UnitedHealthcare Medicare Review

Pros Explained

• High average Medicare star rating: UnitedHealthcare’s Medicare Advantage plans are rated an average of 4.2 out of 5 stars by the Centers for Medicare and Medicaid Services (CMS). The only nationwide insurer with a higher average star rating was Blue Cross Blue Shield. 
• Many plans offer additional gap coverage: UnitedHealthcare offers both Medicare Advantage plans and prescription drug plans that have additional coverage during the donut hole phase, which makes this company a great option for people with extensive medication needs. It’s one reason UHC earned the top spot on our lists of the Best Medicare Advantage Plans and the Best Medicare Part D Plans. 
• Affordable Medicare supplement plans: UnitedHealthcare offered the best pricing for Medigap plans of the providers we reviewed, with an average monthly Plan G cost of $184 in Texas and Florida. 
• Largest national provider network: As the largest provider of Medicare Advantage plans, it’s no surprise that UnitedHealthcare also has the largest national MA provider network of all major insurers.

Cons Explained

• Slightly below average J.D. Power score: UnitedHealthcare was ranked fourth in the J.D. Power 2022 U.S. Medicare Advantage Study, with a score just one point below the industry average. A few companies were better rated, but other companies fared worse. 
• Medicare Advantage plans are not low-cost: For 2023, UHC Medicare Advantage plans limit the maximum OOP to $5,299.47, on average, which is on par with other major insurers like Blue Cross Blue Shield and Cigna. The average drug deductible ($85.82) is also middle-of-the road. These aren't major strikes against the company, but there are plans with lower overall costs available.

Third Party Ratings

UnitedHealthcare has good customer satisfaction and financial strength ratings. The company’s Medicare Advantage plans have an average CMS star rating of 4.2 out of 5 stars by the Centers for Medicare and Medicaid Services; prescription drug plans have a 3.8 average CMS star rating. The National Association for Quality Assurance (NCQA), which measures Medicare plan quality and member experience, gave UHC plans 3.9 out of 5 stars, on average. NCQA ratings tend to be lower than CMS ratings; in fact, the average NCQA rating for Medicare plans among major insurers is 3.48. 

UnitedHealthcare was ranked fourth in the J.D. Power 2022 U.S. Medicare Advantage Study. The company scored 808 out of 1,000, just slightly below the industry average of 809. The top-scoring company, Kaiser Permanente, received an 844 out of 1,000. 

UnitedHealthcare gets high marks for financial stability, with a grade of A+ (Superior) from AM Best, an independent credit ratings agency that evaluates insurance companies. This is the highest grade received by any of the Medicare Advantage providers we reviewed, and it indicates that UnitedHealthcare has a superior ability to pay claims. 

Policies Available

Medicare Advantage (Part C) Plans

Medicare Advantage plans are one way to receive Medicare Part A and Part B coverage with extra benefits, including a limit on out-of-pocket expenses. Most MA plans, including UnitedHealthcare’s, include prescription drug coverage so you don’t need to purchase a separate Part D plan. Most of UnitedHealthcare’s MA plans also include additional drug coverage during the gap phase, which is important if you anticipate spending more than $4,460 on prescriptions in 2023. Plans also come with extra benefits, like vision, dental, hearing, fitness, and OTC benefits. 

UnitedHealthcare offers the largest national provider network and a variety of plan types, including HMOs, PPOs, and special needs plans. Some plans come with $0 copays for primary care visits, virtual visits, and lab tests, along with $0 copays for Tier 1 and Tier 2 drugs. 

Part D Prescription Drug Plans

Part D plans offer coverage for your prescription medications. They’re available to people who have Medicare Part A and/or Part B, as well as people who have certain Medicare Advantage plans that don’t include prescription drug coverage. It’s a good idea to get this coverage even if you don’t currently take medications, or a late enrollment penalty may apply. 

