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UnitedHealthcare Insurance (Complete Guide)

UnitedHealthcare Insurance (Complete Guide) | Very Good Coverage

What is UnitedHealthcare? And what kind of health insurance and Medicare service do they offer?

UnitedHealthcare is one of the leading health provider insurance groups in the USA. It is located in Minnesota, and is very popular for its Medicare insurance services. UnitedHealthcare is currently rated as the insurance company with the second largest revenue in the USA.

In addition to the original Medicare services of the federal government, UnitedHealthcare provides Part C and D plans for their members. There are also Medicare supplements with many benefits, and it is important to understand how they work and the most ideal option for you.

This guide contains information from reputable resources like Medicare Made Clear provided by UnitedHealthcare.

UnitedHealthcare Medicare Services

The health insurance plan initiated by the federal government for seniors that are 65 years old or more and people with disabilities is known as Original Medicare.

Original Medicare is the combination of Part A and B Medicare. Part A Medicare refers to all hospital care while Part B covers medical visits and other related care.

However, original Medicare does not cover all health issues. Although it will cover some of your expenses, you are obliged to settle other costs on your own.

Some of the costs that your Original Medicare insurance will not cater for include the following:

  • Vision services
  • Dental services
  • Hearing services
  • Drug prescription services.

UnitedHealthcare offers you Medicare supplement plans that will help you offset some of the costs that your Original Medicare does not cover. Alternatively, you can choose from other plans like Part D that will help you cover drug prescription expenses.

There is also the Part C plan that stands for Medicare Advantage. This plan will help you cover all Original Medicare costs in addition to other benefits. Some of the incentives you can benefit from UnitedHealthcare Medicare Advantages include the following:

  • Combination of all hospital-related costs, outpatient and doctor care, all covered in the plan.
  • You can also get coverage for your drug prescription costs, Part D.
  • It will include other health benefits like vision hearing and dental services.

Eligibility for UnitedHealthcare Medicare

People that are eligible for UnitedHealthcare Medicare insurance are those that are a citizen of the USA for a minimum of 5 successive years and are

  • Either 65 years old or more.
  • Less than 65 years old but has disabilities defined by the federal government to qualify for Medicare
  • Anyone at any age that has been diagnosed with a terminal renal disease or health issues like ALS.

When you enroll for Medicare insurance with UnitedHealthcare, you are allowed to change your plan based on your health condition. United Health care will allow you to change to another plan just once annually, and this will be during the Medicare Open Enrollment periods. The time for this is between October 15 and December 7. However, if your Medicare is employer-sponsored, there may be some limitations in rejoining certain plans.

Basics of UnitedHealthCare Medicare

Before enrolling with UnitedHealthcare, here are some of their core Medicare services that you should know in detail.

  • The first one refers to Original Medicare also known as Part A and B, which is fully covered by the Government. This is offered by UnitedHealthcare, but your Social Security Benefits will cover its cost.
  • The second coverage is Medical Advantage also known as Part C. Here, UnitedHealthcare offers a plan that will cover your Original Medicare and other additional services like drug prescription costs and coverage for your basic care like Dental, vision, and hearing.
  • Medicare Supplement offers Coverage for Pocket Costs. If you enroll for any UnitedHealthcare Medicare supplement plan, it will cover up for the out-of-pocket costs that Original Medicare leaves you with, such as copayments and deductibles.
  • Drug Prescription is one of the cores of health and wellbeing. But unfortunately, your Original Medicare will not cover up drug prescription costs. UnitedHealthcare has packages for you that will cover drug prescriptions so you do not have to pay out of your pocket every time you need a drug.

There are numerous Plans under various insurance Parts that will cover your drug prescription. All you have to do is choose the most ideal plan.

Share cost Payment

If you want to go for the default original medicare plan when the need arises for you to pay for extra costs you have to do so without limitation. This can be very expensive.

But if you choose any of the UnitedHealthcare Medicare plans, it will help you cover other health expenses that your Part A and B will not originally cater for. You will be remunerated for this shared cost via monthly payments, copayments, deductibles, and co-insurance policies.

