UnitedHealthcare, the largest provider for Medicare Advantage plans, offers plans in over two-thirds all US counties. UnitedHealthcare partners with AARP to insure the Medicare products that bear the AARP brand.
UnitedHealthcare has high ratings overall and three quarters of its members are in highly-rated plans. In a recent survey of members satisfaction, the provider ranked fourth among large Medicare Advantage providers.
Here are some facts about UnitedHealthcare Medicare Advantage.
Pros and cons of UnitedHealthcare Medicare Advantage
UnitedHealthcare offers many advantages and disadvantages.
Pros
Largest network: UnitedHealthcare offers the largest Medicare Advantage network of all companies, with more than 850,000 network care providers.
Highly rated plans: Although UHC has plans with lower star ratings from the CMS, the provider has 28 contracts rated 4 stars or higher that include 76% of its existing Medicare Advantage members.
Home benefits: UnitedHealthcare offers $0 copay telehealth visits, as well as annual home health visits for members who need a house call.
Strong advocate network: Members have the opportunity to work with experts advocates in case they have questions or with care coordinators in complex cases.
Cons
Average member satisfaction ratings: UnitedHealthcare scores in J.D. despite being a giant in the industry. The recent 2020 Medicare Advantage Study by Powers, which assessed member satisfaction, was middle-of the-road.
Available Medicare Advantage plans
UnitedHealthcare offers a variety of Medicare Advantage plans. They vary in structure, cost, and benefits.
In general, UnitedHealthcare offers Medicare Advantage Prescription Drug Plans, as well as stand-alone prescription drug plans and Medicare Advantage Plans without drug coverage. UHC also offers Medicare Advantage Patriot Plans that are targeted at veterans and people who have existing drug coverage.
Available Part D prescription drug plans
Although many UnitedHealthcare Medicare Advantage plans offer Part D drug coverage as well, the company also offers stand-alone Part D prescription drugs plans. These plans do not offer medical coverage and are intended to be used in conjunction with Medicare Part A and Part B.
UnitedHealthcare provides drug coverage through AARP MedicareRx Plans. While these plans cover both brand-name and generic prescription drugs, different plans provide different types of coverage. The AARP MedicareRx Walgreens plan (PDP), for instance, offers $0 copays on Tier 1 medications at more than 9,200 Walgreens or Duane Reades in the U.S.
UnitedHealthcare members can save money on their drug costs by using the following methods:
- Insulin savings: Many UHC Medicare Part D and Medicare Advantage plans reduce monthly out-of pocket costs for insulin covered by UHC Medicare Advantage to $35
- Drug copays of $0: UHC has eliminated copays for covered drugs on Dual Special Needs Plans.
- Bonus drug coverage: Many UHC Medicare Advantage plans offer bonus drug coverage for commonly prescribed drugs that are not covered by Medicare. These could include prescription vitamins such as vitamin B12 and drugs that treat erectile dysfunction.
- Home prescription delivery: Many plans include $0 copays when members order Tier 1 or Tier 2 drugs through the OptumRx pharmacy at home.
Additional benefits
UnitedHealthcare Medicare Advantage provides most MA members with access to dental care (and a large Medicare Advantage dental network), eye examinations, and discounted hearing aids. There are many other benefits that come with the plans. These are some of the best:
- UnitedHealthcare’s Renew Active membership program offers members access to many gyms and fitness centers, as well local classes and events. Members have access to a library online of workout videos as well as an online brain health program through AARP Staying Sharp.
- Allowance for over-the counter items: Plan members might be eligible to receive an allowance that can be used towards over-the–counter items such as first-aid supplies and vitamins, pain relievers, and cough and cold medicine.
- Health food benefit: Many Dual Eligible Special Needs Plans offer a credit of up to $660 per annum to help you buy fruits, vegetables, seafood, and other healthy products.
- Health rewards: Members can earn up to $120 for completing health-related tasks such as getting an annual physical, flu shot, or being active and tracking steps.
- Home visits: Many plans include HouseCalls. This program offers members an annual visit with a licensed practitioner in their home. It can also be used to manage care.
