UnitedHealthcare 2025 Medicare Advantage Plans Deliver Choice, Stability

UnitedHealthcare^® today introduced its 2025 Medicare Advantage plans, featuring more choice, broad access to care and stability in the most popular benefits to meet the evolving and varied needs of Medicare consumers.

UnitedHealthcare Medicare Advantage plans will continue to reach 96% of Medicare consumers with benefits designed to meet the broad needs of individuals nationally. Highlights of UnitedHealthcare 2025 individual Medicare Advantage plans include:

More Coverage Choices to Meet Diverse Needs

UnitedHealthcare is introducing 140 new plans for 2025, many of which offer new designs and benefits more tailored to specific consumer populations and needs.

• UnitedHealthcare’s footprint of America’s most-chosen Dual Special Needs Plans (D-SNPs) will expand to reach 135,000 additional dual-eligible consumers. When including all products designed for this population, UnitedHealthcare will reach 93% of those eligible, offering benefits that matter most to them and helping to position the company to serve these consumers long term. Benefits may include:
  • Credits to help pay for over-the-counter (OTC) products and healthy food – enabled with the UnitedHealthcare UCard®.
  • $0 copays for all covered prescription drugs on most plans.
  • $0 annual physical exams, $0 lab tests and $0 preventive care.
  • $0 copay for virtual medical and mental health visits.
  • Rewards for physical activity, an annual wellness visit and more.

• Meanwhile, the company’s footprint of Chronic Special Needs Plans (C-SNPs) will nearly double to reach 70% of people who can enroll in these plans (more than 23 million additional consumers) – those living with severe or disabling chronic conditions, including diabetes, chronic heart failure and cardiovascular disease. This significant expansion will mean more affordable coverage options for members with these qualifying conditions. UnitedHealthcare C-SNPs offer lower average copays on benefits that are more highly utilized when compared to standard (i.e., non-SNP) plans, including specialist visits and prescription drug use. UnitedHealthcare C-SNP plans will also feature benefits like:
  • Monthly credit to pay for OTC products and healthy food.
  • $0 copays on dental, vision and hearing exams.
  • $0 diabetic supplies from Optum^® Home Delivery Pharmacy, plus coverage for footcare and diabetic shoes.
  • $25 or less for one-month supply of covered insulin.
  • $0 annual physical exams, $0 lab tests and $0 preventive care. 

• The UnitedHealthcare standard plan portfolio will include new options in select markets that prioritize medical or ancillary benefits, along with a new plan that gives eligible members a quarterly credit that can be used to lower and even eliminate out-of-pocket costs for Medicare-covered Parts A and B services. Benefits available across non-SNP plans may include:
  • $0 annual physical exams, $0 lab tests and $0 preventive care.
  • $0 copays on dental, vision and hearing exams.
  • $0 copays on hundreds of prescription drugs, at the pharmacy or by mail.
  • $0 copay for virtual medical and mental health visits.

Benefit Stability, Ease Where it Matters Most to Members

• Savings: Most members will have stability in specialist and pharmacy copays plus industry-leading prescription drug coverage. Additionally, members will have options for plans with low and $0 premiums, $0 primary care copays, coverage for routine vision, dental and hearing care, plus a free gym membership.
• Access: Members may again access Medicare Advantage’s largest national provider network^[ii] through UnitedHealthcare, available across more plans and reaching nearly 96% of individuals eligible for Medicare in the company’s coverage area. 
  • Members in plans that have access to the UnitedHealthcare National Network can see any of more than 1 million network providers, whether in their neighborhood or away from home.
  • Members will also experience an enhanced, more intuitive provider search function to guide them in finding the right care.
• Formulary Strength & Rx Savings: Each year, the Medicare Advantage formulary evolves to maintain broad therapeutic coverage for the diverse Medicare population and to deliver consistent quality with the most cost-effective options.
  • The company’s Medicare Advantage formulary will cover more of the most-used tier 1 prescriptions than any national competitor.^[iii]
    • All covered generic adherence medications will remain covered in tier 1 on our MAPD formulary.
    • The top 20 most commonly used generics, particularly those essential for managing chronic conditions such as heart disease and diabetes, will be available on tier 1. And members will have tier 2 coverage for four commonly used non-Medicare covered drugs (generic Viagra, folic acid, vitamin D, B12).
  • All members will have $0 tier 1 and tier 2 copays with Optum Home Delivery Pharmacy. 
  • A month supply of covered Part D insulin is $35.
  • Members may get a 100-day prescription drug supply for prescriptions on tiers 1-3.
• UnitedHealthcare UCard®: The UCard is the all-in-one access point for members to use their benefits – including all the features of a traditional health ID card and much more. To date in 2024, members have completed more than 71 million transactions in-store and online – spending more than $3.3 billion on their health and well-being.
  • For 2025, the UCard will transition from a scannable barcode to magstripe technology on most plans, allowing members to swipe their card just like they swipe their personal debit or credit cards, creating a more intuitive and secure experience. 

