Medicare Advantage

Medicare Carrier Summary Pages

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UHC/AARP SUMMARY

As a Fortune 500 company and the top insurer in the United States, UnitedHealthcare serves people in all 50 states, offering a host of benefits ranging from individual and group insurance to Medicare Advantage, Medigap supplemental insurance and more. The company’s network includes 1.2 million physicians and healthcare professionals along with over 6,500 hospitals and healthcare facilities. In 2018, UHC ranked first in its sector (insurance and managed care) on Fortune’s list of the “World’s Most Admired Companies” for the eighth straight year. At the end of the first quarter in 2018, the company had posted consolidated revenues of $55.19 billion.

Medicare Products

UnitedHealthcare is one of the top Medicare insurers in the country and the only health insurer to sell products with the AARP branding. The company offers Medicare Advantage policies, Medigap supplement insurance and standalone Medicare prescription drug plans.

Medicare Advantage

Plan availability varies widely based on where you live. To give you an idea of the plans available, we’ve listed some of UHC’s Medicare Advantage 2018 offerings in Los Angeles, California. This table isn’t exhaustive, so make sure to get a customized quote for your options.

UnitedHealthcare/AARP

Medicare Advantage Plans

Highlights
MedicareComplete SecureHorizons Plan 1 (HMO) Premium: $0

Deductible: None

Copays: $0 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($4 copay for tier 1)

Extra benefits: eye and hearing exams; eyeglasses, contacts and hearing aids; and fitness membership

MedicareComplete SecureHorizons Plan 2 (HMO) Premium: $0

Deductible: None

Copays: $0 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($4 copay for tier 1)

Extra benefits: eye and hearing exams; eyeglasses, contacts and hearing aids; and fitness membership

MedicareComplete SecureHorizons Plan 3 (HMO) Premium: $17/month

Deductible: None for medical / $405 for prescription drugs

Copays: $0 primary / 19% of the cost for specialists

Required referral? Yes

Drug coverage? Yes (25% coinsurance for tier 1)

Extra benefits: eye and hearing exams; eyeglasses, contacts and hearing aids; and fitness membership

MedicareComplete SecureHorizons Premier Premium: $27/month

Deductible: None

Copays: $0 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($0 copay)

Extra benefits: preventive and comprehensive dental; eye and hearing exams; eyeglasses, contacts and hearing aids; and fitness membership

MedicareComplete SecureHorizons Essential (HMO) Premium: $0

Deductible: None

Copays: $5 primary / $10 specialist

Required referral? Yes

Drug coverage? No

Extra benefits: eye and hearing exams; eyeglasses, contacts and hearing aids; and fitness membership

Medigap

Medigap supplemental insurance can offset your out-of-pocket costs if you have original Medicare. These policies are standardized in all but three states (Massachusetts, Minnesota and Wisconsin), meaning that Medigap Plan A in Colorado covers the same benefits as Medigap Plan A in Texas. UnitedHealthcare offers the following standardized Medigap policies in 2018: A, B, C, F, G, K, L and N.

Availability

Though UnitedHealthcare offers Medicare products in all 50 states, you may not find every policy available in every zip code. Using zip codes for the largest cities in each state, we found that UnitedHealthcare offered 2018 Medicare Advantage plans in all areas except the following: Alaska, Delaware, the District of Columbia, Kentucky, Michigan, Minnesota, Mississippi, Montana, North Dakota, South Dakota and Wyoming.

Note that this doesn’t mean you won’t find a UHC Medicare Advantage plan in these states. UHC claims to offer plans in every state except Delaware, Montana, South Dakota and Wyoming. Even within the same state, plans and pricing vary, so it’s important to get a personalized quote based on where you live.

Medigap availability also varies. UnitedHealthcare offers all of its standardized Medigap policies in all 50 states, with the exception of Vermont (Plan G is not available here). UHC “Select” versions of Plans C and F are also available in some states.

AETNA SUMMARY

Founded in 1853 in Connecticut, Aetna has become a major player in the health insurance industry, providing a variety of products to individuals and employers throughout the United States. Medicare Advantage represents an increasingly significant portion of the company’s product line. Aetna’s Medicare membership increased by 8 percent in 2017, which includes a growth of 16 percent in the company’s Medicare Advantage policies. By the end of the year, 87 percent of Aetna Medicare Advantage customers had plans that were rated 4 stars or higher by the Centers for Medicare and Medicaid Services. Aetna posted revenues of $60.5 billion in 2017.

