UnitedHealthcare & Medicare Advantage Plans
UnitedHealthcare is a massive option for your health coverage. According to the Kaiser Family Foundation, the company accounted for 28% of Medicare Advantage enrollments in 2022. UnitedHealthcare has several different types of plans available that cater to different areas.
- Written by Christian Simmons
Christian Simmons is a writer for RetireGuide and a member of the Association for Financial Counseling & Planning Education (AFCPE®). He covers Medicare and important retirement topics. Christian is a former winner of a Florida Society of News Editors journalism contest and has written professionally since 2016.Read More
- Edited ByLee Williams
Senior Financial Editor
Lee Williams is a professional writer, editor and content strategist with 10 years of professional experience working for global and nationally recognized brands. He has contributed to Forbes, The Huffington Post, SUCCESS Magazine, AskMen.com, Electric Literature and The Wall Street Journal. His career also includes ghostwriting for Fortune 500 CEOs and published authors.Read More
- Published: October 18, 2021
- Updated: November 30, 2022
- 4 min read time
- This page features 7 Cited Research Articles
- Edited By
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 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.
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.
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.
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.
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.
Pros and Cons of Medicare Coverage from UnitedHealthcare
One of the pros of opting for UnitedHealthcare is the company’s size. According to a study from 2022, it has more Medicare Advantage enrollees than any other company. 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. In the J.D. Power 2022 U.S. Medicare Advantage Study, UnitedHealthcare scored 808 out of an 1,000-point scale on their overall customer satisfaction index ranking.
Insurance Business Magazine also ranked UnitedHealthcare as the best health insurance company in the U.S. in 2022. Overall, there are few Medicare Advantage companies with as great of a reach, general customer satisfaction and number of options as UnitedHealthcare.
7 Cited Research Articles
- J.D. Power. (2022, August 18). Customers Perceive Shortfall in Medicare Advantage Plan Coverage of Mental Health and Substance Abuse Services, J.D. Power Finds. Retrieved from https://www.jdpower.com/sites/default/files/file/2022-08/2022100%20U.S.%20Medicare%20Advantage_0.pdf
- Rosanes, M. (2022, September 9). Revealed – 10 Largest Health Insurance Providers in the US. Retrieved from https://www.insurancebusinessmag.com/us/news/healthcare/revealed--10-largest-health-insurance-providers-in-the-us-419929.aspx
- Freed, M. & et al. (2022, August 25). Medicare Advantage in 2022: Enrollment Update and Key Trends. Retrieved from https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2022-enrollment-update-and-key-trends/
- 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/
- 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
- 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
- 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
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