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UnitedHealthcare is the market leader in U.S. health insurance. Its Medicare offerings are robust, with a wide range of options and broad national coverage. It offers an app and online tools, numerous extra benefit programs, and telehealth options. UnitedHealthcare plans sometimes cost more than competitors’ plans, though they offer various options at different price points.
- Pros & Cons
- Key Takeaways
- Company Overview
- UnitedHealthcare is the largest health insurer in the U.S., with a broad national scale and a wide range of Medicare products and benefits.
- It is the only Medicare plan to jointly promote Medicare plans with AARP.
- UnitedHealthcare offers robust online capabilities, such as a drug cost estimator and a plan recommendation tool for prospective members.
- Member benefits include the common Medicare Advantage extras plus home visits and telehealth coverage.
Founded in 1974 as Charter Med Incorporated, Minnesota-based UnitedHealthcare Group operates two main businesses: Optum, a health services and information technology firm that serves healthcare clients around the world, and UnitedHealthcare, the largest health insurer in the U.S. with a 14.4% market share. United Healthcare writes more than $150 billion a year in direct premiums.
UnitedHealthcare offers Medicare plans nationwide, including Medicare plans co-branded with the AARP. The company offers online, phone, and in-person support. Members can also get service via the UnitedHealthcare app.
UnitedHealthcare offers Medicare Advantage plans in all 50 states and Medicare Supplement Insurance (Medigap) in all 50 states as well.
- Year Founded 1974
- Kinds of Plans Medicare Advantage HMO, HMO-POS, and PPO Plans; Private Fee-for-Service (PFFS) Plans; Stand-alone Prescription Drug Plans (PDP); Dual-eligible Special Needs Plans (D-SNP); Medicare Supplement Insurance (Medigap) Plans
- Number of Plans 5
- Payment Options Pay Medicare Advantage or Prescription Drug Plan premiums by mail or via automatic payments from checking account or credit or debit cards, via automatic deduction from Social Security or Railroad Retirement Board benefit checks.
- Customer Service By telephone, online chat, or make an appointment to meet an agent in-person
- Phone Number Prospective Members: 877-596-3258; Current Medicare Advantage and Prescription Drug Plan Members: Call the number on the back of your Member ID card or 800-721-0627 for technical issues. Current Medicare Supplement Insurance (Medigap) Plans: 800-523-5800
- Official Website www.uhc.com/medicare
- Offers largest national network of providers: UnitedHealthcare boasts a gigantic provider network with 1.3 million doctors and healthcare professionals and more than 6,500 hospitals and care facilities.
- Recommends plan options that might fit your needs: UnitedHealthcare’s online plan recommendation tool helps narrow down the choices with recommendations of best-fit plans. Recommendations are based on specific doctors, medications, travel habits, and other preferences, or you can skip over the details and answer basic questions.
- Virtual visits and free house calls are available on some plans: UnitedHealthcare has multiple ways to get healthcare from home through virtual visits with a telehealth company and an annual house call.
- Only health insurer partnered with AARP: AARP and UnitedHealthcare have partnered to co-brand Medicare insurance plans. Investopedia chose AARP Medigap plans as the best for set pricing because prices don’t change as you age.
- Highly rated plans: UnitedHealthcare received a 3.5-star overall rating for Medicare in 2020.
- Prices can be higher: Some UnitedHealthcare Medicare Advantage plans average higher premiums or out-of-pocket maximums than some competitor plans. You may get more for these higher prices, such as access to a broad national network and extra benefits, but if cost is your primary concern, you may be able to find cheaper options in some markets on some products.
Medicare Advantage Plans
UnitedHealthcare offers several types of Medicare Advantage plans, including HMO, HMO-POS, and PPO plans. Most UnitedHealthcare Medicare Advantage plans include extra benefits like dental, vision, hearing, fitness, and in-network telehealth visits. It also boasts the largest Medicare Advantage network of doctors, specialists, and other healthcare providers, though network size varies by market.
1. HMO Plans
These plans require members to get all of their care within the HMO network of providers. Many of these plans include prescription drug coverage and allow members to see providers around the country via the UnitedHealthcare Medicare National Network for in-network rates and UnitedHealthcare Passport, which covers members for certain services with the costs of the HMO network while traveling.
2. HMO-POS Plans
HMO-POS (Point of Service) plans are like HMO plans but offer somewhat more flexibility to see healthcare providers outside of a specific network than HMO plans. Members in UnitedHealthcare’s HMO-POS plans can get some covered services outside the HMO network, but out-of-network care costs more.
3. PPO Plans
UnitedHealthcare’s PPO plans don’t require members to choose a PCP or get referrals to see in-network specialists or hospital visits. Many of these plans provide access to the UnitedHealthcare Medicare National Network at in-network prices.
