Medicare is a wonderful program that helps millions of Americans have quality, affordable health insurance in retirement. It is one of the most important aspects of Americans’ retirement plans. Although the benefits provided by original Medicare part A and B, are very comprehensive, they do leave many significant holes uncovered. These gaps in coverage can leave you exposed to high out-of-pocket spending. One of the best ways to lower the cost of service and limit your out-of-pocket spending is with a private Medicare insurance plan. United Healthcare Medicare plans are some of the most popular and competitive plans available. In this article, we will review the various United Healthcare Medicare plans available, and show you how they can help you save money.
Before diving into United Healthcare Medicare plans, it's helpful to review how original Medicare works. That way, you will understand how much you might spend without a private Medicare insurance plan in place.
Medicare is split into two parts, Part A and Part B. Part A provides Hospital insurance, which will cover you when you are needing care in an Institutional setting. You will use your part A when you stay in the hospital overnight or longer, as well as when you need skilled nursing, home health care, and hospice care. When you use these services, you can expect to pay out of pocket. Medicare does not pay the full cost. For part A coverage, you will pay the Part A deductible, which is $1,600 for 2023. Once you have paid this amount, Medicare will pay for a hospital stay up to 60 days, and skilled nursing home care for up to 20 days. You will not pay any type of daily coinsurance as long as your stay does not exceed those lengths. If you need a longer stay in the hospital, beyond 60 days, or more skilled nursing care, beyond 20 days, you will then be subject to daily coinsurance payments.
Part B of original Medicare is your medical insurance coverage. You will use this much more regularly than Part A, because it covers things like doctor's visits, physical and occupational therapy, and other routine care. Just like with Part A, though, you will have to pay out of pocket for all the services and procedures that you encounter during the year. You will have to pay the Part B deductible, which is $226 for 2023. Once you paid this amount, Medicare will cover the first 80% of the cost for Your Part B care. You are responsible for the other 20%. You may also be responsible for something called Part B excess charges, which can be as much as 15% of the Medicare approved charges. These charges, if they are applicable, are added on top of your standard 20% coinsurance. Excess charges are pretty rare, so you may not encounter them in your care.
The most important thing to understand about medicare, especially Medicare Part B, is that there is no cap on your spending during the year, unlike with traditional health insurance. Instead of being capped, your costs are potentially unlimited, and this can be a real problem if you need care like chemotherapy. 20% of the cost of chemotherapy can be very expensive. It is for this reason, and others, that many people look to a private Medicare insurance plan to help reduce or eliminate out of pocket costs in Medicare. There are three main types of private Medicare insurance plan, and United Healthcare offers all of them:
In the next sections, we’ll look at the details for each kind of plan.
Medicare supplement insurance is a kind of coverage that works with your original Medicare benefits. Medicare supplement insurance plans are known as secondary coverage. They will pay only after the primary payer has paid claims. In this case the primary payer is Medicare. Medicare Supplement Plans, which are also known as Medigap Plans, by United Healthcare come in one of 10 standardized options.
These Medigap plans have benefits that are standardized throughout 47 States. This means that each one of the standardized Medigap plans provides the same exact coverage in each of the 47 States. This makes comparing plans from different insurance companies very simple, and allows you to select the level of coverage that you're most comfortable with.
When you use your Medigap plan at the doctor's office, you will pay with both your Original Medicare card and your UnitedHealthcare Medicare Supplement card. Your provider will bill Medicare first. Once you have met the part B deductible, Medicare will pay the first 80% of the cost for your care. The remaining 20% will be billed to your Medigap plan. How much your Medigap plan will pay of this 20% depends on which specific Medigap plan you enrolled in.
If you are enrolled in the most comprehensive plan, Plan G, the plan will pay the full amount due, which means that your only medical costs for the year will be the Part B deductible. On the other hand, there are less comprehensive Medigap plans that will pay a smaller percentage of your costs. For example, Plan K will pay 50% of the amount that you would normally pay. In this way, you can see how the different standardized plans will cover different percentages of your out-of-pocket costs. With Medicare supplement insurance, there are no networks, and no requirements for referrals. You can see any provider in the country that accepts Medicare patients.
United Healthcare Medicare Advantage plans work in a different way than Medicare Supplement Insurance. A Medicare Advantage plan is actually a contract between the Centers for Medicare and Medicaid services (CMS), and an insurance company. It is a way for you to receive your Part A and Part B benefits through a private insurance company.
A Medicare Advantage plan works in a different way than Medicare Supplement Insurance. With a Medicare Advantage plan, you will pay a co-payment or coinsurance amount for each service and procedure that you received during the year. Your plan will keep track of how much you spend on co-payments and co-insurance.
Importantly, Medicare Advantage plans must provide an annual out-of-pocket maximum amount. This is a cap on the amounts that you spend for medical care. This is an improvement over original medicare, and helps protect your savings in the event of the need for serious medical care.
Medicare Advantage plans are also popular with people because they provide extra benefits, which are coverages for things that are not covered by Original Medicare. Examples for United Healthcare Medicare Advantage plans include:
Not all of these extra benefits are available from every Medicare Advantage plan, but they give you a good idea of what is possible. Medicare Advantage plans also frequently offer prescription drug coverage.
The third type of United Healthcare Medicare Plans are Part D drug plans. These are plans that provide prescription drug coverage under Part D of Medicare. You can use a standalone Part D drug plan with original Medicare Parts A and B, and also with Medicare Supplement Insurance. In almost all cases you cannot combine a standalone Part D drug plan with a Medicare Advantage plan.
Prescription drug plans generally have a monthly premium as well as an annual deductible. Once you are beyond the deductible, you'll usually pay co-insurance or co-payments for each prescription that you have filled during the year. How much you pay depends on the type of medication you use. The medications that a Part D plan covers are listed on the Plan’s Formulary. Note that Plan’s aren’t required to cover every prescription drug that’s on the market. Instead, they’re required to cover at least two medications in every therapeutic category.
Every prescription drug on the formulary is assigned a tier, and the higher the tier, the more expensive it will cost to fill that prescription. Unlike with the Medicare Advantage plan, there is no annual cap on your prescription drug spending for 2023, but this will change beginning in 2024 due to recent legislative updates to Medicare Part D.
No, this is a common source of confusion. AARP is a separate entity from United Healthcare, but AARP has endorsed certain United Healthcare Medicare plans. They are two completely separate and unrelated entities though.
No. When you become eligible for Medicare and enter it, you will need to make an election to join a separate plan. You can use United Healthcare, but you will have to actively enroll in the plan of your choice.
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