AARP Medicare Complete is a PPO Medicare Advantage plan offered by United Healthcare. (By the way, If you do not have a basic understanding of how Medicare Advantage plans work, please refer to our other blogs for a quick tutorial.) The plan is offered on a regional basis is Connecticut, Mass, RI and Vermont. It was a $0 monthly premium plan in 2011 but now has a $20 monthly premium for 2012.
Here is a basic summary of the strengths and weaknesses of the plan. (Looking for AARP Medicare Complete 2013 Info? CLICK HERE)
Network- United has built up a strong network in Connecticut. The AARP Medicare complete network is second only to the network of Connecticare. Overall, they are very good with network.
In Network Benefits- The AARP Med Complete plan certainly had some benefit changes for the worse for 2012. The most notable changes are Hospital inpatient charge ($400 a day 1-4), Outpatient surgery and Major Radiology at 20% cost share. Copays went up slightly for a primary care doc ($20) and a specialist ($45). Many Advantage plan members, worry about about office copays but the concern should be with the Outpatient surgery and Major Radiology. At 20% cost share, there can be substantial out of pocket costs for the insured.
Out of Network Benefits-The out of network benefit feature is a plus due to the freedom it allows. The fact that the cost share is 30% to the insured is of a concern however. The combined in and out of pocket max for this plan is $10,000 which seems to be a bit excessive.
Overall- While this plan may not look as good as the Anthem PPO (click here for info on the Anthem PPO) on paper, it tends to run much more smoothly. We receive far more client plan and benefit issues from the Anthem PPO than we do with the AARP Medicare Complete PPO. Again, the benefits do not compare well with the Anthem PPO but the administration of the plan is far better on the United side.
If you have specific questions or need any additional information, please email Edward Crowe at [email protected] or call at 203-796-5403
For a link to the Application, Benefit Summaries and Rates click the link below