4. Private Fee-for-Service Plans
UnitedHealthcare’s Private Fee-for-Service (PFFS) plans have no provider network, which means members can get care from any doctor, hospital, or other healthcare providers so long as they participate with Medicare. UnitedHealthcare PFFS plans without prescription drug coverage can be paired with a Stand-Alone Prescription Drug Plan.
5. Dual-Eligible Special Needs Plans (D-SNP)
Dual-Eligible Special Needs plans (D-SNP) are a Medicare Advantage plan for people who have both Medicare and Medicaid. D-SNPs offer the benefits of Medicare Advantage with additional benefits the private insurer may choose to include.
UnitedHealthcare’s D-SNP plans, called UnitedHealthcare Dual Complete, help people coordinate care and benefits and typically include extra benefits such as dental care, vision coverage, free rides to and from doctor visits and pharmacies, and credits to buy health products over the counter and healthy foods at local retailers. All of UnitedHealthcare’s D-SNP plans include prescription drug coverage. In 2021, UnitedHealthcare removed copayments on covered drugs in most D-SNP plans.
Stand-Alone Prescription Drug Plans
Stand-Alone Prescription Drug Plans (PDP) cover medications that fall into the Medicare coverage gap. On UnitedHealthcare’s website, you can estimate the cost of specific drugs and compare those costs on PDPs versus Medicare Advantage Prescription Drug Plans (MAPDs). UnitedHealthcare offers three PDP categories, in partnership with AARP, each with slightly different costs, coverage, and drug lists:
- AARP MedicareRx Walgreens: Low premiums and access to 9,000 Walgreens and Duane Reade pharmacies nationwide
- AARP MedicareRx Preferred: No deductibles and coverage of most generic and brand-name drugs covered by Medicare Part D
- AARP MedicareRx Saver Plus: Low copayments on many generic and some brand-name drugs, best for people who want coverage but don’t take a lot of medications
Medicare Supplement Insurance (Medicap) Plans
Medicare Supplement plans, also known as Medigap, cover some of the costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. You must have Medicare Parts A and B, and you can’t have Medicare Advantage to get a Medigap plan. There are 10 standardized plans that cover different costs; not all are available in every state.
- UnitedHealthcare offers Medigap Plans with the AARP: A, B, D, G, K, L, N
All Medigap plan benefits are the same no matter the insurer, but costs and any additional benefits can vary.
Most Medicare Advantage plans offer extra benefits, such as fitness, dental, and vision benefits, as well as hearing aids, over-the-counter medications, and meal benefits. UnitedHealthcare offers a robust set of extra benefits, including dental, vision, and hearing benefits. The UnitedHealthcare Renew Active program offers free gym memberships, workout videos, and an online brain health program from AARP's Staying Sharp.
Other extra benefits include:
- Over-the-Counter Benefits: UnitedHealthcare offers FirstLine, a program that gives members an allowance for over-the-counter health products like vitamins and pain relievers.
- In-Home Visits: Through the UnitedHealthcare HouseCalls program, most Medicare members can get a free annual in-home visit with a doctor, nurse, or medical assistant, who performs a physical exam and health screenings. These providers share the information from the visit with members' primary care doctors and leave members with a checklist to discuss with their primary care doctors at their next visit.
- Telehealth: UnitedHealthcare offers virtual visits on many of its plans, including Medicare Advantage. These online consultations are through telehealth services such as Teladoc, American Well, or Doctor on Demand. Not every plan includes this benefit. UnitedHealthcare Medicare Advantage plans include coverage for telehealth visits.
UnitedHealthcare offers many ways to get customer service, including by phone, online, mail, and in-person.
Prospective members interested in learning more about UnitedHealthcare Medicare Advantage options can call 800-607-2877 between 7 a.m. and 10 p.m. CT, seven days a week, or make an appointment to meet with an agent. Current members call the customer service phone number on the back of their member ID card.
When you first visit the UnitedHealthcare website, you may be offered a chat option, though you’ll have to enter some basic personal information to begin.
Medicare Prescription Drug Plans
Current members call the customer service phone number on the back of their member ID card between 7 a.m. and 10 p.m. CT, seven days a week.
App and Social Media
UnitedHealthcare also offers a UnitedHealthcare app where members can find and have video chats with in-network healthcare providers, view their claims and payments, get cost estimates, and refill prescriptions. You can chat with UnitedHealthcare representatives via Meta and Twitter seven days a week via direct message.
The National Association of Insurance Commissioners (NAIC) tracks complaints against insurers of all types, including health insurers. In its complaint index, NAIC divides the company's share of complaints by its share of premiums in the U.S. market. A score of less than 1.0 means the insurer received fewer than expected complaints; a score of greater than 1.0 means they received more than expected.
UnitedHealthcare's current overall complaint index (based on the year 2021) is 0.96. Its Medicare Supplement complaint index is a fantastic 0.25. There is no business line index for Medicare Advantage.
AM Best has given UnitedHealthcare an A+ (Superior) financial strength rating. This means that AM Best believes the company is well poised to meet its financial obligations and fulfill its policies.
