Learn About United Healthcare Plans for AARP Members

Overview of UnitedHealthcare AARP Plans

UnitedHealthcare partners with AARP to offer health insurance options designed for people age 50 and older. These plans fall into two main categories: Medicare Advantage plans and Medigap supplemental insurance plans. Understanding the difference between these options helps you learn what each type covers and how they work with your healthcare needs.

Medicare Advantage plans, also called Part C plans, are an alternative to Original Medicare. They combine hospital coverage, medical coverage, and usually prescription drug coverage into one plan. UnitedHealthcare Medicare Advantage plans typically include additional benefits that Original Medicare does not cover, such as dental care, vision care, and hearing services. These plans have network requirements, meaning you generally need to use doctors and hospitals within the plan's network to receive coverage at the lowest cost.

Medigap plans work differently. They supplement Original Medicare by covering some of the costs that Medicare doesn't pay, such as copayments, coinsurance, and deductibles. If you choose a Medigap plan, you keep Original Medicare and add the supplemental coverage on top. Medigap plans do not include prescription drug coverage, so you would need to enroll in a separate Part D prescription drug plan.

According to the Centers for Medicare and Medicaid Services, approximately 28 million people are enrolled in Medicare Advantage plans as of 2024, representing about 46% of all Medicare beneficiaries. UnitedHealthcare is one of the largest Medicare Advantage insurers in the country. The organization operates these plans in all 50 states, though specific plans and coverage areas vary by location.

Practical takeaway: Before exploring specific plans, determine whether you want coverage through Medicare Advantage (all-in-one plans with networks) or Original Medicare with a Medigap supplement (more provider choice but separate coverage types).

What UnitedHealthcare Medicare Advantage Plans Include

UnitedHealthcare Medicare Advantage plans typically cover the services that Original Medicare covers, plus additional services. Hospital inpatient care, doctor visits, emergency services, and preventive care are standard. The plans also include prescription drug coverage, which is a significant advantage because you don't need to purchase a separate Part D plan.

Many UnitedHealthcare Medicare Advantage plans offer extra benefits beyond what Medicare covers. Dental benefits may include cleanings, exams, and fillings, with some plans covering more extensive procedures like crowns and root canals. Vision benefits typically cover eye exams and may help pay for glasses or contact lenses. Hearing benefits often include hearing aid coverage and hearing exams. Some plans also offer fitness benefits, allowing members to join gyms or wellness programs at no additional cost.

The structure of costs in Medicare Advantage plans differs from Original Medicare. Instead of paying a deductible and then coinsurance percentages, you typically pay copayments for specific services. For example, a doctor visit might cost $15 to $25 per visit, a specialist visit might be $45 to $75, and an emergency room visit might be $250 or more. Prescription drugs are covered under the plan's formulary, which is a list of covered medications organized into tiers based on cost.

Network restrictions are an important feature of Medicare Advantage plans. UnitedHealthcare networks vary by plan and region. In-network care costs less because you're using providers who have contracts with the plan. Out-of-network care is typically more expensive or may not be covered at all, except in emergencies. When choosing a plan, you should review whether your current doctors are in the network.

Out-of-pocket maximums are another key feature. Medicare Advantage plans have yearly limits on how much you pay for covered services. Once you reach this maximum, the plan pays 100% of covered services for the rest of that year. For 2024, the out-of-pocket maximum for Medicare Advantage plans cannot exceed $8,300 for in-network services. This provides financial protection against very high medical costs.

Practical takeaway: Review the specific plan documents to understand which doctors and hospitals are in-network, what copayments you'll pay, which medications are covered, and what the out-of-pocket maximum is for the year.

Understanding UnitedHealthcare Medigap Plans

Medigap plans offered through UnitedHealthcare are supplemental insurance policies that work alongside Original Medicare. These plans help cover costs that Original Medicare leaves unpaid. Understanding what gaps they fill helps you see their value alongside your Medicare coverage.

Original Medicare typically covers about 80% of approved healthcare costs after you meet the deductible. The remaining 20% is your responsibility. Additionally, there are deductibles for hospital stays and doctor visits, and coinsurance costs for various services. Medigap plans are designed to cover some or all of these gaps. Different Medigap plan types, labeled A through G, offer different levels of coverage for these costs.

Plan F was historically the most comprehensive Medigap option, covering the Medicare Part B deductible and many other out-of-pocket costs. However, Plan F became unavailable to new beneficiaries after January 1, 2020. People who enrolled in Plan F before that date can keep it, but new enrollees must choose from other available plans. Plan G is now the most comprehensive option for new enrollees and covers most of the same costs that Plan F covered, except for the Part B deductible.

Other common Medigap plans include Plan N and Plan C. Plan N typically costs less than Plan G but requires you to pay copayments for some doctor visits and emergency room visits. Plan C is a moderately priced option that covers the Part B deductible and many other costs. Plans A, B, D, and K are also available in some states and offer varying levels of coverage at different price points.

One major advantage of Medigap plans is provider choice. Unlike Medicare Advantage plans with their networks, Medigap plans let you see any doctor or hospital that accepts Medicare. You have the freedom to seek care from any provider without worrying about whether they're in-network. This flexibility is valuable if you have established relationships with specific doctors or prefer having more choice.

It's important to note that Medigap plans do not include prescription drug coverage. You must enroll in a separate Medicare Part D prescription drug plan if you want coverage for medications. Part D plans are offered by various insurers and have different formularies and costs.

Practical takeaway: If you prefer maximum provider choice and want simplified billing from Medicare, a Medigap plan may suit you. Compare the different plan types to find the coverage level and cost that works for your situation, and remember to enroll in Part D separately for prescription drugs.

How to Compare UnitedHealthcare Plans and Understand Costs

Comparing health insurance plans requires looking at multiple factors beyond just the monthly premium. The total cost of healthcare depends on the premium, copayments, deductibles, coinsurance, and out-of-pocket maximums. Planning for these costs helps you understand which plan might work best for your budget and healthcare needs.

Start by listing your current doctors and preferred hospitals, then check whether they're in-network for the Medicare Advantage plans you're considering. Contact the doctors' offices directly or use UnitedHealthcare's online provider directory to verify network status. If your doctor is out-of-network, you'll pay more out-of-pocket, so this matters significantly for your total costs.

Next, review the prescription medications you take regularly. Find each medication on the plan's formulary to see what tier it's in and what your copayment will be. Some medications have restrictions or require prior authorization from the plan before they'll be covered. If the medications you need are expensive or restricted on a particular plan, that plan may cost more overall even if the premium is lower.

Calculate estimated annual costs by considering your typical healthcare usage. If you rarely see doctors and take few medications, a plan with a lower premium but higher copayments might work well. If you have chronic conditions and see specialists regularly, a plan with higher premium but lower copayments might be more economical. You can estimate costs by multiplying your expected number of visits by the copayment amount, then adding the monthly premiums.

Consider using Medicare's official Plan Finder tool at Medicare.gov, which allows you to enter your medications and doctors to see which plans cover them. This tool shows estimated costs based on your healthcare profile. UnitedHealthcare also provides plan comparison tools on their website and through AARP,