UnitedHealthcare & Medicare Advantage Plans

UnitedHealthcare is a massive option for your health coverage. According to the Kaiser Family Foundation, the company accounted for 26 percent of Medicare Advantage enrollments in 2020. UnitedHealthcare has several different types of plans available that cater to different areas.

UnitedHealthcare Medicare Advantage Plans Coverage

Medicare Advantage plans cover everything that is included in Original Medicare as well as additional benefits and expanded coverage. There are several different types of these plans on the market, which are available by government-approved private insurance companies.

Regardless of what Medicare Advantage plan you end up selecting, you are guaranteed national emergency care coverage.

HMO Plans

HMO plans are a very common type of Medicare Advantage offered by companies like UnitedHealthcare.

In these plans, you typically have a primary care physician that you choose and must stay within your plan network to receive coverage. The only time you can leave your network for treatment is if you are in a medical emergency.

To see a specialist, you may need a referral from your primary care physician.

HMO-POS Plans

A health maintenance organization (HMO) in conjunction with its point of service — collectively known as an HMO-POS — is essentially a hybrid of an HMO and a preferred provider organization (PPO).

In an HMO-POS plan, you still have a primary care physician but can get some care outside of your network at a higher cost. You typically still need a referral from your primary care physician to see a specialist as well.

PPO Plans

UnitedHealthcare’s PPO plans offer some more flexibility than you can get from a typical HMO plan. You can leave your network to receive care but may have to pay higher premiums when you do so.

Also, in some plans provided by UnitedHealthcare, you may not need a primary care physician or referrals to see specialists.

PFFS Plans

Private fee-for-service (PFFS) plans allow you to use any doctor who participates in Medicare, instead of having to rely on a primary care physician or stay within a certain plan network.

Your specific UnitedHealthcare plan will determine how much you pay for treatment and services when you receive them.

SNPs

UnitedHealthcare also offers access to special needs plans (SNPs). You must meet certain requirements to qualify, like being eligible for Medicare and Medicaid, if you stay in a skilled nursing facility, or if you have a certain qualifying condition like diabetes, cardiovascular disease or chronic heart failure.

Average Cost of UnitedHealthcare Medicare Advantage Plans

UnitedHealthcare offers many $0 premium options, which can be a major factor if you are looking to save money on your health care in retirement.

Remember that you are still responsible for your Part B premium and other costs, so your health care is in no way free. You still have the option to obtain Medicare Advantage benefits without adding additional expenses, though.

Outside of $0 premiums, your costs will vary depending on the type of plan you choose and where you live. More populated states and areas tend to have more options, which can give you a better chance of finding a cheaper plan.

Speaking with a knowledgeable Medicare advisor can help you compare Medicare Advantage plans.

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Pros and Cons of Medicare Coverage from UnitedHealthcare

One of the pros of opting for UnitedHealthcare is the company’s size. According to the Kaiser Family Foundation, it has more Medicare Advantage enrollees than any other company by a significant option. This is due in part to its diversity of options and availability across the country.

But there are some cons as well. While it is the larger company, UnitedHealthcare has ranked behind Humana and several other companies in customer satisfaction. And according to the Star Tribune, UHC was sanctioned in 2021 by the U.S. Centers for Medicare & Medicaid Services for not spending enough of its premium revenue on medical benefits.

As a result, some of UnitedHealthcare’s plans cannot add new members this year.

Average Rating of UnitedHealthcare

UnitedHealthcare is typically a well-regarded company with good ratings. According to J.D. Power, the company ranked fourth in customer satisfaction in 2020 and scored at about the industry average.

Insurance Business Magazine also ranked UnitedHealthcare as the best health insurance company in the U.S. in 2021. Overall, there are few Medicare Advantage companies with as great of a reach, general customer satisfaction and number of options as UnitedHealthcare.

Last Modified: November 16, 2021

6 Cited Research Articles

  1. Snowbeck, C. (2021, September 15). Feds penalize UnitedHealthcare plans for underspending premiums on medical care for seniors. Retrieved from https://www.startribune.com/feds-penalize-unitedhealthcare-plans-for-underspending-premiums-on-medical-care-for-seniors/600097385/
  2. Rosanes, M. (2021, August 23). Top 10 health insurance companies in the U.S. Retrieved from https://www.insurancebusinessmag.com/us/news/healthcare/top-10-health-insurance-companies-in-the-us-212292.aspx
  3. Kaiser Family Foundation. (2021, January 13). A Dozen Facts About Medicare Advantage in 2020. Retrieved from https://www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage-in-2020/
  4. J.D. Power. (2020, June 18). Medicare Advantage Plans Struggle to Communicate Effectively with Members. Retrieved from https://www.jdpower.com/sites/default/files/file/2020-06/2020068%20U.S.%20Medicare%20Advantage%20Study.pdf
  5. UnitedHealthcare. (2021). 2021 Medicare Advantage benefit plan names. Retrieved from https://www.uhcprovider.com/content/dam/provider/docs/public/health-plans/medicare/MA-SNP-Benefit-Plan-Name-Overview.pdf
  6. UnitedHealthcare. (n.d.). What are HMO, PPO, EPO and POS health insurance plans? Retrieved from https://www.uhc.com/understanding-health-insurance/types-of-health-insurance/understanding-hmo-ppo-epo-pos