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AARP Medicare Advantage CareFlex from UHC WI-18 (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 WI-18 (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 WI-18 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Wisconsin. 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 WI-18 (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 WI-18 (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 WI-18 (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.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) plan has an annual drug deductible of $600. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies and mail order. Tier 2 generic drugs carry a $12 copay for a 1-month standard pharmacy supply, but you can save with no copay for a 3-month supply through preferred mail order. For brand-name and specialty medications, costs are based on coinsurance rather than flat copayments. Tier 3 preferred brand drugs require a 16% coinsurance for both standard pharmacies and mail-order fills. Tier 4 non-preferred drugs require a 36% coinsurance, while Tier 5 specialty drugs carry a 26% coinsurance for a 1-month supply across standard and mail-order options.
Additional Benefits
The AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) plan provides comprehensive healthcare coverage with many essential services available at no copay and no coinsurance. Members pay nothing for primary care visits, preventive care, annual routine eye and hearing exams, and home health services. For more intensive medical needs, inpatient hospital stays require a $550 daily copay for the first five days, while emergency room visits carry a $130 copay. While basic preventive dental is covered with no copay, comprehensive dental treatments and transportation services are not covered under this plan. Diagnostic lab services and diabetic supplies feature no copay, but durable medical equipment requires a 50% coinsurance. Specialist visits and physical therapy are also highly accessible, requiring no coinsurance and low copays up to $60.
Inpatient Hospital See details
AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) covers inpatient acute hospital stays with no coinsurance, requiring a $550 daily copay for days 1 through 5 and no copay for days 6 and beyond. Inpatient psychiatric care is also covered with no coinsurance and a $550 daily copay for days 1 through 4 and no copay for days 5 through 90, though hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay ranging from $0 to $550, observation services carry a $550 daily copay, and outpatient substance abuse sessions have a copay of up to $55.
Partial Hospitalization See details
Partial hospitalization is covered under the AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) plan with a $105.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) covers Medicare-covered ground and air ambulance services with a $275 copay and no coinsurance, with prior authorization required. Transportation services to plan-approved or any health-related locations are not covered under this plan.
Emergency Services See details
AARP Medicare Advantage CareFlex from UHC WI-18 (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 require a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care services under AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) are covered with no copay and no coinsurance for primary care provider visits, telehealth, and opioid treatment. Specialist visits, mental health sessions, and physical therapy require no coinsurance and copays ranging from no copay to $60, while chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by the AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) with no copay and no coinsurance for covered services, which include annual physical exams, kidney disease education, and fitness benefits. However, several services are not covered under this plan, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, home safety modifications, and counseling.
Hearing Services See details
Hearing services under the AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) plan are partially covered, providing one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids are partially covered with a $199 to $1,249 copay and no coinsurance, excluding inner, outer, and over-the-ear types, while OTC hearing aids are covered with a $199 to $829 copay and no coinsurance.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) with no deductible, no coinsurance, and no copay for one annual routine eye exam. Eyewear is covered up to a $150 limit every two years with no copay for contacts and frames and a $0 to $153 copay for lenses, though other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by the AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) plan, with Medicare-covered dental requiring no copay and a 20% coinsurance, and preventive services such as exams and cleanings available with no copay and no coinsurance. However, comprehensive treatments including restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) with no copay, though prior authorization is required. Medicare Part B chemotherapy and other infusion drugs require no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) covers durable medical equipment (DME), prosthetics, and medical supplies with no copay and 50% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require 50% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) covers diagnostic and radiological services with prior authorization required. Lab services have no copay and no coinsurance, diagnostic procedures require a $50 copay with no coinsurance, outpatient X-rays have a $30 copay, and therapeutic radiological services carry a 20% coinsurance, while diagnostic radiological services feature copays starting at $0.
Home Health Services See details
AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) covers home health services with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) with no copay and no coinsurance, though prior authorization is required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the 100-day Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered under the AARP Medicare Advantage CareFlex from UHC WI-18 (HMO-POS) plan, which includes a chronic illness meal benefit with no copay, no coinsurance, and prior authorization required. Acupuncture, over-the-counter (OTC) items, and other additional services are not covered.
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