear allowance every two years. Eyeglass frames feature no copay, and lenses have a copay ranging from $0.00 to $153.00 with no coinsurance, while other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services through AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) are partially covered, offering preventive care like exams, cleanings, and x-rays with no copay and no coinsurance, and Medicare-covered dental with no copay and 20% coinsurance. However, several services are not covered, including restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics.
Home infusion bundled services are covered by the AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) with no copay, while associated Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance up to 20% coinsurance. Covered Part B insulin drugs have a $35 copay and no coinsurance up to 20% coinsurance, and prior authorization is required for these services.
AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment benefits under the AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) are covered, offering durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes with no copay and a 50% coinsurance. Diabetic supplies are covered with no copay, and prior authorization is required for these medical equipment services.
AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) covers diagnostic services with no coinsurance, requiring a $50 copay for tests and no copay for lab services. Radiological services are also covered with prior authorization, featuring no copay for diagnostic radiology, a $30 copay for outpatient X-rays, and 20% coinsurance for therapeutic radiology.
Home health services are covered under the AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) plan, as none of the sub-services, including intensive cardiac, pulmonary, and SET for PAD rehabilitation, are covered in practice.
AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and 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 Medicare coverage are not covered.
Other Services are partially covered under the AARP Medicare Advantage CareFlex from UHC RI-5 (HMO-POS) plan, which offers Over-the-Counter (OTC) items and meal benefits with no copay and no coinsurance. Acupuncture is not covered, and the meal benefit requires prior authorization.
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