Medicare Products

Aetna sells Medicare Advantage policies, Medigap supplement insurance and standalone Medicare prescription drug plans nationwide. Plan availability and pricing depend on where you live, and plans may be listed under one of Aetna’s subsidiaries, such as Coventry Health Care.

Medicare Advantage

Because plan availability varies based on location and other demographic information, it’s not possible to list all of Aetna’s plan offerings in a general way. State regulations and other factors also affect availability. But we wanted to give you an idea of what might be available from Aetna in 2018, so we’ve used Los Angeles County to highlight a few products and their features.

Aetna/Coventry

Medicare Advantage Plans

Highlights
Medicare Choice Plan (PPO) Premium: $79

Deductible: $750 for out-of-network care

Copays: $10 primary / $40 specialists

Required referral? No

Drug coverage? Yes ($0 copay for tier 1)

Extra benefits: vision coverage, Silver Sneakers fitness benefit and 24/7 nurse hotline

Medicare Select Plan (HMO) Premium: $0

Deductible: None

Copays: $0 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($0 copay for tier 1)

Extra benefits: routine hearing and eye exams, Silver Sneakers fitness benefit and 24/7 nurse hotline

Medicare Prime Plan (HMO) Premium: $0

Deductible: None

Copays: $0 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($0 copay for tier 1 at preferred pharmacy)

Extra benefits: eye and hearing exams; eyeglasses, contacts and hearing aids; limited dental; and Silver Sneakers fitness plus 24/7 nurse hotline

Medigap

Medigap plans, which are standardized in all but three states (Massachusetts, Minnesota and Wisconsin), can help you cover the costs that original Medicare doesn’t cover. Aetna offers the following standardized Medigap supplemental insurance plans in 2018: A, B, C, D, F, high-deductible F, G and N.

Availability

Using information available from Aetna’s website, we found that the company offers 2018 Medicare Advantage plans in the following areas:

  •       Alabama
  •       Arizona
  •       California
  •       Colorado
  •       Connecticut
  •       Delaware
  •       D.C.
  •       Florida
  •       Georgia
  •       Illinois
  •       Indiana
  •       Kentucky
  •       Louisiana
  •       Maine
  •       Maryland
  •       Massachusetts
  •       Michigan
  •       Mississippi
  •       Nevada
  •       New Jersey
  •       New York
  •       North Carolina
  •       Ohio
  •       Pennsylvania
  •       South Carolina
  •       Tennessee
  •       Texas
  •       Utah
  •       Virginia
  •       Washington
  •       Wisconsin

States not listed do not have Aetna Medicare Advantage products available. The company’s Medigap offerings also vary by location. In 2018, Aetna offers standardized Plans A, B, F, high-deductible F, G and N in all but eight states. Of these eight states:

  •       New York only sells Aetna Plans A, B and F;
  •       Vermont only sells Aetna Plans A, B, C, D and N; and
  •       Six areas – Alaska, Connecticut, the District of Columbia, Hawaii, Maine and Washington – don’t have Aetna Medigap policies at all.

This does not include the three states that standardize Medigap plans differently. In addition to the standard Aetna Medigap offerings, people in Michigan and New Jersey may also have access to Medigap Plan C.

Even within the states in which Aetna offers Medicare Advantage and Medigap policies, it’s important to note that plan availability still varies by zip code. Get a customized quote for accurate plan information.

ANTHEM/BCBS SUMMARY

Blue Cross Blue Shield has been delivering health insurance products since 1929. Today, the association of independently operated companies with the BCBS branding serves more than 106 million members across the United Stated and in Puerto Rico. The company as a whole insures one in three Americans with products ranging from individual health insurance to Medicare Advantage.

Anthem, an independent licensee of Blue Cross Blue Shield, shares an intertwined history with BCBS. The company serves more than one in eight Americans with an affiliated health plan, and its Medicare Advantage business remains strong. In 2018, over 70 percent of the company’s Advantage customers had plans with at least a 4-star rating. Anthem reported revenues of $90 billion in 2017, representing 40 percent growth over the last five years.

Medicare Products

As one of the country’s largest insurers, Blue Cross Blue Shield sells a broad array of products, including Medicare Advantage plans and Medigap supplemental insurance.

