What You Need To Know About UnitedHealthcare Medicare Plans

33 minute read| Updated for September, 2020

Learn About UnitedHealthcare Medicare Plans

Finding the right Medicare plan is a top priority for those who are preparing to enter Medicare. As there are various UnitedHealthcare Medicare plans to choose between, it is important to know the differences between each.

UnitedHealthcare has a rich offering of extra benefits for their Medicare Advantage plans.

UnitedHealthcare is owned by UnitedHealth Group. It is one of the largest Medicare insurers in the country, boasting more than 115,000,000 customers nationwide.

UnitedHealthcare offers both Medicare Supplement insurance and Medicare Advantage plans. Their Medicare health plans are popular and highly trusted, as many of them are endorsed by AARP.

UnitedHealthcare Medicare Supplement Insurance

Medicare Supplement Insurance is also known as Medigap, as these policies fill in the gaps in Original Medicare. These “gaps” are the costs that you are expected to pay out of pocket under Parts A and B.

UnitedHealthcare is one of the most well-known Medicare Supplement insurance providers. In fact, all of their Medigap plans are endorsed by AARP. Medicare Supplement Insurance policies are issued in 10 standardized plans: Plans A, B, C, D, F, G, K, L, M, and N. Each of these plans cover a different portion of the gaps in Original Medicare.

Benefits Plan A Plan B Plan C Plan D Plan F Plan G Plan K Plan L Plan M Plan N
Part A Coinsurance and Copay 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
Part B Coinsurance and Copay 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Part A Deductible 100% 100% 100% 100% 100% 50% 75% 50% 100%
Part B Deductible 100% 100%
Blood (first 3 pints per year) 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Part B Excess Charges 100% 100%
Foreign Travel Emergency 80% 80% 80% 80% 80% 80%

The least comprehensive Medigap plan is Plan K. When you have Plan K, the plan pays 50% of the Part A and B deductibles and co-insurance. However, you do get a strict out-of-pocket maximum (OOPM) of $5,880, which means that this amount is the most that you could possibly be responsible for paying during any one-year period.

The most comprehensive plan is Plan F. This plan will cover 100% of your Medicare-approved costs for services and procedures. Just as a reference point, you will probably never pay a doctor or hospital if you have Plan F. It should be noted: Plan F is not available to anyone who becomes eligible for Medicare on or after January 1, 2020. If you were eligible before this date, you can keep Plan F, or you may enroll in it if you wish to apply for it. Plan G is the most comparable plan in terms of cost and benefits to Plan F.

Extra Benefits From UnitedHealthcare Medicare Supplement Plans

The benefits shown in the above figure are standardized across all Medigap plans. As such, every insurance company must provide those benefits listed for each of the plans. However, UnitedHealthcare offers benefits beyond what the Medicare program requires.

It is important to note that extra benefits are not guaranteed, as changes are made to them occasionally. Also, they are not required, and not every carrier provides them. Availability of extra benefits also vary by state.

Some of the extra benefits offered by UnitedHealthcare include:

  • Fitness plans or gym memberships
  • Discounted vision exams and eyewear
  • Access to 24-hour nurse helplines

UnitedHealthcare Medicare Supplement Eligibility

To be eligible for Medicare Supplement insurance, you must be enrolled in both Part A and B of Original Medicare. One other requirement, in some states, is that you be age 65 or older. This is true even if you are eligible to enroll in Medicare at an earlier age.

The Cost of UnitedHealthcare Medicare Supplement Insurance Plans

UnitedHealthcare is a private insurance company. This means that they can set their own premiums. However, these premiums are still subject to regulation. UnitedHealthcare’s premiums are generally set for a community as a whole (an entire county or set of zip codes is considered a community). This is known as “Community Rating.”

Premiums are set based on the demographics of the entire community rather than on your age. Premiums are adjusted each year based on changes in the community demographics. UnitedHealthcare is known for having stable premiums, which means that increases tend to be gradual and small.

In addition to your Medigap premium, you must keep paying your Part B premium in order to have Medigap coverage. You will also need to pay for a standalone prescription drug plan since Medigap does not cover prescription drugs.

Medicare Advantage plans offer savings that surpass those of Original Medicare.

UnitedHealthcare Medicare Advantage Plans

UnitedHealthcare is also a major force in the Medicare Advantage market. Medicare Advantage plans, also known as Medicare Part C, are an entirely separate program from Original Medicare. This factor sets them apart from Medigap, which acts as a supplement to Original Medicare.

