If you are researching AARP Medicare Advantage, you are probably trying to understand how these plans work, what they cover, how much they may cost, and how they compare with Original Medicare. Medicare Advantage plans can combine several types of Medicare coverage into one plan, but the details can vary significantly by location and plan.
AARP-branded Medicare Advantage plans are offered through UnitedHealthcare. Availability, premiums, provider networks, prescription drug coverage, and extra benefits can differ depending on the plan and where you live.
This guide explains the basics in simple language so you can understand what to look for when comparing Medicare Advantage options.
What Is AARP Medicare Advantage?
AARP Medicare Advantage refers to Medicare Advantage plans available to AARP members through UnitedHealthcare.
Medicare Advantage, also called Medicare Part C, is an alternative way to receive Medicare benefits. Instead of receiving Part A and Part B benefits directly through Original Medicare, you enroll in a private Medicare Advantage plan that contracts with Medicare.
Most Medicare Advantage plans include:
Medicare Part A hospital coverage
Medicare Part B medical coverage
An annual out-of-pocket maximum
Coverage through a plan network
Prescription drug coverage in many plans
Additional benefits that may not be included with Original Medicare
The exact benefits depend on the specific plan.
How Does AARP Medicare Advantage Work?
When you enroll in a Medicare Advantage plan, you continue to have Medicare, but the private plan administers your Medicare-covered healthcare benefits.
You generally continue paying your Medicare Part B premium, although some Medicare Advantage plans may help pay part or all of that premium through plan-specific benefits.
Instead of paying Medicare deductibles and coinsurance directly under Original Medicare, you pay the copayments, coinsurance, and deductibles established by your Medicare Advantage plan.
For example, a plan might charge one copayment for a primary care visit and a different amount for a specialist visit.
The plan also establishes rules regarding its provider network and covered services.
What Does AARP Medicare Advantage Cover?
Coverage varies between plans, but Medicare Advantage generally provides Medicare Part A and Part B benefits.
Hospital Care
Part A coverage can include medically necessary inpatient hospital services and certain other facility-based care.
Doctor Visits
Part B generally covers medically necessary physician and outpatient medical services.
Preventive Care
Medicare-covered preventive services may be included, such as certain screenings, vaccinations, and wellness services.
Prescription Drugs
Many Medicare Advantage plans include prescription drug coverage.
These are commonly known as Medicare Advantage Prescription Drug plans, or MA-PD plans.
You should check the plan's formulary before enrolling to make sure your medications are covered.
Dental, Vision, and Hearing Benefits
Some Medicare Advantage plans offer benefits for:
Routine dental care
Vision exams
Eyeglasses or contact lenses
Hearing exams
Hearing aids
These benefits are plan-specific, so they should not be assumed to be included in every AARP Medicare Advantage plan.
AARP Medicare Advantage HMO Plans
An HMO, or Health Maintenance Organization, generally requires members to use doctors and hospitals within the plan's network except for emergencies and certain other situations.
Some HMO plans may also require you to select a primary care provider and obtain referrals before seeing certain specialists.
The major thing to check is whether your preferred doctors, hospitals, and pharmacies participate in the network.
AARP Medicare Advantage PPO Plans
A PPO, or Preferred Provider Organization, generally gives you more flexibility when choosing healthcare providers.
You typically pay less when you use in-network providers, while out-of-network care may still be covered at a higher cost for covered services.
PPO plans can therefore be useful for people who want more provider flexibility, but the costs and rules depend on the individual plan.
Special Needs Plans
Medicare Advantage also includes Special Needs Plans (SNPs) for people who meet specific eligibility requirements.
Examples include plans designed for:
People with certain chronic conditions
People who qualify for both Medicare and Medicaid
People living in certain institutional settings
Not everyone qualifies for an SNP, and availability varies by location.
How Much Does AARP Medicare Advantage Cost?
There is no single price for AARP Medicare Advantage.
Your actual costs depend on the plan available in your area.
Potential costs can include:
Monthly Medicare Advantage premium
Medicare Part B premium
Copayments
Coinsurance
Deductibles
Prescription drug costs
Out-of-network costs
Annual out-of-pocket expenses
Some Medicare Advantage plans have a $0 monthly plan premium, but $0 does not mean the healthcare is completely free.
You can still have copayments, deductibles, coinsurance, and other expenses.
What Is the Medicare Advantage Out-of-Pocket Maximum?
One important feature of Medicare Advantage is the annual out-of-pocket limit for covered Part A and Part B services.
After you reach the plan's applicable maximum for covered services, the plan generally pays 100% of covered Part A and Part B services for the remainder of the year.
This can provide financial protection from unlimited covered medical expenses.
However, the out-of-pocket maximum does not necessarily apply to every healthcare expense. For example, certain premiums, prescription drug costs, or services that are not covered by the plan can be treated differently.
Always check the plan's evidence of coverage.
AARP Medicare Advantage vs. Original Medicare
Original Medicare consists primarily of:
Part A
Part B
You can generally visit any doctor or healthcare provider that accepts Medicare, although you may have significant out-of-pocket expenses unless you have additional coverage.