Medicare Advantage

Blue Cross Blue Shield comprises over 30 different companies across the United States, which includes various entities listed under Anthem. A variety of factors (primarily your zip code) influence whether you have access to these plans or not. We’ve listed several of the plans available in Los Angeles County, California, for both BCBS and Anthem. This list isn’t exhaustive; it’s just meant to give you an idea of the options.

Anthem/BCBS

Medicare Advantage Plans

Highlights
Anthem MediBlue Plus (HMO) Premium: $79

Deductible: $750 for out-of-network care

Copays: $10 primary / $40 specialists

Required referral? No

Drug coverage? Yes ($0 copay for tier 1)

Extra benefits: vision coverage, Silver Sneakers fitness benefit and 24/7 nurse hotline

Anthem StartSmart Plus (HMO) Premium: $0

Deductible: None

Copays: $0 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($0 copay for tier 1)

Extra benefits: routine hearing and eye exams, Silver Sneakers fitness benefit and 24/7 nurse hotline

Anthem Value Plus (HMO) Premium: $0

Deductible: None

Copays: $0 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($0 copay for tier 1 at preferred pharmacy)

Extra benefits: eye and hearing exams; eyeglasses, contacts and hearing aids; limited dental; and Silver Sneakers fitness plus 24/7 nurse hotline

Anthem Connect Plus (HMO) Premium: $0

Deductible: None

Copays: $0 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($0 copay for tier 1 at preferred pharmacy)

Extra benefits: eye and hearing exams; eyeglasses, contacts and hearing aids; limited dental; and Silver Sneakers fitness plus 24/7 nurse hotline

Blue Shield 65 Plus Plan (HMO) Premium: $0

Deductible: None

Copays: $0 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($0 copay for tier 1)

Extra benefits: vision coverage, Silver Sneakers fitness and 24/7 nurse hotline

Blue Shield 65 Plus Choice Plan (HMO) Premium: $0

Deductible: None

Copays: $0 primary / $5 specialists

Required referral? Yes

Drug coverage? Yes ($3 copay for tier 1)

Extra benefits: hearing exams, dental and vision coverage, Silver Sneakers fitness and 24/7 nurse hotline

Medigap

Medigap supplemental insurance can alleviate some of the out-of-pocket costs associated with original Medicare, such as the Part A hospital deductible. All but three states – Massachusetts, Minnesota and Wisconsin – standardize their Medigap policies the same way, so a Plan F in Ohio covers the same benefits as one in Rhode Island. In 2018, Anthem typically sells Plans A, F, G and N, with an “innovative” option for plans I, F and G in some states. BCBS sells all 10 Medigap policies, though not in every state.

Availability

Availability for Medicare Advantage depends on several factors, but where you live plays the biggest role. Using information from websites for both Anthem and Blue Cross Blue Shield, we found that the following states do not have any plan offerings from either company in 2018: Alaska, Delaware, D.C., Iowa, Maryland, Mississippi, North Dakota, South Dakota, Vermont, Wyoming. Every other state does.

Medigap supplemental insurance also varies by zip code. In 2018, Aetna and/or BCBS offer standardized Medigap plans in every state except Hawaii (excluding the three states that standardize their Medigap policies differently).

Even where Anthem and/or BCBS offer Medicare Advantage and Medigap supplemental plans, availability varies widely based on where you live. A personalized quote is the best way to explore your options with these companies.

HUMANA SUMMARY

Headquartered in Kentucky, Humana provides medical benefit products to 14 million people and specialty products to 7 million people around the United States. Medicare Advantage accounts for a significant portion of the company’s offerings. In 2017, 79 percent of Humana’s revenue from premiums and services came from contracts with the federal government. This figure includes 15 percent directly related to Medicare Advantage contracts in Florida. In total, the company covers nearly 2.9 million people with individual Advantage plans nationwide. Humana reported operating revenues of nearly $53.8 billion in 2017.

Medicare Products

Within the framework of Medicare products, Humana sells Part D prescription drug plans, Medicare Advantage plans and Medigap supplemental insurance. The company’s Medicare Advantage line includes Humana Gold Plus HMO, Humana Choice PPO and Humana Gold Choice PFFS. Each has its own benefits and drawbacks depending on what you need in a health plan.

Medicare Advantage

Humana’s offerings vary by state. You may have access to more or fewer plans depending on where you live, even within a state with a lot of options. Because plan availability varies so widely, we’ve chosen to focus on the Humana Medicare Advantage plans being sold in Los Angeles in 2018 just to showcase some features and benefits.