Medicare Available in your State

As a senior or someone who qualifies for Medicare, you should be aware of what is on offer for you in your state:

  • For Original Medicare, you do not have to bother because it is the same in all regions of the US.
  • For Medicare Advantage and Drug Prescription, availability depends on states, regions, and counties that UnitedHealthcare covers.
  • Medicare supplements will help with additional costs and they are available nationwide. But this depends on the UnitedHealthcare plan you choose because some of them are location-based.

How to Enroll for UnitedHealthcare Medicare at the Right Time

IEP means Initial Enrollment Period, and it refers to the first time you sign up for any UnitedHealthcare Medicare plan.

The window for IEP includes the following:

  • Three months before the month you turn 65.
  • The month you turn 65
  • Three months after the month you turn 65.
  • Even if you enroll prior to your birth month, your United Health care Medicare will only begin on the first day of your birth month.
  • If you enroll exactly on your birthday months or after, you are going to have a delayed Medicare coverage.
  • If you are less than 65 years old and you have a disability that makes you qualify for Medicare, you will automatically get Part A and B enrollment as soon as you receive your Social Security benefits. The same situation will apply if you are under 65 years old and suffer from ALS.

Choice Review

UnitedHealthcare will allow you to review your choice once every year. This can only take place during the Medicare Open Enrollment period, Oct. 15 to Dec. 7

Special Enrollment

People that have significant life changes will be allowed to undergo a special enrollment period. Some of the life changes that can trigger this include the following:

  • When you retire and want to leave an employer-sponsored health plan.
  • When you relocate from a serviced area.

Part A, Hospital Coverage

Part A Medicare is under the federal government Original Medicare and it covers all costs accumulated from hospital stays and nursing services after a hospital stay. Hospital coverage will also cater for hospice care and any care from home.

What Health Providers Can You See for Hospital Coverage?

You are allowed to make use of any health provider in the USA that is offering Medicare services and receiving new patients at that particular point in time.

What Coverage Limit is Available for Part A?

There are some limitations to Hospital coverage, and an example is if you stay over in a hospital for more than 3 months, you will have to pay some out-of-pocket costs.

What Does Part A Not Cover?

Services provided by doctors in a hospital are not under hospital coverage. Some other services that you have to pay extra costs for include in-hospital costs such as phone calls, safekeeping care offered by the hospital will also not be covered by Part A. Safekeeping services include cleaning, feeding, bathing, etc. However, if these services are medically necessary, Part A will cover for them.

Part A Premium Costs

For premium costs, seniors or their spouses who have paid for Social Security for a minimum of 10 years will not be required to pay any Part A premium cost.

However, if you have not contributed to social security for a limited number of years, you will pay a cost of around $411 for Part A. This cost may even increase if you do not enroll as at when due.

Part A Shared Costs

Deductible: Before Part A will start to settle some of your costs, you will have to pay some deductible costs for hospital stays. The fee for this is around $1,288 depending on other limitations.

  • Copay: After you have stayed in the hospital for a particular number of days, you have to pay some copay costs. From the end of the second month to the third month, the cost is $322 per day. At the end of the third month, the cost will increase to $644 per day.If the hospital visit is in a skilled nurse facility, you will settle a cost of $161 per day from the end of the third week till the seventh week. For any drug prescription, you get from a hospital visit, you will have to make a copayment of around $5.
  • Coinsurance: You are also required to settle a small coinsurance fee for inpatient care.

When to Join Part A?

You can enroll for Part A if you qualify for Medicare in any of the ways defined by the federal government.

How to Sign Up?

Signing up for Part A is already automatic if you have started receiving social security benefits. Also, you will not have to pay for any monthly premium cost.

If you do not receive social security already, you can sign up for Part A at a local social security office.

Will You Be Allowed to Sign Up?

You will be allowed to sign up if you qualify for Medicare. Also, you will not be refused if you have a medical history and a preexisting health complication.

Part B, Doctors Visit

If you are a recipient of social security benefits then you automatically become eligible for Medicare and you can enroll for Part B Medicare.

