UnitedHealthcare Medicare Advantage Plans New York 2025

If you plan on exploring some of the potential UnitedHealthcare Medicare Advantage plans for 2025, it’s crucial to stay informed about its potential offerings. This article zeroes in on the plans that may be available, the possible costs, and some potential enhancements that may be expected.

Discover some of the specifics you may need for a clear understanding of how you could potentially find the best Medicare Advantage plans in New York that may 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 may provide extensive access to care through its Medicare National Network which could include 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 will likely extend some of its Medicare Advantage Plans to residents of New York, potentially providing coverage that could go beyond that of Original Medicare. These plans may encompass a variety of potential benefits that could include:

  • Prescription drug coverage

 

  • Dental coverage

 

  • Vision coverage

 

  • Fitness benefits

 

And the best part is, that there may not be any extra premium charges.

Additionally, UnitedHealthcare Insurance Company will likely provide a variety of Medicare Advantage plans that could 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 emergencies.

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

Referrals may be obtained through the UnitedHealthcare Provider Portal where providers could 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 could provide 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

Some UnitedHealthcare Medicare Advantage plans in New York may offer affordable and comprehensive healthcare coverage. But what makes them potentially stand out are the potential features and advantages they could offer.

 

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Some of the possible features could provide extra value that may go beyond Original Medicare and will likely address various requirements, potentially resulting in reduced expenses.

When it comes to medication needs, UnitedHealthcare Medicare Advantage plans in New York may integrate Medicare Part D prescription drug coverage. This could ensure that beneficiaries will likely be able to access certain essential medications that may be within the same plan framework. Apart from the basic benefits provided by Original Medicare, these plans may also offer augmented benefits.

Some of these features may differ based on the specific plan and location but will likely be intended to streamline the member experience and may encompass services such as dental, vision, or fitness programs.

 

Prescription Drug Coverage

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

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

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

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

 

Possible Benefits and Features

Beyond comprehensive coverage, certain UnitedHealthcare Medicare Advantage Plans may include a range of possible benefits and features. Some of these potential benefits and features could include:

  • Renew Active® fitness program, potentially offered at no extra cost, which may assist members in achieving their fitness and cognitive health objectives

 

  • Coverage for mammograms and colonoscopies

 

The plan could also provide dental coverage, potentially encompassing routine checkups and various other dental services. In terms of vision coverage, the plan may also include routine eye exams, prescription glasses or contact lenses, and services such as cataract surgery that could be covered by Original Medicare.

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

 

Access to Care: UnitedHealthcare Medicare National Network

UnitedHealthcare’s Medicare National Network may offer some of 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 will likely ensure 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 will likely ensure that beneficiaries could have access to a wide range of healthcare services, regardless of their location.

 

Doctor and Hospital Networks

UnitedHealthcare’s provider network in New York may seem extensive, with 106,000 providers as of 2021. These providers will likely include a wide range of specialists, potentially ensuring that beneficiaries may have access to certain comprehensive healthcare services. However, becoming a part of this network could involve a credentialing process.

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

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

This could ensure that beneficiaries may have easy access to the health care services they need when they need them.

 

Telehealth Services

UnitedHealthcare will likely provide members with various options for virtual visits with some local providers or those that may be through UnitedHealthcare’s preferred virtual care platform.

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

These services may provide convenient access to treatment and prescriptions as necessary.

 

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Enrollment and Eligibility

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

  • Medicare Initial Enrollment Period (IEP)

 

  • Medicare Annual Enrollment Period (AEP)

 

 

  • Special Enrollment Period (2 months) for current Medicare enrollees to transition plans outside the standard enrollment periods.

 

The eligibility requirements for some UnitedHealthcare Medicare Advantage plans may 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 call one of our licensed agents at 1-844-350-0776 (TTY user 711) Mon-Fri 8am-9pm Est. They will be able to provide comprehensive information, personalized guidance, and ongoing assistance to navigate the enrollment process for private insurance companies, making it easier for beneficiaries to make informed decisions about their healthcare.

 

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 may allow 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 before 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

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 will likely be 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 will likely be available for Medicare beneficiaries in New York. One such resource could be the Health Insurance Information, Counseling, and Assistance Program (HIICAP) that could potentially offer 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 may be responsible for verifying medical claims and accuracy to ensure people are receiving the services they need.

They could assist with resolving inquiries, complaints, and information requests related to Medicare. Other resources available for Medicare beneficiaries in New York may include the 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 will likely be a complementary resource that could offer information, education, and counseling to both current Medicare beneficiaries and individuals approaching Medicare eligibility.

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

HIICAP may provide a range of services to Medicare beneficiaries, which could include an education on the Medicare Program, Medigap policies, Medicaid, Medicare Advantage Plans, and Long-term care. Trained counselors will likely be 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 will likely offer 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 will likely be where UnitedHealthcare shines. In New York, Medicare beneficiaries could 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 may provide phone, email, and live chat support for Medicare recipients in New York, potentially making it easier for beneficiaries to seek assistance in a manner that may be the most convenient for them.

In addition to English, customer support will likely be available in Cantonese, Mandarin, Korean, South Asia, and many other dialects to cater to the diverse linguistic needs of their members.

UnitedHealthcare will likely also adhere to stringent protocols for identifying, monitoring, resolving, and reporting possible appeals and grievances from Medicare beneficiaries.

Beneficiaries may also 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

Some UnitedHealthcare Medicare Advantage Plans in New York will likely offer a comprehensive healthcare solution that could go beyond the coverage provided by Original Medicare.

With various plans such as HMO, PPO, and Dual Complete, and potential benefits that may include prescription drug coverage, dental, vision, and fitness programs, these plans could be designed to cater to diverse healthcare needs.

With a robust network of providers and an efficient customer support system, UnitedHealthcare could ensure 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 possible changes for UnitedHealthcare in 2025?

Since the plans for 2025 have not been released yet, we do not know what changes may occur during the 2025 calendar year. However, be sure to keep checking back to this article and website for updated information.

 

What are the advantages of UnitedHealthcare?

The main advantage of UnitedHealthcare is its above-average customer satisfaction ratings, which may also affect the potential access to a wide range of doctors and hospitals.

 

Is UnitedHealthcare Medicare Advantage a good plan?

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

 

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

Some UnitedHealthcare Medicare Advantage Plans in New York may offer supplementary benefits that could include prescription drug coverage, dental, vision, and fitness programs, that could go beyond Original Medicare.

These possible benefits may 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