Humana

Medicare Advantage Plans

Highlights
Gold Plus HMO Premium: $0

Deductible: $0

Copays: $0 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($0 copay for tier 1)

Extra benefits: vision, dental and hearing exams; acupuncture; Silver Sneakers fitness; some reimbursement for mail-order OTC drugs and supplies; reduced-fee rides on transportation

Gold Value Plus HMO Premium: $16

Deductible: $183 for medical / $405 for prescriptions

Copays: $0 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($0 copay for tier 1)

Extra benefits: vision, dental and hearing exams; chiropractic; Silver Sneakers fitness; some reimbursement for mail-order OTC drugs and supplies; reduced-fee rides on transportation

Medigap

In all but three states (Massachusetts, Minnesota and Wisconsin), Medigap supplemental insurance plans are standardized at the federal level. This means that Plan G in Colorado will cover the same benefits in the same amounts as Plan G in Michigan. In 2018, Humana offers Medigap Plans A, B, C, F, high-deductible F, G, K, L and N, though not all plans are available in every state. Humana does not offer Plans D or M.

Availability

Plan availability depends on where you live, so it’s not always easy to get an accurate picture of where companies sell policies. In 2018, Humana offers plans nationwide except for the following: Alaska, Connecticut, the District of Columbia, Maryland, Massachusetts, New Jersey, Rhode Island and Vermont. Humana also sells Medigap plans in every state that has standardized Medigap policies, although not every plan will be available in every zip code.

Note that even in states where we couldn’t find Humana policies, you may have access to a Humana plan. That’s why it’s important to get a customized quote when researching Medicare Advantage information. Your zip code plays a key role in Medicare plan availability.

KAISER PERMANENTE SUMMARY

Founded over 70 years ago, Kaiser Permanente has evolved to become one of the largest not-for-profit health plans in the United States. The company serves 12.2 million people despite offering coverage to just eight states and the District of Columbia. Medicare Advantage is an important part of Kaiser’s offerings. In seven states plus the District of Columbia, the Centers for Medicare and Medicaid Services rated Kaiser’s Advantage plans as 5 stars (the highest score) in 2018; plans in the remaining state, Georgia, received 4.5 stars. Kaiser reported operating revenues of $72.7 billion in 2017.

Medicare Products

While limited in terms of where it operates, Kaiser Permanente offers a variety of Medicare Advantage plan options for those who live in the company’s service areas.

Medicare Advantage

State regulations on health plans, location and other factors affect plan options, and Kaiser Permanente covers a limited area in the United States. We’ve chosen to highlight a few plans from California – specifically Los Angeles and Sacramento – in the chart below to give you an idea of the Kaiser Medicare Advantage coverage you might find in 2018.

Kaiser Permanente

Medicare Advantage Plans

Highlights
Senior Advantage

LA, Orange Co. (HMO)

Premium: $0

Deductible: None

Copays: $15 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($5 copay for tier 1)

Extra benefits: routine hearing and eye exams; extra benefits, like Silver Sneakers and dental, can be purchased for $20/month

Senior Advantage Enhanced

Sac., Sonoma (HMO)

Premium: $98

Deductible: None

Copays: $25 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($6 copay for tier 1)

Extra benefits: routine hearing and eye exams; extra benefits, like Silver Sneakers and dental, can be purchased for $20/month

Senior Advantage Basic

Sac., Sonoma (HMO)

Premium: $25

Deductible: None

Copays: $35 for primary and specialists

Required referral? Yes

Drug coverage? Yes ($7 copay for tier 1 at preferred pharmacy)

Extra benefits: routine hearing and eye exams; extra benefits, like Silver Sneakers and dental, can be purchased for $20/month

Medigap

Medigap policies can help fill out-of-pocket gaps left by original Medicare. All Medigap policies are standardized at the federal level except for those in Massachusetts, Minnesota and Wisconsin (these states standardize differently). Kaiser Permanente only sells Medigap plans in Washington state as of 2018. The policies available are Medigap Plans A, F, K and N.

Availability

Kaiser sells Medicare Advantage policies in the following areas:

  •       California
  •       Colorado
  •       D.C.
  •       Georgia
  •       Hawaii
  •       Maryland
  •       Oregon
  •       Virginia
  •       Washington

As we mentioned earlier, Kaiser only offers Medigap supplemental insurance in one state: Washington. We should also note that availability may not be consistent even in states where Kaiser operates. Plan availability depends largely on zip code, so get a quote using your location for accurate information about your options.

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