Part B Medicare will help you settle for all costs that have to do with necessary visits to a doctor for any health service. Part B Medicare will also include coverage for outpatient services such as the following:

  • Clinic care
  • Qualified nurse care
  • Lab testing
  • Diagnostic screens.

What Provider Will Attend to Part B?

You can pick any health provider that offers Medicare services and is receiving new patients at that particular time.

Coverage Limitation for Part B?

Part B has limitations for a few of the services it offers. An example of this is the cost of screenings and therapy.

What does Part B not cover?

On specific occasions, Part B will cover basic health care like hearing, vision, and dental. It will not cover any cost that is not within the USA, neither will it cover expenses from services like bathing and cleaning up.

Part B Premium Cost

The amount you pay for Part B premium cost is dependent on your annual income. Many people pay a monthly premium for part B. However, if you are already a recipient of social security benefits, your Part B costs will be deducted from your benefits automatically. Part B premium ranges from about $100 to $400

Part B Shared Costs

  • Deductibles: Like Part A, Part B also requires you to pay a deductible cost before it starts sharing your costs. This is around $166 annually
  • Copay: Copay costs for outpatient hospital services is around $1,288.
  • Coinsurance: Upon settling the cost of your deductibles. Part B gives you 80% coverage while you settle the 20% coinsurance costs.

When to Join?

As soon as you qualify for Medicare, you can enroll for Part B. If you do not want to join as soon as you qualify, there are windows for you to join later in the years but only at specified periods. Late enrollment can also attract a penalty.

How to Sign Up?

Since it is under the Original Medicare offered by the federal government, you can enroll as soon as you start receiving your Social Security benefits. If you do not qualify yet, you can visit a local social security office to enroll.

Will Your Enrollment Be Refused?

If you qualify for Medicare, your eligibility is automatic so your enrollment cannot be denied. Also, if you have preexisting health complications, disabilities, or medical history, you will not be refused Part B Medicare.

Part C, Medicare Advantage

Medicare Advantage is not part of the Original Medicare offered by the federal government. Only Private insurance companies like UnitedHealthcare will offer these plans in addition to Original Medicare.

Part C will offer coverage for your Original Medicare, Part A and B, and some additional health services, depending on the private company. They can also include another Part D and another probate plan for drug prescription. This will come with no added premium cost.

Getting one Medicare plan to fit in for all your health excesses is quite impossible. This is why UnitedHealthcare has a wide range of Part C for you to take advantage of. You can make a choice according to your wellbeing or the budget you plan.

UnitedHealthcare has a collaboration with AARP for its Medicare service. The aim is to make sure that you get more out of your Medicare than just the Original Medicare offered by the federal government. Most of the plans on offer will cover up drug prescriptions.

The 3 plans from UnitedHealthcare Medicare Advantage include:

  • PPO
  • HMO

What Will These Plans Cover?

The benefits that your UnitedHealthcare Medical Advantage plans will cover include the following:

  • Doctor Visit

All copay costs for doctor visits under UnitedHealthcare Medicare advantage is set at $0. Doctor visits will also cover every care received and laboratory examinations.

  • Telemedicine

The plans will allow you to communicate with a telehealth expert. You will have 24/7 access to this expert from your home.

  • Drug Prescriptions

These plans will give you free copay access to fitness and health drugs that are supposed to be more than $150.

  • Dental Coverage

You will get dental care at no cost for copay, and you will have access to any Medicare dental network available in the USA.

  • Vision Care

Just like dental coverage, you will also have access to eye tests. If need be, you will get sophisticated frames and prescription lenses free of charge too.

  • Network

UnitedHealthcare Medicare Advantage plans will grant you access to one of the largest coverage for medicare advantage in the country. Here, you will have access to more health providers, qualified doctors, and skilled nurses.

  • Hearing

You will get zero cost copay for hearing tests that will not be covered by your original Medicare. This will save you a lot of out-of-pocket costs on hearing aids. The hearing aids are from some of the best brands in the nation.

  • Health and Fitness

Another benefit is free access to a large network of fitness gyms in the country. This is nationwide access, and a great option for you if you are always on the go.

  • Over the Counter Purchases

UnitedHealthcare refers to this benefit as First Line, and it will help you save costs on medications, health products, home, and online purchases. Most UnitedHealthcare plans will give their members allowance for important wellbeing products.