UnitedHealthcare’s Part D plans offer a very good value relative to the industry, and the company has a preferred plan that’s great for people who take a lot of medications. It offers a $0 deductible, $0 copays for mail-delivery generics, and full coverage for Tier 1 and Tier 2 medications during the coverage gap. 

UnitedHealthcare was our top pick on our list of the Best Medicare Part D Providers. 

Medicare Supplement Plans (Medigap)

Medicare Supplement plans help cover costs like copayments, coinsurance, and deductibles not covered by Part A or Part B. Medigap plans are standardized and must follow federal and state laws. UnitedHealthcare offers Plans A, B, C, F, G, K, L, and N and offers better pricing for the popular Medigap Plan G than its competitors. Both factors contributed to the company earning the top spot on our list of the Best Medicare Supplement Insurance Providers. 

You must be an AARP member to enroll in an AARP Medicare Supplement Plan from UnitedHealthcare. AARP membership is not required for Medicare Advantage or Part D plans. 

Cost

UnitedHealthcare’s pricing is not outstanding, but it’s very reasonable, especially considering the value-packed benefits UHC plans include, such as additional drug coverage in the gap phase. Medicare Advantage premiums are slightly better than average at $14.07 per month for 2023. This is down from $16.83 in 2022. The average drug deductible beats the industry average by about $13 per month, at $85.82. As noted, the average limit on out of pocket expenses for MA plans is $5,299.47, which is near the average of all other major Medicare providers. 

The company’s prescription drug plans are also affordable, with three options that offer great coverage for the price. And UnitedHealthcare’s Medicare Supplement Plan G is priced better than any other provider we reviewed. 

Customer Service

UnitedHealthcare offers a member portal for each of its plans that allows you to complete many actions online. The company also offers extended customer service hours from 7 a.m. to 10 p.m. CT, seven days per week, and live chat. For general plan information, call the number on your member ID card. You can also reach UnitedHealthcare at one of the following phone numbers if you have technical issues:

• Medicare Advantage and Part D members: 1-800-721-0627
• Medicare Supplement members: 1-800-523-5800

Methodology

Literature Review

We identified top companies by market share within the industry offering Medicare plans from various business and market insight databases including Statistia, Plunkett, and Gale. We also considered user-generated data from Google to determine public interest and trends in Medicare plans. 

Data Collection and Verification

Our data was collected through third-party rating agencies, official government websites and databases, and directly from companies via websites, media contacts, and existing partnerships. Our sources include: AM Best, the National Committee for Quality Assurance (NCQA), J.D. Power, and the Centers for Medicaid and Medicare Services (CMS).

Data was verified to ensure data integrity and accuracy by cross-referencing the records and citation corresponding to each data point with our primary sources.

Ratings Methodology

We calculated star ratings for the quality of each company’s plan types. Factors considered for companies offering Medicare plans were: 

• Plan quality and customer satisfaction: CMS and NCQA ratings were considered to measure these criteria. Each organization independently rates the quality of Medicare plans on a one-to-five scale to help people compare plans during open enrollment. 
• Cost to value: This is a measure of plan value based on plan premiums, deductibles, maximum out-of-pocket amounts, whether additional drug coverage is offered in the Medicare gap, and star ratings.
• Additional coverage offered in the Medicare gap: The coverage gap or "donut hole" refers to a period when there is a limit on drug coverage. During this time, members are responsible for up to 25% of brand name and generic drugs. You may spend less on prescription drugs if your plan provides additional coverage during the gap.
• State availability: This measure indicates how widely available plans are across the U.S.
• Additional plan benefits: This measure concerns additional benefits available, including vision, dental, hearing, non-emergency transportation, worldwide emergencies, gym memberships, and telehealth. 
• Types of plans available: Insurance companies offer Medicare Advantage plans through managed care organizations, including HMOs and PPOs. This measure concerns the number of managed care options available.
• Special needs plans: This is a measure of whether the company offers plans designed for those with specific diseases.
• Financial strength: This measure accounts for each company’s AM Best financial strength rating to understand how well it’s positioned to pay insurance claims. 

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