UnitedHealthcare Medicare Advantage Plan Review in 2024

UnitedHealthcare (UHC), part of UnitedHealth Group, is a major healthcare insurance company in the United States operating in over 100 countries worldwide. UnitedHealthcare's insurance products cover millions of people in all 50 states.

Tracing its origins to the 1970s, UHC boasted assets of over $200 billion in 2022 and over $300 billion in revenue. UHC has established itself as a preeminent healthcare insurance company in the United States. Its innovation and successful healthcare strategy have given it a strong reputation. This article will discuss UnitedHealthcare's Medicare Advantage plans and help you decide if it is a good option.

Is UnitedHealthcare good insurance?

Provider overview

• Available in all 50 states, with variations based on plan types
• Provides dental, vision, hearing, and lifestyle benefits
• Rated 5 out of 5 by CMS

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Given its strong reputation, brand history, and size, UnitedHealthcare is considered a high-quality insurance company and a significant player in Medicare. This means you can expect a wide range of available providers and a robust customer support to settle your medical claims. Third-party sources highly rate UHC, and we will discuss the details of UHC’s Medicare Advantage plan later in the article.

Several things must be considered when evaluating which Medicare Advantage plan to purchase. For example, even though UnitedHealthcare’s nationwide network of providers is robust, most plans are designed for local areas, often based on zip codes. Regardless of insurance carrier, plan availability is often marketed or available based on location. See below for the pros and cons of choosing one of UnitedHealthcare’s Medicare plans.

Pros and cons of UnitedHealthcare Medicare plans

This section discusses the potential pros and cons of choosing one of UnitedHealthcare's Medicare Advantage plans. Carefully consider this list or any other information you may find before choosing.

UnitedHealthcare Medicare Advantage plans: how does it work?

There are several structures that UnitedHealthcare’s Medicare Advantage plan can take. The most significant differences include a requirement to enroll with a PCP, patient access to specialists, and the network size a patient can access.

UnitedHealthcare offers the following plan structures: health maintenance organization (HMO), health management organization-point of service (HMO-POS), preferred provider organization (PPO), and special needs plans (SNPs). This section will take each of the network plans/structures and inform a potential consumer of how each operates.

PPO

Preferred provider organization (PPO) plans are the first style of plan discussed in this section. Patients have a flexibility for receiving services with both in-network vs out-of-network providers, but out of network services have higher cost shares.

HMO

Health maintenance organization (HMO) plans are very common across the insurance industry, including in the Medicare Advantage arena. HMOs are very popular because they help reduce costs and spending for both insurers and patients by developing a cohesive in-network approach to health management. Monthly premiums for HMO plans can be very low, maybe even $0 per month, depending on where you live.

Copays for doctor office visits can be very low, typically ranging from $0-45. Commonly, you must pick a primary care doctor in the HMO network and stay within the network for any type of specialist or any other needs. Sometimes those specialist visits will also require a referral. The downside of the HMO approach is that the options for in-network providers may be limited or located far away.

HMO-POS

HMO-POS (point-of-service) plans are a hybrid of the traditional HMO and point-of-service options for out-of-network services. Patients still have a primary care doctor but can get care out-of-network services at a higher cost. Specialist visits typically require a referral as well. A few negatives of these plans are that they are not widely available, nor do all providers accept them.

SNPs

UnitedHealthcare also offers special needs plans (SNPs). To participate in this plan, you must meet specific eligibility requirements, as they cater to unique health conditions or financial status. There are three types of SNPs under the UnitedHealthcare umbrella:

• Dual Special Needs Plans (D-SNPs) for patients with both Medicaid and Medicare (often referred to as “dual eligible”).

• Chronic Special Needs Plans (C-SNPs) for people who have serious or disabling chronic conditions.

• Institutional Special Needs Plans (I-SNPs) for people who live in locations such as a skilled nursing center, rehabilitation hospital, or long-term care hospital.

