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4 Parts of Medicare Covered/Not Covered by Part B

 

UnitedHealthcare offers a portfolio of Medicare products and is part of UnitedHealth Group, which delivers innovative products and services to more than 12 million unique individuals. For more than four decades, UnitedHealthcare has served the health care coverage needs of Medicare beneficiaries. UnitedHealthcare serves one out of every five Medicare beneficiaries through a variety of products, including Medicare Advantage plans, Medicare Supplement Insurance plans, and Medicare Part D prescription drug plans.

Medicare Advantage plans offer all of the benefits covered under Original Medicare and more. Many plans also include Medicare Part D prescription drug coverage. Depending on residency, there may be several Medicare Advantage plans from which to choose, including HMO, POS, PPO and PFFS plans.

  • Health Maintenance Organization (HMO) plans enable members to receive care through a network of contracted local doctors and hospitals that coordinate their care. Some plans do not require referrals for specialty care.
  • Point-of-Service (POS) plans include all of the features of HMO plans plus the ability to go outside the contracted network for certain health care services, typically at a higher cost. POS plans offer open access to providers with no referrals needed.
  • Preferred Provider Organization (PPO) plans give members access to a network of contracted local doctors and hospitals, but also allow them the flexibility to seek covered services from physicians or hospitals outside of the contracted network, typically at a higher cost. Members do not need a referral for specialty care.
  • Private Fee-for-Service (PFFS) plans give members the freedom to receive care from any Medicare-approved provider who agrees to accept the plan’s terms and conditions of payment. Referrals are not needed for specialty care.

Medicare Advantage Special Needs Plans provide health care coverage for people with a qualifying chronic condition, those who reside in a contracted skilled nursing or assisted living facility or those who qualify for both Medicare and Medicaid (also referred to as “dual eligible”).

Medicare Supplement Insurance plans are offered to those enrolled in Medicare Parts A and B. These plans may provide more freedom to choose doctors and hospitals and to see specialists without referrals. Medicare supplement insurance plans also offer nationwide coverage.

Medicare Part D plans are available in all 50 states and the five U.S. territories. These plans provide a way to add drug coverage to Original Medicare or Medicare Supplement Insurance coverage.