These allowances can be used to settle over-the-counter purchases such as vitamins, pain suppressors, cold drugs, etc. For some of the plans, you will get allowances that cover healthy food products from certain retail stores in the country.

More Medicare for the Money You are Paying

UnitedHealthcare tailors their medicare advantage to offer more to the plan members even during these economic difficult times. They also make sure that you get the type of health care you want at your most convenient place.

Choosing a Medicare Advantage plan from UnitedHealthcare will help you get more for the money you are paying.

Their guarantees include the following:

  • Top-Notch Medicare

UnitedHealthcare Medical Advantage will offer you plans so that you can choose the one that fits your budget the most and reduce out-of-pocket expenses. They will give you access to some of the largest and most reputable Medicare Advantage specialists in the country. This also includes drug prescription, hospital visits, and lab examination will have $0 copays.

  • Benefits Coverages to Keep you at your healthiest State

You will get benefits at zero cost on some of the services that Original Medicare does not offer.

  • Fitness and wellbeing

Benefits will help keep your body in the best shape and your mind sharp. This comes with a zero-cost gym membership and virtual mental health programs. You will also get health materials and resources for your caregivers and health provider to follow, making sure that you remain in a state of healthiness.

  • Care Options

UnitedHealthcare Medicare Advantages will make sure that you get numerous options for your health care anywhere and anyhow that is suitable for you. You will receive health visits at home from qualified professionals, either virtually or physically. This benefit also includes health coverage nationwide, even if it is in an emergency.

Part D, Drug Prescription

Your original Medicare will not cover the cost of drugs that you need for healthiness. For this, UnitedHealthcare has a Part D, Drug prescription plan, that will help you settle all your drug purchases. This will ensure that you do not get maxed out from out of pocket costs.

ARRP has a plan for this purpose, known as MeidcareRX. It offers this plan through UnitedHealthcare. This plan is tailored to make sure that you save as much as you can on drug prescriptions.

MedicareRX will still cover your drug prescription regardless of if your health status changes or not.

Aside from the ARRP plan, UnitedHealthcare drug prescription plan will cater for generic and branded medications. However, the plan has a list of the type of drugs they cover.

You can also get your drug prescription Plans in other ways with UnitedHealthcare:

  • The first option is to purchase the Part D plan that is a standalone plan. As long as you have the Original Medicare or any Supplemental plan that UnitedHealthcare offers you can enroll in this plan.
  • The second option that will cover your prescription drug is the Medical Advantage plan. For this, you will have to buy a Medicare Advantage plan that covers drug prescriptions because not all of them do.
  • UnitedHealthcare Medicare Supplements also has plans with drug prescription features.

Ways to Purchase Drug with UnitedHealthcare

If you have any of the prescription drug plans, you can get your medications in either of the 2 ways.

Selected Network Pharmacy

There are many plans that will cover up this cost as long as the pharmacy you choose is within the preferred network.

Mail Order

With this plan, you can save enough costs by getting a minimum of 3 months’ drug supply at your home. ARRP and UnitedHealthcare offer these services via OptumRX.

UnitedHealthcare Medical Advantage and Drug Prescription Plan

If you do not want just a prescription drug plan, and you are looking for more coverage, Medical Advantage plus Prescription Drug is the most suitable alternative. Plans under these services will offer coverage for hospital and doctor visits, and prescription drugs at the very least.

UnitedHealthcare makes sure that you get more benefits for your original Medicare. Some of the benefits include the following:

  • Reduced costs on premium payments. For some plan, this will even be as low as $10
  • Copays and annual limits will be covered.
  • More than one thousand generic and branded drugs will be covered.
  • No copay cost for home delivery services offered by OprumRX.
  • Other core benefits like Hearing, dental, and vision care.

Home Delivery Limitation

You should be familiar with the limitations of UnitedHealthcare home delivery for the drug prescription plan.

For MedicareRX that UnitedHealthcare offers in collaboration with AARP, OptumRX delivery services will not be available in regions like Guam, Northern Mariana Island, and American Samoa.