Medicare Advantage combines Part A and Part B coverage through a private Medicare plan and typically includes an annual out-of-pocket maximum.
Here is a simplified comparison:
| Feature | Original Medicare | Medicare Advantage |
|---|---|---|
| Part A coverage | Yes | Yes |
| Part B coverage | Yes | Yes |
| Private plan | No | Yes |
| Provider network | Generally broader | Usually plan-specific |
| Annual Part A/B out-of-pocket maximum | No standard annual maximum | Yes |
| Prescription coverage | Usually requires Part D | Often included |
| Dental/vision extras | Limited | May be included |
| Referrals | Generally no | May be required |
| Plan rules | Government program | Plan-specific |
Neither option works exactly the same way for every person.
AARP Medicare Advantage vs. Medicare Supplement
Medicare Advantage and Medicare Supplement Insurance, also called Medigap, are different approaches.
With Medicare Supplement coverage, you generally remain enrolled in Original Medicare and use the supplement to help pay certain Medicare cost-sharing amounts.
Medicare Advantage replaces the way you receive most Medicare Part A and Part B benefits through a private plan.
A person generally cannot have a Medicare Supplement policy and Medicare Advantage plan at the same time.
Prescription Drug Coverage
Prescription coverage is an important part of comparing Medicare Advantage plans.
A plan's drug coverage may depend on:
The medications you take
The drug tier
Your pharmacy
The plan's formulary
Deductibles
Copayments
Coinsurance
Coverage rules
Before enrolling, create a list of every prescription you regularly use and check it against the plan's formulary.
A plan that looks inexpensive based on its monthly premium may not be inexpensive overall if your medications have high out-of-pocket costs.
Provider Networks Matter
One of the most important things to check before enrolling is the provider network.
Verify that:
Your primary care doctor is included
Your specialists are included
Your preferred hospital is included
Your pharmacies are participating
Any important healthcare facilities you use are covered
Do not rely only on the fact that a doctor accepts Medicare.
A doctor may accept Medicare but not participate in a particular Medicare Advantage plan.
Additional Benefits
Some Medicare Advantage plans offer additional benefits beyond Original Medicare.
Depending on the plan, these may include:
Routine dental benefits
Vision benefits
Hearing benefits
Fitness programs
Transportation benefits
Over-the-counter allowances
Wellness programs
Certain home-based services
Benefits can change from one plan to another and from one year to another.
Always review the current plan documents instead of assuming that a benefit will continue indefinitely.
Who Can Enroll in AARP Medicare Advantage?
Generally, you must:
Be eligible for Medicare.
Have Medicare Part A and Part B.
Live in the plan's service area.
Meet any additional eligibility requirements for a particular plan.
AARP membership may also be relevant because AARP-branded Medicare products are associated with AARP and UnitedHealthcare.
Enrollment rules can depend on your individual Medicare status and the enrollment period.
When Can You Enroll?
Medicare has several enrollment periods.
Initial Enrollment Period
Your Initial Enrollment Period occurs around the time you first become eligible for Medicare.
For many people, this begins three months before the month they turn 65 and continues for several months afterward.
Annual Election Period
The Medicare Annual Election Period generally runs from October 15 through December 7 each year.
During this period, eligible beneficiaries can make certain changes to their Medicare coverage for the following year.
Medicare Advantage Open Enrollment Period
The Medicare Advantage Open Enrollment Period generally runs from January 1 through March 31.
People already enrolled in Medicare Advantage may have certain opportunities to change plans or return to Original Medicare during this period.
Special Enrollment Periods may also apply in specific circumstances.
How to Compare AARP Medicare Advantage Plans
If multiple plans are available where you live, compare the details rather than looking only at the monthly premium.
Compare the Premium
Look at both the plan premium and your Medicare Part B premium.
Compare the Deductible
Check what you must pay before certain services are covered according to the plan's cost-sharing structure.
Compare Copayments
Look at the costs for:
Primary care
Specialists
Urgent care
Emergency care
Hospital stays
Diagnostic services
Check Prescription Costs
Review your medications and the plan's drug coverage.
Check the Maximum Out-of-Pocket Amount
A lower maximum can affect your financial exposure if you require substantial healthcare during the year.
Check the Network
Make sure your doctors and hospitals are participating providers.
Review Extra Benefits
Dental, vision, hearing, fitness, transportation, and other benefits may differ considerably between plans.
What Information Should You Have Before Choosing a Plan?
Before comparing plans, gather:
Your Medicare information
Current medications
Preferred doctors
Preferred hospitals
Preferred pharmacy
Expected healthcare needs
Current insurance information
Your monthly healthcare budget
This makes it easier to compare plans based on your actual situation.
Is a $0 Premium Medicare Advantage Plan Really Free?
No.
A $0 plan premium does not mean there are no healthcare costs.
You may still pay:
Medicare Part B premiums
Doctor visit copayments
Specialist copayments
Hospital costs
Prescription costs
Deductibles
Coinsurance
Out-of-network expenses
The total cost of a plan depends on how frequently you use healthcare and which services you need.
Can You Use AARP Medicare Advantage While Traveling?
