UnitedHealthcare Medicare Advantage Plans New York 2025

If you’re exploring Unitedhealthcare Medicare Advantage plans in 2025, it’s crucial to stay informed about the latest offerings. This article zeroes in on the plans available, their costs, and new enhancements to expect.

Discover the specifics you’ll need for a clear understanding of how you can find the best Medicare Advantage plans in New York can align with your healthcare needs.

 

Key Takeaways

  • UnitedHealthcare offers a range of Medicare Advantage Plans in New York including HMO, PPO, and Dual Complete (HMO D-SNP) plans that provide comprehensive coverage and supplemental benefits beyond Original Medicare such as prescription drug, dental, vision, and fitness benefits.

 

  • UnitedHealthcare Medicare Advantage plans in New York are affordable, with an average monthly premium of $30.79, and include special features like integrated Part D prescription drug coverage, $0 copays for certain services, and additional benefits designed to enhance overall healthcare and quality of life.

 

  • UnitedHealthcare provides extensive access to care through its Medicare National Network that includes a large network of doctors and hospitals, telehealth services, and simple enrollment processes during designated periods, with customer support offered in multiple languages to assist members.

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UnitedHealthcare Medicare Advantage Plans in New York: An Overview

UnitedHealthcare extends its Medicare Advantage Plans to residents of New York, providing coverage beyond that of Original Medicare. These plans encompass a variety of supplementary benefits that include:

 

  • Prescription drug coverage
  • Dental coverage
  • Vision coverage
  • Fitness benefits

 

And the best part is, there are no extra premium charges.

Additionally, UnitedHealthcare Insurance Company provides a variety of Medicare Advantage plans that accommodate the unique needs of individuals.

 

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These include Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans for individuals with Medicare. For those eligible for both Medicare and Medicaid, UnitedHealthcare offers the Dual Complete (HMO D-SNP) plans, providing supplementary assistance and benefits specific to the dual-eligible demographic.

 

Health Maintenance Organization (HMO) Plans

If you’re looking for reduced monthly premiums, decreased out-of-pocket costs, and supplementary benefits beyond Original Medicare, the UnitedHealthcare HMO plan might just be what you need.

Operating under a Medicare contract, this plan provides access to a network of healthcare providers, ensuring quality care at affordable rates. However, it’s worth noting that these plans may have restrictions on networks.

This implies that members may only receive coverage for health care services provided by providers within the approved network of the plan, except in emergency situations.

As for referrals for specialist visits, UnitedHealthcare has a streamlined process. UnitedHealthcare makes the referral process in HMO plans seamless and convenient.

Referrals can be obtained through the UnitedHealthcare Provider Portal where providers can submit new referral requests and check the status of existing referrals.

Comparison with other Medicare Advantage Plans, such as those by Aetna, reveals a similarity in coverage, with costs and specific coverage options differing based on the individual plan and the plan’s contract renewal.

 

Preferred Provider Organization (PPO) Plans

UnitedHealthcare’s Preferred Provider Organization (PPO) plan is ideal for individuals seeking flexibility in their healthcare decisions. This plan provides members with:

 

  • Access to a network of contracted physicians and hospitals
  • The ability to manage prescription drug costs effectively
  • No requirement for referrals for specialists, giving members greater autonomy in overseeing their healthcare
  • Access to a wide range of providers, including those from affiliated companies

 

Moreover, the PPO plan with UnitedHealthcare offers additional benefits like the flexibility to consult any doctor nationwide who accepts Medicare, without requiring referrals for specialist or hospital visits. Also, when visiting doctors within the UnitedHealthcare Medicare National Network, there is a possibility of reduced in-network expenses.

 

Dual Complete (HMO D-SNP) Plans

For individuals eligible for both Medical Assistance from the State and Medicare, UnitedHealthcare offers the Dual Complete (HMO D-SNP) Plans. These plans provide benefits beyond Original Medicare and are specifically tailored to meet the unique needs of individuals with both Medicare and Medicaid.