The National Committee for Quality Assurance (NCQA) is a leading health plan accreditation organization that rates plans based on quality and customer satisfaction measures. In the 2019–2020 ratings, UnitedHealthcare plans scored between 2.0 to 4.0 out of 5.0. These composite scores include customer satisfaction, satisfaction with the doctors, and satisfaction with the health plan.
Some UnitedHealthcare plans that don’t score high in NCQA’s overall health plan rating do better on member experience measures; some score well overall but poorly on member experience with the health plan.
In its 2021 U.S. Medicare Advantage Study, J.D. Power measured member satisfaction with Medicare Advantage plans based on the plans’ coverage and benefits, choice of healthcare providers, cost, customer service, information and communications, and billing and payment processes. UnitedHealthcare ranked seventh out of 10 insurance companies with a score of 795 points out of 1,000.
Medicare Star Ratings
The Centers for Medicare and Medicaid Services (CMS) rates Medicare Advantage and Prescription Drug Plans on a five-star quality rating system. These ratings incorporate member complaints into the overall rating. Star Ratings vary by state, county, and plan.
In the 2021 Star Ratings, UnitedHealthcare’s plans received between 3.0 and 5.0 out of 5.0 Stars. The average UnitedHealthcare Star Rating is 3.87 overall. Their Medicare Advantage Part C plans average 3.77 Stars, and their Part D Prescription Plans score an average of 3.89. Four UnitedHealthcare plans got the top score (5.0), and seven plans earned 4.5 out of 5.0.
Medicare health plan costs depend on many factors, including where you live, which type of coverage you want, and what insurance company you choose.
- Details on premiums, copayments, coinsurance, deductibles, and out-of-pocket maximums for each plan are available on the UnitedHealthcare website.
- You can put in your zip code to see plans and prices for your area.
Health plan costs typically require trade-offs; a low-premium plan tends to have higher out-of-pocket costs and vice versa.
UnitedHealthcare’s three PDP categories have a range of costs.
AARP MedicareRx Walgreens
- Copayments as low as $0 on prescriptions filled at Walgreens pharmacies
- $0 copayments on 90-day supplies of Tier 1 drugs through OptumRx Home Delivery
- $0 annual deductibles on Tiers 1 and 2, $445 on Tiers 3, 4, and 5
AARP MedicareRx Preferred
- 50% off copayments on Tier 1 prescriptions at preferred retail pharmacies
- $0 copayments on 90-day supplies of Tier 1 and 2 drugs through OptumRx Home Delivery
- $0 annual deductibles
AARP MedicareRx Saver Plus
- Copayments as low as $1 on prescriptions filled at preferred retail pharmacies
- $3 copayments on 90-day supplies of Tier 1 drugs through OptumRx Home Delivery
- $445 annual deductibles
Competition: UnitedHealthcare vs. Kaiser Permanente
UnitedHealthcare has the largest share of the Medicare Advantage market (26%), offers the largest provider network nationally, and offers plans in 66% of U.S. counties. They score well on quality, according to CMS Star Ratings, with an average of 3.78 out of 5.0 Stars. Kaiser Permanente’s drawbacks are its relatively limited availability—they operate in only seven states. Kaiser Permanente does better on the CMS Star Rating, with six out of seven Kaiser Permanente plans receiving a 5.0 for the 2021 plan year, putting their overall average at 4.93.
Kaiser Permanente also beat UnitedHealthcare on the J.D. Power 2021 Medicare Advantage Study, ranking second overall with a score of 846 out of 1,000 compared to UnitedHealthcare’s 795. They also only offer HMO plans, which can feel restrictive for members who want to see healthcare providers outside of the HMO network.
For quality, Kaiser Permanente is a clear winner if you live in the states they serve. For breadth of choice and products that offer more flexibility, UnitedHealthcare has the edge.
|Number of States Available (Medicare Advantage)||50||7|
|Customer Service Options||Telephone, online, in person, chat||Telephone, online, in person, chat|
|AM Best Rating||A (Excellent)||Not rated|
|Average CMS Star Rating||3.78||4.93|
UnitedHealthcare is the clear market leader in the Medicare market and offers a full assortment of Medicare insurance products. Though some costs may be higher with some UnitedHealthcare plans, the benefits are robust, and the network of healthcare providers is especially large. Their online tools and user-friendly website, high-quality ratings, and unique partnership with AARP should offer consumers peace of mind.
How We Reviewed Medicare Providers
Even Medicare health plans with a national presence can vary locally in their cost, quality, and customer satisfaction. To evaluate Medicare plans, we looked at health insurance industry ratings from the primary accrediting agency for health plans, NCQA, and the Medicare Star Ratings from CMS, the regulatory agency that oversees Medicare. We included the National Association of Insurance Commissioners’ complaint index and AM Best’s financial stability ratings. We also considered information from the companies on their programs and strategies.