Other important detail you should know include the following:

  • UnitedHealthcare has a collaboration with OptumRX.
  • Regardless of your plan, you are not required to use the home delivery service from OptumRx for a period of 90 to 100 days of your drugs.
  • If you are a first-time user of OptumRX, before you fill the prescription list provided by your health provider, you must first approve it.
  • The home delivery will be in about 5 days after OptumRx receives your drug prescription list.

UnitedHealthcare Medicare Supplement or Medigap

Just like other plans, Medicare supplements will help cover up for the limitations of Original Medicare. UnitedHealthcare Medigap plan is the AARP Medicare Supplement insurance.

Its features include the following:

  • Low Expenses

Medicare supplement will help you with no or low out-of-pocket costs.

  • Doctor Preference

You can choose your health provider from any of the hospitals or doctors that offer Medicare services, as long as they accept you as their patient. You do not need a referral for this.

  • Life Coverage

UnitedHealthcare Medigap features will remain the same every year, and so will the medical coverage they offer, regardless of if your health status changes.

  • Traveling coverage

Medicare supplements will provide coverage for you everywhere in the nation.

  • Other Plans

The medical supplement works with the drug prescription plan, and this will let you have more coverage.

UnitedHealthcare Medigap coverage will continue to be renewable forever, as long as you do not stop paying premiums at the specific time and your enrollment details are correct. Changes made to UnitedHealthcare Medicare supplement are only applicable to members of a plan in a state.

UnitedHealthcare and AARP Medical Supplement Plan

UnitedHealthcare Medicare coverage has been going on for more than three decades. In this period, they have collaborated with many other brands for health benefits and this is why ARRP endorse their Medigap plans

Even though Medicare supplements are usually similar regardless of the insurance company, AARP Medicare Supplement Plan from UnitedHealthcare stands out with so many features and benefits.

UnitedHealthcare is the leading health Insurance company in the USA when it comes to Medicare supplements. It has more than 4 million members under its plans.

ARRP is not an insurer itself, and this is why they make use of UnitedHealthcare Medical supplement for their members. To sign up for the plan via ARRP, you must be a member.

UnitedHealthcare Dual Special Need Plans

This is a plan that UnitedHealthcare offers to those that are eligible for Medicare and Medicaid Services. The plan has many benefits way beyond original Medicare. It will help with the coordination of care and has a premium zero cost. UnitedHealthcare introduces some exclusive benefits into this plan, and they all come at no cost.

Coverage for Dual Special Need Plans

Some of the coverage for this plan includes the following:

  • Dental Care

This is one of the core services from UnitedHealthcare and it features in most of their plans. Dental coverage will require no cost, and it comes with an all-inclusive dental service.

  • Drug Prescription

Dual Special Need Plans will also cover drug prescriptions. You will also have the normal option of home delivery from OPtumRx and all of these comes at no cost.

  • Credits on Products

You will get credits to purchase some of your important products at zero cost, and this will include over counter medication purchases.

  • Meal Costs

You will receive allowances to purchase food products at specific retail stores.

  • Vision Care

Dual Special Need Plans will also cover all vision examinations as well as frames and lens costs.

  • Transportation Coverage

The plan will cover all the costs of transportation, including trips to the hospital or pharmacy.

Who is the Dual Special Need Plan Adequate for?

You can enroll for UnitedHealthcare Dual Special Need Plans if you meet the following requirements:

  • You have both Medicare and Medicaid full benefits.
  • You have a complicated medical requirement.
  • You are in need of assistance to organize your health care
  • You want to take advantage of the additional benefits at zero cost.

Dual Special Need Plans are not right for you if:

  • You are not eligible for both Medicare and Medicaid. Eligibility for only one of the two does not count.
  • You suffer from end-stage renal failure. If this is you, you can reach out to UnitedHealthcare agents and on how you should go about it.
  • Some Dual Special Need Plans are not accessible by people who reside in certain regions, but there will be other plans from Medical Advantage that they can enroll for.

Note: You should not make use of Dual Special need plans for emergency situations or urgent health care provision. In case of an emergency, call 911.



Greg McKnight

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