The Dual Complete (HMO D-SNP) Plan offers the following benefits:

 

  • Supplemental health care benefits not covered by Medicare Parts A, B, and D
  • Collaborative coverage with both Medicare and Medicaid
  • Customizable benefits
  • Incentives for healthy food
  • Over-the-counter (OTC) products
  • Utility expenses
  • Transportation benefits for medical appointments and pharmacy visits

 

This plan provides comprehensive coverage, including covered services, and complements Medicare and Medicaid benefits.

Essentially, these plans facilitate the integration of Medicare and Medicaid benefits, offering a more cohesive healthcare approach for dual-eligible individuals.

 

Comparing UnitedHealthcare Medicare Advantage Plans

With an average monthly premium of $30.79, UnitedHealthcare Medicare Advantage plans in New York offer affordable and comprehensive healthcare coverage. But what makes them stand out are the additional features and advantages they offer.

 

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These features provide extra value beyond Original Medicare and address various requirements, potentially resulting in reduced expenses.

When it comes to medication needs, UnitedHealthcare Medicare Advantage plans in New York generally integrate Medicare Part D prescription drug coverage. This ensures that beneficiaries can access essential medications within the same plan framework. Apart from the basic benefits provided by Original Medicare, these plans also offer augmented benefits.

These features differ based on the specific plan and location but are intended to streamline the member experience and may encompass services such as dental, vision, or fitness programs.

 

Monthly Premiums and Cost Savings

Exploring the financial details of UnitedHealthcare Medicare Advantage Plans reveals further advantages. The standard monthly premiums for these plans in New York amount to $30.79 in 2025.

When considering these plans, it’s important to take into account how they can provide cost savings through the availability of budget-friendly plans with $0 premiums, as well as reduced copays for medications such as insulin.

Moreover, Medicare Savings Programs have been created to assist individuals with restricted incomes in covering Medicare expenses such as premiums. This means that certain Medicare Advantage plans offer the option of low or $0 monthly premiums, making quality healthcare more accessible.

 

Prescription Drug Coverage

UnitedHealthcare Medicare Advantage plans provide extensive prescription drug coverage. They provide prescription drug coverage through three distinct Prescription Drug Plans (PDPs), which assist members in reducing medication costs by utilizing a formulary list that outlines covered drugs.

This coverage is similar to standard Medicare Part D plans, which encompass a diverse array of prescription drugs and offer coverage for most drugs within specific protected classes.

However, it’s important to note that UnitedHealthcare Medicare Advantage prescription drug coverage encompasses co-payments, deductibles, and coinsurance, all of which factor into the total out-of-pocket expenses for medications.

The formulary list, also known as the Prescription Drug List (PDL), categorizes medications into tiers that have an impact on the cost and accessibility of prescribed drugs within the plan.

 

Extra Benefits and Features

Beyond comprehensive coverage, UnitedHealthcare Medicare Advantage Plans include a range of supplementary benefits and features. Some of these benefits and features include:

 

  • Renew Active® fitness program, offered at no extra cost, to assist members in achieving their fitness and cognitive health objectives
  • $0 copays for both in-person and virtual visits
  • Coverage for mammograms and colonoscopies

 

The plan also provides dental coverage, encompassing routine checkups and various other dental services. In terms of vision coverage, the plan includes routine eye exams, prescription glasses or contact lenses, and services such as cataract surgery that are covered by Original Medicare.

These benefits not only provide a comprehensive healthcare package but also contribute to an enhanced quality of life for the beneficiaries.

Access to Care: UnitedHealthcare Medicare National Network

UnitedHealthcare’s Medicare National Network offers the following benefits:

 

  • Access to quality healthcare services across the United States
  • Services from participating healthcare providers throughout the country
  • Accessibility in all 50 states, the District of Columbia, and all U.S. territories

 

This network ensures nationwide access to care.

 

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With a vast network of doctors and 6,700 hospitals, the reach is considerable. This extensive network ensures that beneficiaries have access to a wide range of health care services, regardless of their location.

 

Doctor and Hospital Networks

UnitedHealthcare’s provider network in New York is extensive, with 106,000 providers as of 2021. These providers include a wide range of specialists, ensuring that beneficiaries have access to comprehensive health care services. However, becoming a part of this network involves a credentialing process.

Doctors and hospitals must complete an electronic Provider Credentialing Application or submit their CAQH and NPI numbers for credentialing.