Each SNP plan may include tailored offerings for the group they are catered toward, but each will have the basic similarities previously discussed.

UnitedHealthcare Medicare Advantage benefits

The benefits provided by UnitedHealthcare’s Medicare Advantage plans can be grouped together as such:

• Treatment, services, stays, visits, and operations covered by Parts A and B of Original Medicare.
• Extra extended benefits over and beyond the coverage of Original Medicare.

All Medicare Advantage plans must cover everything covered under Original Medicare, and UnitedHealthcare’s plans are no exception. Those visits include treatment for illness or injury, doctor trips, and hospital stays. Additionally, UnitedHealthcare’s Medicare Advantage plans may consist of the following services:

• Dental care. Exams, cleanings and X-rays.
• Eye care. Exams, eyeglasses and corrective eyewear/lenses.
• Hearing care. Hearing tests and hearing aids.
• General health and exercise. Wellness programs and fitness memberships.
• Other. Extra perks such as transportation to medical visits and virtual provider appointments (telemedicine/telehealth).

The cost of UnitedHealthcare’s Medicare Advantage

Each plan calculates the monthly premium for UnitedHealthcare’s Medicare Advantage differently. Every patient’s situation will be unique and localized. Geographic location is a significant factor, and the patient’s city, state, zip code, etc., are all plan availability and cost aspects.

These are just a few selected examples from one location. As you evaluate UnitedHealth’s offerings, it will be important to refer to local reviews in addition to the cost of services. A $0 premium refers to the amount paid over a patient’s Part B monthly premium. It’s important to continue to pay your monthly Part B premium to maintain Medicare Advantage coverage.

UnitedHealthcare Medicare Advantage Reviews and Ratings

As you consider enrolling in a Medicare Advantage plan, it is essential to remember reviews and feedback are very localized. A patient’s experience in Arkansas has no bearing or influence on a patient’s experience in Virginia. Similarly, a high or low-rated plan in Shelby County, Tennessee, will not be open to you in Davidson County, Tennessee.

Always look to your local area for the most accurate ratings and pricing. Third-party rating sites, like J.D. Power and Think Advisor, conduct studies on consumer services such as Medicare Advantage insurance.

Overall customer satisfaction with Medicare Advantage plans is 652 (on a 1,000-point scale), which is squarely in the good-to-great range of the newly redesigned U.S. Medicare Advantage Study index model. Plans perform highest on trust, ease of business, and meeting member product/coverage needs.

J.D. Power

NCQA

The National Committee for Quality Assurance, a leader in improving access to care and healthcare insurance plan accreditation, rated Medicare advantage plans from 1-5, with 1 being a low score and 5 being a high score.

The NCQA rated UnitedHealthcare's plans in a range of 2.5-4, based on location.

J.D. Power

J.D. power, a trusted leader in providing third-party analytics and reviews, rated Medicare Advantage plans based on customer satisfaction in five, heavily populated U.S. states (FL, PA, CA, TX, & NY in 2023).

In Florida, UnitedHealthcare's plan ranked 2nd overall in customer satisfaction in 2023. In the other states it was not rated or not in the top 3.

What to consider when choosing a UnitedHealthcare Medicare Advantage plan

As you choose a Medicare Advantage plan, several factors must be considered. To get started, consider some of the things from the list below:

1. Ensure any physician you plan to see is included in the plan's Provider Network. If your provider is not in the plan's network, but you have out of network coverage, make sure you review the costs associated with that.
2. Make sure your plan covers your medication(s).
3. See what pharmacies near you fall under the plan’s coverage.
4. Compare/contrast potential total out-of-pocket expenses (Maximum Out-of-Pocket Amount).
5. See the amount for potential coinsurance/copayments would be.
6. Find which dental or vision providers are covered in your plan’s area.

Do not choose a plan based on monthly premium costs alone; there are many factors to consider as you decide on the plan.