For the purposes of today’s review, I am going to review AARP Medicare Advantage Plan 1 (HMO) for a senior living in Maricopa County, Arizona. Since HMO plans are location-specific, I picked a zip code to get more information. The general principles and costs of this plan are similar regardless of where it is offered.
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What is AARP Medicare Advantage from UnitedHealthcare?
This plan, AARP Medicare Advantage Plan 1, is an HMO or Health Maintenance Organization. This means that they require you to use a certain “network” of high-value doctors, pharmacies, and hospitals.
You will also have to select one of their in-network primary care providers (PCPs) who will serve as a “gatekeeper” for your care. This means they will dictate whether or not seeing a specialist is required and that many of your services will require pre-authorization. If you elect to go outside of your network of providers, the costs will be steep. Generally, HMOs are low cost plans if you stay in-network and adhere to your PCPs care plan.
How much does AARP Medicare Advantage cost?
The monthly premium for this plan (in addition to your Medicare Part B premium) is $0. Most Medicare Part B premiums in 2021 are $148.50/month, so this needs to be factored into the cost. This plan also has no deductible, meaning your coinsurance will kick in right away. The out-of-pocket max for this plan is $3,900. The out-of-pocket maximum is a feature of Medicare Advantage not found in traditional Medicare and is my favorite benefit. This protects you from costs getting too far out of your control in a given plan year.
What is the average monthly cost for AAARP Medicare Advantage?
Below are costs for commonly utilized services for beneficiaries under this plan. The dollar amounts listed are for in-network providers only. The monthly cost for this plan without any copays is $0 plus the $148.50 that is standard for part B.
|Primary Care Visit||$5|
|Urgent Care Visit||$40|
These types of services tend to be low cost because they can all help avoid health complications. Insurance companies like UnitedHealthcare encourage individuals to seek primary care by offering no or low co-pays. Similarly, colonoscopies and other screening cost $0 because they can prevent more expensive treatments down the road. Utilize these yearly to make sure to stay on top of any health conditions that may be prevented or mitigated.
What if I am hospitalized?
Unfortunately, the daily co-pay for inpatient hospitalizations is $230 per day for the first seven days, then $0 afterwards. Remember that if you take an ambulance ride to the hospital, receive care in the ER and are admitted within 24 hours, you will only pay the ambulance co-pay of $250 and the inpatient hospitalization copay of $230 for the first day. The ER copay is waived if you are admitted within 24 hours. This will not be in your control while you are in the hospital, but if you are in the ER longer than 24 hours, the ER copay of $90 will be added to your bill.
What are the drug costs with AARP Medicare Advantage?
Prescription drug coverage is a part of Medicare Part D, and often covered by Medicare Advantage Plans. For this AARP Medicare Advantage Plan, Part D is included for no additional premium. In my opinion, this is what makes Medicare Advantage plans particularly great. Below is a snippet of costs you will find for prescription drugs from in-network pharmacies under this plan:
As you can see, preferred generic drugs and regular generic drugs will be the most cost effective pathway for getting medications. Always remember to ask your doctor if there is a generic alternative to the medication they are prescribing you. This will save you tons of money without actually changing the medication itself.
If you need to find the list of preferred drugs and view the details about each tier, search for the Medicare Prescription Drug list or ask for the formulary. This will come from AARP/UnitedHealth themselves and should be a part of your benefits information they send to you when you initially enroll.
Is the AARP Medicare Advantage plan good?
Medicare Advantage is so great because of all of the additional benefits you can get without additional costs. One of these with AARP Medicare Advantage is preventive dental services like x-rays, cleaning and fluoride for no additional cost. If you want more dental coverage, you can purchase additional dental benefits for an increased premium.
Additionally, another benefit in this plan is 36 one-way transportation trips for $0. This is great for those that have difficulty finding transportation or are no longer driving themselves.
Other benefits of this plan include a local fitness membership and virtual medical and mental health visits. A cool part of UnitedHealth is their nursing hotline which you can call 24/7 to get medical advice.
Overall, this is a really good Medicare Advantage plan. AARP and UnitedHealth both have great reputations and a large network that will give you comprehensive services for a low cost. At no additional premium cost per month, this is a great option if offered in your service area.
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