UnitedHealthcare, a Medicare Advantage organization, makes it easy for its Medicare Advantage plan members to locate in-network doctors and hospitals. Beneficiaries can utilize the search tools on the UnitedHealthcare website to find network providers.

This ensures that beneficiaries have easy access to the health care services they need, when they need them.

 

Telehealth Services

As the healthcare landscape continuously evolves, telehealth services have emerged as a crucial component in delivering convenient and efficient care. UnitedHealthcare provides members with various options for virtual visits with local providers or through UnitedHealthcare’s preferred virtual care platform.

UnitedHealthcare’s telehealth program offers a variety of services including 24/7 Virtual Visits, Virtual Primary Care, and Virtual therapy.

These services provide convenient access to treatment and prescriptions as necessary. And the best part? The cost for these services is affordable, with virtual primary care visits priced at $99 or less.

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Enrollment and Eligibility

The process of enrolling in a UnitedHealthcare Medicare Advantage plan is quite simple. There are specific enrollment periods during which individuals can enroll in or modify their plan. These include:

 

  • Medicare Initial Enrollment Period (IEP)
  • Medicare Annual Enrollment Period (AEP)
  • Medicare Advantage Open Enrollment Period
  • Special Enrollment Period (2 months) for current Medicare enrollees to transition plans outside the standard enrollment periods.

 

The eligibility requirements for UnitedHealthcare Medicare Advantage plans require individuals to be at least 65 years old or have a qualifying disability.

For Special Needs plans, individuals must have Original Medicare Part A and Part B, reside in the plan’s service area, and satisfy specific plan eligibility criteria. To enroll, one can visit the UnitedHealthcare website or complete the enrollment process online at www.SocialSecurity.gov.

Alternatively, they may call Social Security at 1-800-772-1213 or engage with a UnitedHealthcare sales representative by dialing 1-877-596-3258.

 

Enrollment Periods

The General Enrollment Period, which runs from January 1 to March 31, and the Annual Election Period, occurring annually from October 15 to December 7, are the primary enrollment periods for UnitedHealthcare Medicare Advantage plans. Additionally, there are Special Enrollment Periods which are designated times outside of the standard enrollment periods during which individuals can enroll in or modify their Medicare Advantage plan.

These periods may be triggered by particular life events, such as loss of alternative coverage, relocation, or eligibility for both Medicare and Medicaid.

Furthermore, there’s the 5-Star Special Enrollment Period which allows individuals to enroll in a Medicare Advantage Plan or Prescription Drug Plan that holds a 5-star rating. This period is accessible annually from December 8 to November 30 of the subsequent year.

The Initial Enrollment Period spans over 7 months, commencing 3 months prior to reaching the age of 65 or, for individuals with disabilities, upon receipt of their 25th disability check. This period extends 3 months after the qualifying event, allowing individuals the opportunity to enroll in a UnitedHealthcare Medicare Advantage plan.

 

Eligibility Criteria

In order to qualify for a UnitedHealthcare Medicare Advantage plan, individuals generally need to be 65 years old or have a qualifying disability and have received disability benefits for 24 months.

In certain states, individuals under 65 may be eligible if they are on Medicare due to disability or End-Stage Renal Disease. Contrary to what you might think, eligibility for UnitedHealthcare Medicare Advantage plans is not influenced by income levels.

However, enrollment in a UnitedHealthcare Medicare Advantage plan does require U.S. citizenship or qualified legal residency.

And if you’re wondering about pre-existing conditions, there are no specific requirements related to pre-existing conditions for enrolling in UnitedHealthcare Medicare Advantage plans.

 

New York Medicare Resources and Assistance

Numerous resources and forms of assistance are available for Medicare beneficiaries in New York. One such resource is the Health Insurance Information, Counseling, and Assistance Program (HIICAP) that offers complimentary and unbiased information, counseling, and assistance on health insurance.

 

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Beneficiaries can seek assistance from HIICAP by contacting 1-800-701-0501 or by accessing and completing an application online.

In addition to HIICAP, UnitedHealthcare Customer Support for Medicare beneficiaries in New York is responsible for verifying medical claims and accuracy to ensure people are receiving the services they need.

