Understanding UnitedHealthcare Medicare Advantage Plans in Illinois

Known as Part C, Medicare Advantage Plans have emerged as a popular alternative to Original Medicare, that might offer a comprehensive package of potential benefits. UnitedHealthcare, a preeminent insurance company, is instrumental in providing some of these possible benefits to Illinois residents.

The critical aspect of these plans is they require healthcare providers to accept Medicare patients, which will likely ensure that the services might be covered under the plan.

What is a Medicare Advantage Plan?

Provided by private companies that contract with Medicare, a Medicare Advantage (MA) Plan is an alternative to Original Medicare. It consolidates Parts A (Hospital Insurance) and B (Medical Insurance) benefits, often including prescription drug coverage (Part D) as well.

The plans offer an array of options such as:

• Health Maintenance Organizations (HMOs)

• Preferred Provider Organizations (PPO)

• Private fee-for-service plans

• Special Needs Plans (SNPs)

These plans offer a comprehensive set of healthcare benefits that meet or exceed those offered by the federal Medicare program, including Original Medicare. They often include additional benefits such as Medicaid extra benefits, vision, hearing, dental, and wellness programs.

UnitedHealthcare’s Role

Recognized as a Medicare Advantage organization, UnitedHealthcare Insurance Company contracts with Medicare to offer these plans. They organize a network of healthcare providers including doctors and hospitals, ensuring that beneficiaries could have healthcare service access.

Additionally, UnitedHealthcare may also offer some of the following services and programs:

• Customer service inquiries

• Claims processing

• Clinical services to enrollees

• Medicare Advantage plans, including HMOs and PPOs

• Special programs such as house calls, clinical health coaches, and assistance in complex care management.

Availability in Illinois

As of 2024, Illinois has 158 Medicare Advantage plans available through UnitedHealthcare. These include Health Maintenance Organization (HMO) plans, which require the use of a network of local providers for benefits, except in emergencies.

Illinois residents could also have the option to choose from UnitedHealthcare’s Preferred Provider Organization (PPO) plans. These plans allow for out-of-network services at a higher cost without needing referrals for specialty care.

Furthermore, groups such as employers, unions, and government sub-entities in Illinois will likely have access to certain UnitedHealthcare Group Medicare Advantage plans that could potentially offer a variety of healthcare benefit choices, which may include:

• Medical coverage

• Prescription drug coverage

• Vision coverage

• Dental coverage

• Hearing coverage

• Wellness programs

Comparing UnitedHealthcare Medicare Advantage Plans

Most UnitedHealthcare Medicare Advantage plans in Illinois could be available in various forms, each could offer unique attributes and potential benefits.

From Health Maintenance Organization (HMO) plans, which require the use of a provider network for covered services, to Point of Service (HMO-POS) plans that allow members some flexibility to use providers outside the network for certain healthcare services, the options are diverse.

The Preferred Provider Organization (PPO) plans to offer even greater flexibility, allowing members to get services both within and outside the network, with different cost implications.

UnitedHealthcare Medicare Advantage plans may be able to provide more comprehensive benefits than Original Medicare, potentially maintaining important member rights and protections.

These plans could also cater to special needs. For instance, the Special Needs Plans (SNPs) offer tailored benefits and services to meet the unique healthcare needs of specific Medicare consumer groups.

For Medicare-eligible retirees in Illinois, UnitedHealthcare will likely offer combined medical and prescription drug coverage in Group Medicare Advantage plans, including HMO and PPO options.

AARP Medicare Supplement Plan

UnitedHealthcare Insurance Company will likely insure the AARP Medicare Supplement Insurance Plans, which have the endorsement of AARP. These plans may be available in all states, and specific plans could be available through UnitedHealthcare Insurance Company of America in Illinois.

Enrollment in an AARP Medicare Supplement Insurance plan requires AARP membership. It’s an important requirement to keep in mind. These plans are designed to fill the gaps in Original Medicare coverage, possibly helping to cover out-of-pocket costs that Medicare might not cover.

Medicare Prescription Drug Plan

Most UnitedHealthcare Medicare Advantage plans include prescription drug coverage, also known as Medicare Part D. These will likely be insured through the UnitedHealthcare Insurance Company or one of its affiliated companies.

Interestingly, enrollment in a UnitedHealthcare Medicare Prescription Drug plan does not require AARP membership. This means that even non-AARP members could potentially benefit from the prescription drug coverage that might be offered by UnitedHealthcare.

Possible Insured Member Services

In addition to the comprehensive coverage, UnitedHealthcare Medicare Advantage plans may offer a host of wellness benefits, which could include:

• Fitness memberships

• Yearly health assessments

• Health reminders

• Nurse support

They also offer potential benefits such as vision, dental, and chiropractic coverage riders.

Members might also be able to enjoy some of the following benefits through UnitedHealthcare:

• Access various programs and services which may include transportation and meal benefits close to home that may come at no additional cost through UnitedHealthcare’s national network.

• Potentially facilitate access to some preferred drugs, such as certain insulins, which may come with no out-of-pocket cost through UnitedHealthcare’s Vital Medication Program.

Potential Costs and Coverage

It’s vital to comprehend the costs and coverage of UnitedHealthcare Medicare Advantage plans in Illinois to make an informed decision.