Travel benefits depend on the plan.
Emergency and urgent care rules can differ from routine care outside the plan's service area.
If you travel frequently, check:
Emergency coverage
Urgent care coverage
Out-of-network rules
Travel-related benefits
Service-area requirements
People who spend extended periods in different locations should pay particular attention to network restrictions.
What Happens If You Move?
Moving can affect your Medicare Advantage options.
If you permanently move outside your current plan's service area, you may qualify for a Special Enrollment Period that allows you to make changes to your Medicare coverage.
Contact Medicare or the plan to understand the rules that apply to your specific move.
Can You Change From Medicare Advantage to Original Medicare?
In certain situations, you can switch from Medicare Advantage to Original Medicare.
The timing of the change matters because Medicare enrollment periods and Special Enrollment Period rules can affect your options.
If you are considering switching, also investigate whether you can obtain Medicare Supplement coverage and what underwriting or guaranteed-issue rules may apply in your situation.
How to Keep Medicare Advantage Costs Under Control
You can potentially reduce your overall healthcare spending by:
Staying within the plan's network
Using preferred pharmacies
Reviewing your prescription formulary
Using preventive services
Comparing plans each year
Understanding copayments before receiving care
Taking advantage of included benefits
Checking whether prior authorization is required
Reviewing your annual plan documents
A plan with a low monthly premium is not automatically the lowest-cost choice for your particular healthcare needs.
Common Mistakes to Avoid
Looking Only at the Monthly Premium
A low premium can be attractive, but total annual healthcare costs matter more.
Ignoring the Provider Network
Always check your doctors and hospitals before enrolling.
Forgetting Prescription Coverage
A plan may have attractive medical benefits but expensive drug coverage for your particular medications.
Assuming All AARP Medicare Advantage Plans Are the Same
Plans can differ by location, benefits, premiums, networks, and cost-sharing.
Not Reviewing the Plan Each Year
Benefits and costs can change.
Confusing Medicare Advantage With Medigap
These are different types of Medicare coverage and work differently.
Assuming $0 Means No Costs
You can still have copayments, deductibles, coinsurance, and other expenses.
Questions to Ask Before Enrolling
Before selecting an AARP Medicare Advantage plan, consider asking:
Is my doctor in the network?
Is my preferred hospital included?
Are my medications covered?
What pharmacy should I use?
What is the plan's annual out-of-pocket maximum?
What are specialist copayments?
What are hospital costs?
Are dental benefits included?
Are vision benefits included?
Are hearing benefits included?
Does the plan require referrals?
Does it require prior authorization for certain services?
What happens when I travel?
What happens if I move?
What will my estimated yearly healthcare costs be?
Frequently Asked Questions About AARP Medicare Advantage
What is AARP Medicare Advantage?
AARP Medicare Advantage refers to Medicare Advantage plans offered through UnitedHealthcare for eligible AARP members. These plans provide Medicare Part A and Part B benefits through a private Medicare Advantage plan.
Is AARP Medicare Advantage the same as Original Medicare?
No. Original Medicare is administered through the federal Medicare program, while Medicare Advantage is offered by Medicare-approved private insurance companies.
Does AARP Medicare Advantage include prescription drugs?
Many Medicare Advantage plans include prescription drug coverage, but the specific coverage depends on the plan.
Does AARP Medicare Advantage cover dental and vision?
Some plans offer dental and vision benefits. The amount and type of coverage vary by plan.
Can I keep my doctor?
Possibly. Your doctor must participate in your specific plan's network when network restrictions apply. Always verify this before enrolling.
Is AARP Medicare Advantage available everywhere?
Medicare Advantage plans vary by location. A specific AARP Medicare Advantage plan may not be available in every county or state.
Does AARP Medicare Advantage have an out-of-pocket maximum?
Yes. Medicare Advantage plans have an annual out-of-pocket limit for covered Part A and Part B services, subject to the plan's rules.
Can I have Medicare Supplement and Medicare Advantage at the same time?
Generally, no. Medicare Supplement Insurance is designed to work with Original Medicare, while Medicare Advantage is an alternative way to receive Medicare-covered benefits.
Can I change my Medicare Advantage plan?
Certain enrollment periods and qualifying circumstances allow eligible beneficiaries to change Medicare Advantage plans or return to Original Medicare.
What should I compare before choosing AARP Medicare Advantage?
Compare the monthly premium, deductible, copayments, prescription coverage, provider network, annual out-of-pocket maximum, and additional benefits.
Final Thoughts
AARP Medicare Advantage can provide an alternative way to receive Medicare benefits through a private Medicare Advantage plan. Depending on the plan, members may receive Part A and Part B coverage, prescription drug benefits, an annual out-of-pocket maximum, and additional benefits such as dental, vision, or hearing coverage.
The most important thing is to look beyond the monthly premium. Your doctors, medications, healthcare needs, network restrictions, copayments, and annual out-of-pocket exposure can all affect the overall value and cost of a plan.
Because Medicare Advantage plans can vary by location and change from year to year, reviewing the current plan details before enrolling or renewing is essential.
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