They assist with resolving inquiries, complaints, and information requests related to Medicare. Other resources available for Medicare beneficiaries in New York include 1-800-MEDICARE for guidance on coverage options, the New York State Office for the Aging for financial support, and HIICAP for information on Medicare plans.

 

HIICAP

The Health Insurance Information, Counseling, and Assistance Program (HIICAP) in New York is a complimentary resource that offers information, education, and counseling to both current Medicare beneficiaries and individuals approaching Medicare eligibility.

HIICAP, centrally located at Area Agencies on Aging, offers counseling services through a toll-free helpline.

HIICAP provides a range of services to Medicare beneficiaries, such as education on the Medicare Program, Medigap policies, Medicaid, Medicare Advantage Plans, and Long-term care. Trained counselors are on hand to help with inquiries about Medicare.

If you’re a Medicare beneficiary in New York and wish to seek assistance from HIICAP, you can do so by contacting 1-800-HIICAP or Aging Connect at 212-AGING-NYC (212-244-6469).

HIICAP offers complimentary information, counseling, assistance, and advocacy on Medicare and related health insurance matters.

 

UnitedHealthcare Customer Support

Customer support is an essential component of any healthcare plan, and this is where UnitedHealthcare shines. In New York, Medicare beneficiaries can reach out to UnitedHealthcare customer support by dialing 1-877-596-3258 / TTY 711.

The customer support team is available from 8 a.m. to 8 p.m., 7 days a week, ready to assist you with your healthcare needs.

 

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UnitedHealthcare provides phone, email, and live chat support for Medicare recipients in New York, making it easy for beneficiaries to seek assistance in a manner that is most convenient for them.

In addition to English, customer support is available in Cantonese, Mandarin, Korean, and South Asian dialects to cater to the diverse linguistic needs of their members.

UnitedHealthcare also adheres to stringent protocols for identifying, monitoring, resolving, and reporting appeals and grievances from Medicare beneficiaries.

Beneficiaries have the option to submit a written grievance by completing the Medicare plan appeal & grievance form and sending it via mail as per the provided instructions.

Summary

In conclusion, UnitedHealthcare Medicare Advantage Plans in New York offer a comprehensive healthcare solution that goes beyond the coverage provided by Original Medicare.

With various plans such as HMO, PPO, and Dual Complete, and numerous benefits including prescription drug coverage, dental, vision, and fitness programs, these plans are designed to cater to diverse healthcare needs.

With a robust network of providers and an efficient customer support system, UnitedHealthcare ensures easy access to quality healthcare. So why wait? Explore UnitedHealthcare’s Medicare Advantage plans today and take a step towards better health and peace of mind.

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Frequently Asked Questions

 

What are the changes for UnitedHealthcare in 2025?

In 2025, UnitedHealthcare will add “Care Cash” to several plans, offer $0 cost share for virtual visits on all plans, and remove the Doctors Plan network from their small business offering.

Additionally, the plan name will change to UHC Dual Complete ME-S001 (PPO D- SNP), and members will receive new ID cards.

 

What is the Medicare giveback for 2025?

In 2025, Medicare Advantage plans may offer a Part B premium “giveback,” which can range from 10 cents to $174.70, depending on the county and the specific plan. This benefit might cover the full Part B premium or a partial amount of it.

 

What is the disadvantage of UnitedHealthcare?

The main disadvantage of UnitedHealthcare is its middle-of-the-road customer satisfaction ratings. This affects access to a wide range of doctors and hospitals.

 

Is UnitedHealthcare Medicare Advantage a good plan?

Yes, UnitedHealthcare Medicare Advantage is a good plan, especially for those with complex health needs or chronic conditions, as it provides extensive disease management programs.

 

What are the supplementary benefits of UnitedHealthcare Medicare Advantage Plans in New York?

UnitedHealthcare Medicare Advantage Plans in New York offer supplementary benefits like prescription drug coverage, dental, vision, and fitness programs, going beyond Original Medicare.

These additional benefits provide comprehensive coverage for plan members.

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Speak with a licensed insurance agent

1-844-350-0776
TTY 711

Mon-Fri : 8am-9pm ET