Medicare Advantage plans are annual contracts with UnitedHealthcare and may see changes in possible benefits, premium increases, or copayment adjustments each year.

UnitedHealthcare will likely notify enrollees about potential changes in the specific formulary, pharmacy network, and provider network for their Medicare Advantage Plan. This could ensure that members might be kept up to date about possible changes that might affect their plan.

Potential Premiums and Out-of-Pocket Costs

Most Medicare Advantage plans could have low or sometimes no monthly premiums and could offer additional benefits that may not be covered under Original Medicare.

However, prospective members must continue to pay their Medicare Part B premium unless it is paid for under Medicaid or by another third party.

When choosing a Medicare Advantage plan, it’s important to consider the plan’s potential:

• Premiums

• Deductibles

• Copays

• Coinsurance

This could ensure affordability. Enrollees in Medicare Advantage plans may have higher annual out-of-pocket expenses compared to those with Original Medicare and a Medigap plan.

Prescription Drug Costs

UnitedHealthcare’s Medicare Advantage Special Needs Plans (SNPs) in Illinois include prescription drug coverage along with Medicare Parts A and B benefits.

The Prescription Drug List (PDL) provided by UnitedHealthcare will likely offer a tiered list of medications, possibly guiding members on the cost implications for various drugs.

UnitedHealthcare is likely to update the Medicare Advantage PDL, potentially necessitating members to check current coverage information which could be through either benefit documents, customer support, or utilizing a Medicare journey chat.

For medications, UnitedHealthcare Medicare Advantage plans may provide Tier 2 generic medications at a potentially low cost, might offer discounts on health products, and could include no-cost delivery of a 3-month maintenance prescription supply.

Financial Assistance Programs

Financial assistance programs could help eligible Illinois residents reduce their healthcare costs. UnitedHealthcare may offer some insurance programs like Dual Special Needs Plans (D-SNPs) which could provide low-cost or no-cost health insurance.

Family ACA Marketplace plans may include possible benefits such as unlimited low-cost primary care visits with a primary care provider with 24/7 access.

Some of these plans may be designed to supplement your healthcare coverage and could help you manage your healthcare expenses more effectively.

Choosing a Healthcare Provider

Once you’ve enrolled in a UnitedHealthcare Medicare Advantage Plan, the next step is to select a healthcare provider.

Some UnitedHealthcare Medicare Advantage plans may provide a wide array of healthcare providers across Illinois, which may ensure that members have considerable choices when selecting their healthcare services.

Provider Search Tools

UnitedHealthcare will likely offer a provider search tool that could be utilized to find local healthcare providers who may accept UnitedHealthcare Medicare Advantage plans. The tool could help you find a wide range of healthcare providers, which may include doctors, nursing homes, and home health services, confirming their Medicare acceptance.

Accepting Medicare Patients

It is vital to select healthcare providers who accept Medicare, as it could assure potential coverage and might minimize out-of-pocket expenses. Some Medicare Advantage plans, such as those offered by UnitedHealthcare, may have networks of doctors who are likely to accept Medicare patients and Medicare payment terms.

If a patient chooses a provider who does not accept Medicare, they may be responsible for higher costs or charges that may exceed the Medicare-approved amount.

In-Network vs. Out-of-Network Providers

In-network providers will likely agree to accept a possible discounted rate that may cover inpatient hospital services under a Medicare contract with health plans, which could lead to potential savings on out-of-pocket costs for members. For costs and complete details, consult your health plan’s provider directory.

On the other hand, out-of-network providers, may not have a contract with the health plan, and could charge full price for their services, which may result in greater out-of-pocket expenses for patients.

Summary

Some UnitedHealthcare Medicare Advantage Plans in Illinois could potentially provide a comprehensive and possibly cost-effective alternative to Original Medicare. UnitedHealthcare may offer a wide range of potential benefits and services that will likely cater to the diverse needs of their members.

Remember, it’s essential to understand the eligibility requirements, enrollment periods, and potential costs associated with some of these plans before making your choice. In the end, the key is to select a plan that could be the best fit your specific healthcare needs and budget.

Frequently Asked Questions

What is the most highly rated Medicare Advantage plan?

The most highly rated Medicare Advantage plan for 2024 is UnitedHealthcare, known for its good ratings, affordable costs, and good coverage. AARP/UnitedHealthcare also has top-rated plans, featuring high star ratings and the largest provider network.

Is UnitedHealthcare a good insurance for Medicare?

UnitedHealthcare may offer a variety of Medicare Advantage plans that could include extensive coverage and potentially give out low premiums, making it a good option for those who value flexibility and a wide range of possible benefits.

Additionally, it is the largest Medicare Advantage provider with a large network.

How much does a Medicare Advantage plan cost in Illinois?

In Illinois, if you’re enrolled in Medicare Part A and B, you may have access to a Medicare Advantage plan. We do not know the precise cost of Medicare Advantage plans in 2025 because the plans for 2025 have not been released yet, but make sure to keep checking back to this website for updated information about the 2025 calendar year.

How do I enroll in a UnitedHealthcare Medicare Advantage Plan in Illinois?

To enroll in a UnitedHealthcare Medicare Advantage Plan in Illinois, you can contact one of our licensed agents by calling 1-844-350-0776 (TTY user 711) Mon-Fri 8am-9pm Est.