So, when you have Medicare Advantage, you are no longer in Original Medicare, as it is an alternative coverage. Medicare Advantage plans are required to provide benefits that are at least as good as those provided under Part A and B. Most Medicare Advantage plans offer more generous coverage than Original Medicare.

The main reason people choose Medicare Advantage plans is to reduce or eliminate some of the gaps in Original Medicare. How is this done? Unlike Medigap, Medicare Advantage plans don’t just fill in the gaps in coverage. Instead, they eliminate them entirely via small copayments or coinsurance for services.

There are two important differences between costs under Medicare Advantage and Original Medicare:

  • Copayments and coinsurance are generally lower in a Medicare Advantage plan, and
  • Medicare Advantage plans must have an annual out-of-pocket maximum

When you receive services under a Medicare Advantage plan, you will have to make small payments at the time of service. In this way, coverage under Medicare Advantage is similar to health insurance you get through your employer. Costs are much less than for individual private health insurance.

Medicare Advantage plans work like private insurance in one other way, too. Most Medicare Advantage plans operate as either Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs).

Plans like this offer a network of doctors and facilities. Depending on the specifics of your plan, you may be restricted to that network, or you may pay less if you stay in-network. Many of these Medicare Advantage plans require you to use a primary care physician and receive referrals through him or her.

Having a hard out-of-pocket maximum each year will help you to rest easy. Unlike with Original Medicare, you are not worrying about being on the hook for an unlimited amount of money, should you develop a life threatening disease or go to the hospital multiple times in a year.

Although this out-of-pocket maximum is a main reason why people choose Medicare Advantage plans, another factor acting in their favor is the abundance of extra benefits they offer, which we will cover in the information provided below. 

UnitedHealthcare Medicare Advantage Extra Benefits

There are many services that are normally covered under employer group health insurance that Original Medicare does not cover. For example, vision, hearing, and podiatry services are not covered by Original Medicare. However, many Medicare Advantage plans do cover these services and procedures.

UnitedHealthcare has a rich offering of extra benefits for their Medicare Advantage plans. Depending on the state you live in, UnitedHealthcare may offer:

  • Gym or fitness memberships
  • Emergency coverage worldwide
  • Vision coverage – for exams, lenses, and sometimes frames
  • Hearing coverage – for exams and deep discounts on hearing aids
  • Transportation – for trips to approved medical facilities, like doctors and surgeons
  • Acupuncture, chiropractic care, and podiatry

As you approach the beginning of your Medicare coverage journey, you may want to work with a licensed profession to find a plan that meets your needs.

Prescription Drug Coverage

Many of UnitedHealthcare’s Medicare Advantage plans come with prescription drug coverage. This coverage meets the requirements set by Medicare under Part D. Medicare Advantage plans that offer drug coverage are called MAPD plans.

The drug benefit of your MAPD plan has separate deductibles (if any), as well as different copayments and coinsurance amounts. There is no annual out-of-pocket maximum for drug coverage.

UnitedHealthcare Medicare Advantage Plan Eligibility

Medicare Advantage plans follow the same eligibility rules as Original Medicare. As such, you can enroll in Medicare Advantage at any age, as long as you have both Part A and B. One eligibility restriction is that if you have end-stage renal disease (ESRD), you may not be able to enroll in a Medicare Advantage plan.

However, if you develop ESRD while you are enrolled in a Medicare Advantage plan, you do not have to worry, as you can still keep your coverage. Also, some special Medicare Advantage plans, called Chronic Special Needs Plans (C-SNPs), do accept new patients with ESRD, and are even specially tailored to help these patients with their unique healthcare needs.

UnitedHealthcare Medicare Advantage Plan Costs

Medicare Advantage plans from UnitedHealthcare come with a range of monthly premiums. Many of them actually have no monthly premium, and all of them cost less than Medigap coverage. Medicare Advantage plan pricing and benefits are based on the county in which you live.

Generally, higher density, higher population counties have lower premiums, lower out-of-pocket maximums, and lower cost sharing. However, even in lower population areas, Medicare Advantage plans offer savings that surpass those of Original Medicare. Much of this is due to the fact that you still must continue to pay your Part B premium in order to be covered under Original Medicare.

Moving Forward With UnitedHealthcare Medicare Plans

UnitedHealthcare Medicare plans offer competitive benefits and pricing. They supply a valuable means of protection from high out-of-pocket costs in Original Medicare. They also provide many benefits beyond those available under Part A and B.

As you approach the beginning of your Medicare coverage journey, you may want to work with a licensed profession to find a plan that meets your needs. These knowledgeable experts can help you compare various plans’ benefits and costs, and make sure your current doctors and medicines are covered.