Important Specialty Benefits and Other Plan Features Bring Value, Coverage Not Offered by Original Medicare

• Dental: UnitedHealthcare standard Medicare Advantage plans offer preventive dental coverage for exams, routine cleanings, X-rays and fluoride at a $0 copay, with many plans offering comprehensive dental coverage included in the plan or as an optional add on.
• Hearing: UnitedHealthcare standard Medicare Advantage plans cover more than 2,000 hearing aids and devices. All full dual members will retain $0 hearing exams and an allowance for hearing aids through their UnitedHealthcare D-SNP plan or state Medicaid program.
  
• Vision: Members with a vision benefit will maintain $0 annual eye exams, and the average eyewear allowance will increase by $20 for frames or contacts, with standard lenses continuing to be covered in full.
  
• Rewards: The rewards program helps support overall plan value and experience while encouraging healthy activities like getting an annual wellness visit, completing a health assessment or connecting with others. Members can use their UCard to spend earned rewards on eligible items at participating retailers in-store or online.
  

Medicare Annual Enrollment runs from Oct. 15 to Dec. 7. As the only company to offer Medicare plans with the AARP name, and as the nation’s largest Medicare Advantage, D-SNP and Medicare Supplement carrier, UnitedHealthcare serves 1 in 5 Medicare beneficiaries, or over 13 million people, through a portfolio of products that include Medicare Advantage, Medicare Part D, Medicare Supplement and retiree services.^[iv]

 

About UnitedHealthcare

UnitedHealthcare is dedicated to helping people live healthier lives and making the health system work better for everyone by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. In the United States, UnitedHealthcare offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.7 million physicians and care professionals, and 7,000 hospitals and other care facilities nationwide. The company also provides health benefits and delivers care to people through owned and operated health care facilities in South America. UnitedHealthcare is one of the businesses of UnitedHealth Group, a diversified health care company. For more information, visit UnitedHealthcare at www.uhc.com or follow UnitedHealthcare on LinkedIn.

 

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Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies. For Medicare Advantage Plans: A Medicare Advantage organization with a Medicare contract. For Dual Special Needs Plans: A Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan's contract renewal with Medicare.

Benefits, features and/or devices may vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Food and OTC benefits have expiration timeframes. Call your plan or review your Evidence of Coverage (EOC) for more information.

D-SNP: Eligibility for the healthy food benefit under the Value-Based Insurance Design model is limited to members with Extra Help from Medicare and will be verified after enrollment. For TN only: The healthy food benefit is a special supplemental benefit only available to chronically ill enrollees with a qualifying condition, such as high blood pressure, high cholesterol, chronic and disabling mental health conditions, diabetes and/or cardiovascular disorders, and who also meet all applicable plan coverage criteria. There may be other qualified conditions not listed. Contact us for details.

C-SNP: The healthy food benefit is a special supplemental benefit only available to chronically ill enrollees with a qualifying condition, such as diabetes, chronic heart failure and/or cardiovascular disorders, and who also meet all applicable plan coverage criteria. Contact us for details.

By activating and/or using the benefits and reward funds with your UCard, you agree to the Terms and Conditions available at ucard.uhc.com. UCard does not need to be activated to visit your provider or fill a prescription. Reward offerings may vary by plan and are not available in all plans. By participating in the program or accessing rewards funds, you agree to the Rewards Program Terms of Service.

Optum Home Delivery Pharmacy and Optum Rx are affiliates of UnitedHealthcare Insurance Company. You are not required to use Optum Home Delivery Pharmacy for medications you take regularly. There may be other pharmacies in our network.

You will pay a maximum of $25 for each one-month supply of Part D covered insulin drug through all Drug Payment Stages except Catastrophic Drug Payment Stage where you'll pay $0.

$0 copay may be restricted to particular tiers, preferred medications, or home delivery prescriptions during the initial coverage phase and may not apply during the catastrophic stage.

The fitness benefit varies by plan/area and may not be available on all plans. The fitness benefit includes a standard fitness membership. The information provided is for informational purposes only and is not medical advice. Consult your doctor prior to beginning an exercise program or making changes to your lifestyle or health care routine. Gym network may vary in local market and plan.

If your plan offers out-of-network dental coverage and you see an out-of-network dentist, you might be billed more. 

Other hearing exam providers are available in the UnitedHealthcare network. The plan only covers hearing aids from a UnitedHealthcare Hearing network provider.

Annual routine eye exam and $100-400 allowance for contacts or designer frames, with standard (single, bifocal, trifocal or standard progressive) lenses covered in full either annually or every two years. Additional charges may apply for out-of-network items and services. Vision retail locations include retailer websites.

Virtual visits may require video-enabled smartphone or other device. Not for use in emergencies.

 

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Statistics refer to UnitedHealthcare standard Medicare Advantage plans (i.e. non-Special Needs Plans) unless specified otherwise.

^[i] Most chosen based on total plan enrollment from CMS Enrollment Data, September 2024.

^[ii] Provider network may vary in local market. Provider network size based on Zelis Network360, May 2024.

^[iii] Formulary review based on drug utilization by CMS among competitors 2024 formularies reaching at least 80% of Medicare eligibles.

^[iv] CMS enrollment data, September 2024.

 

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