- UHC’s Advocate4Me program matches members with experts who can answer questions about their health or plan. These advocates are available to assist members in making informed decisions.
- Complex problems can be handled by care coordinators: A single contact point is available to assist people with complex health issues. They can coordinate care, manage claims, and receive support through UHC’s Navigate4Me program.
- Telehealth: Virtually all plans include $0 copays to cover telehealth visits.
Customer service
UnitedHealthcare members may contact the customer service department in these ways:
- The number is on the member’s ID card.
- Chat with a service advocate once members log into their member page.
- For technical problems, call 800-721-0627 (TTY 711) 7 a.m.-10 p.m. Central Time, 7 days a week.
UnitedHealthcare service area
UnitedHealthcare offers Medicare Advantage and Medicare Prescription Drug Plans in all 50 States and Washington, D.C. UnitedHealthcare has plans available in 2117 counties or 66% of the U.S. counties. This is the second-highest provider (Humana tops). Eighty-six percent of Medicare beneficiaries have the option of a UnitedHealthcare plan.
UnitedHealthcare is the nation’s largest health insurance company. It is also the largest for-profit health plan. UnitedHealthcare Medicare Advantage plans have more than 6.5 million beneficiaries. The company also added 827,000 members in the plan year 2021.
Cost
Your plan, location, and health requirements will all affect the cost of Medicare Advantage plans. One of the costs to consider is the plan’s premium, and UnitedHealthcare estimates that 2.5 million members will see $0-premium Medicare Advantage plans in 2021.
You will still have to pay your Medicare Part B premium even if you are a Medicare Advantage user. It is minimum $148.50 for 2021. (Most people will pay the standard amount. However, if you earn more than that, you will pay more.
You should also consider other out-of-pocket expenses:
- What percentage of your Medicare Part B premium is covered by the plan?
- The plan’s annual deductibles as well as any other deductibles such a drug deductible.
- Each visit will have a copayment and/or coinsurance. You might pay a $10 copay to see your primary physician and $45 for specialist visits.
- The maximum out-of pocket and in-network limits are set by the plan.
- It is important to know whether your providers are in or out of network. Also, how often you might need care outside of the network.
- Consider whether you need additional benefits and what the cost of such benefits are.
Use Medicare’s Plan Locator to get an idea of the costs and compare plans available in your area. Select UnitedHealthcare plans to view only, or compare between carriers. You can also shop directly from UnitedHealthcare’s website by entering your ZIP code, and you’ll be able to compare the plans available.
Medicare star ratings
Average Star Rating: 3.9
The Centers for Medicare & Medicaid Services has its own star rating database for every Medicare Advantage plan and each separate Medicare Part D plan. These ratings range from the best (5 stars) down to the worst (1 star). These ratings are based on the quality of care provided by plans and customer satisfaction. Ratings can change year to year.
The average rating for UnitedHealthcare’s Medicare Advantage plans is 3.8. Prescription drug plans (Part D), get an average score 3.9. This is based on the most recent data. The overall average score for UnitedHealthcare’s plans is 3.9. The average star rating of plans from all providers was 4.06.
However, three quarters (76%) are UnitedHealthcare Medicare Advantage members who are in rated agreements. They are in contracts with four stars or more for 2021. Six Medicare Advantage contracts were awarded 4.5 stars and four received 5 stars. There were 22 UnitedHealthcare agreements that were too recent to be measured.
Locate the best Medicare Advantage plan
It’s important to do your research before selecting a health plan for yourself. These are some questions you should ask:
- How much does the plan cost? Are you familiar with the plan’s costs, including copays, coinsurance, deductibles and premiums? Are they affordable?
- Are you a member of a network doctor? Make sure your preferred provider is included in the network.
- Are your prescriptions covered? It is important to know what your plan covers if you are on medication. Which tier do you belong on for prescription drugs? Are there any specific coverage rules?
- Does the plan offer dental coverage? Is the plan designed to provide routine coverage for hearing, vision and dental needs?
- Are there any extras? Are there any additional benefits such as transportation benefits, meal delivery, or fitness memberships?