When you’re nearing retirement, it’s even more critical to select health coverage. Before you enroll in a plan, it is important to understand your choices, as unexpected hospital bills and prescription medications, as well as doctor visits and specialist care, can put a strain on any family’s finances.
One unconfusing thing for those who have already been looking for AARP Health Insurance is the truth that AARP is not a health insurance firm. Rather, there are some AARP-branded Medicare insurance products provided by UnitedHealthcare. Options offered may include Medicare Advantage, Medicare Supplement, and prescription drug plans depending on eligibility and where they live.
Age is also a factor, though not necessarily what a lot of consumers think. It is not a requirement for membership that one be 50 to join the AARP; 18+ is age for adults to join; however, some insurance products may have specific eligibility requirements. Medicare is available at age 65, for instance, but some individuals may be eligible at an earlier age due to a disability, ALS, or End-Stage Renal Disease.
What Does AARP Health Coverage Actually Include
First, one should learn how AARP and the companies that offer the insurance are connected.
AARP is providing members with access to information, programs, discounts, and certain insurance benefits. Its insurance product related to Medicare is not an insurance product provided by AARP itself, but rather by UnitedHealthcare. That is important when you are involved in comparing coverage or working out provider networks or asking for pricing for different plans.
The key Medicare issues that relate to joining the AARP are:
- Medicare Advantage plans: May be a choice in which beneficiaries receive Medicare benefits from a private Medicare-approved insurance company. These plans can provide extra coverage in addition to Original Medicare.
- Medicare Supplement plans: Also known as Medigap policies, they supplement Original Medicare, and some will cover out-of-pocket expenses.
- Medicare Part D plans: Prescription drug plans that help to cover generic and brand-name drugs.
- Help for consumers: Enrollment and coverage information, prepared by AARP, is also available.
AARP Medicare Advantage plans are available to eligible non-members and members of UnitedHealthcare for a fee, and AARP Medicare Supplement insurance has varying membership requirements. The MSP Medicare prescription drug programs are open to members and non-members of AARP.
That’s why it’s important not to look for a universal AARP plan. The options may vary depending on the kind of Medicare that you would like to work for, your place of residence, and your particular eligibility.
Can You Get AARP Coverage Before Age 65
This is one of the most perplexing areas of confusion.
Being a member of AARP is not the same as being eligible for insurance that relates to Medicare. Anyone can join the AARP before they turn 50, but they are not necessarily Medicare-eligible upon joining. AARP firms that adults, age 18 and older, can buy membership, although some benefits will have legal, contractual or age limits.
Most people are eligible for Medicare at age 65. Many qualify sooner, such as those receiving Social Security Disability benefits and those with ALS or End-Stage Renal Disease.
So what are the options for someone below the age of 65 whose Medicare is not available?
Some other options may be:
- Employer-provided insurance: Insurance offered via your job might still be one of the most practical options.
- Spouse’s employer plan: When an individual loses an employer plan, they will be able to use up to an eligible spouse’s plan.
- ACA Marketplace coverage: Individual and Family policies are offered via the Health Insurance Marketplace or state-based marketplaces.
- COBRA: An individual who is no longer eligible for coverage through an employer’s plan might be able to temporarily continue its plan coverage, but the person will most likely have to pay a much larger proportion of the premium for it.
- Medicaid: coverage is based on eligibility, which includes income and state guidelines.
- Individual coverage: private insurers can also provide individual coverage, but as part of your research, you should look into whether the coverage is ACA-compliant and what it entails.
One aspect that should be highlighted is coverage in the marketplace for early retirees and other adults awaiting Medicare eligibility. Monthly Marketplace premiums may be lower with premium tax credits, based on family income and other eligibility requirements. According to HealthCare.gov, the Marketplace is how qualified consumers will receive these premium tax credits.
That is, a 50- or 55-year-old who enrolls in AARP ought not to expect that membership implies major-medical insurance. Prior to the age at which Medicare eligibility starts, the smarter course of action is to examine the sources of health coverage that really exist for your family.
AARP Medicare Advantage vs Medicare Supplement vs Part D
Once you become eligible for Medicare, understanding the differences between the major options is essential. They aren’t interchangeable.
Medicare Advantage
Medicare Advantage plans (known as Part C coverage) are an alternate way people get Medicare coverage – instead of Original Medicare, Medicare Advantage plans offer Medicare benefits through a private Medicare-approved company.
These plans must include the services that are part of Original Medicare and can include extra benefits. Additionally, most Medicare Advantage plans will include prescription drug coverage. Depending on the plan, a member might have to use a specific network, or authorization might be required for other services before they are used.
It could be attractive to consumers who like having a number of benefits in one plan.
Medicare Supplement
Medicare Supplement insurance is not the same. Medigap does not replace how you receive your Original Medicare benefits but works with Original Medicare and helps cover some of the expenses that are not covered by Original Medicare, such as allowed copayments, coinsurance, and deductibles.
One benefit of Original Medicare is that people can go to any doctor or hospital in the U.S. that accepts Medicare. Then, Medigap policies can minimize out-of-pocket costs remaining from Original Medicare.
But Medigap will usually not include routine dental/optic care, hearing aids, long-term care, or prescription drugs. Also, modern Medigap policies do not cover prescription drugs, so if a person needs drug coverage, they might need to acquire it with a separate Part D plan.
Medicare Part D
Part D deals solely with prescription drug coverage. Some of these UnitedHealthcare Medicare-Rx plans are made available by AARP to help cover qualified generic and brand-name drugs.
Don’t shop by premium only when comparing Part D plans. Review:
- If your usual drugs/prescriptions are listed on the formulary.
- The amount you must pay out-of-pocket for your medicines
- The plan deductible
- Preferred pharmacies
- Mail-order options
- Restrictions that may apply to individual medications
If a few of the medications you use are in the higher-cost categories, a low-premium drug plan may be very costly.
How Much Does AARP Medicare Coverage Cost
Not all enrollees pay a single price in the country.
Each has distinct price structures, and what one pays for Medicare Advantage, Medigap, and Part D premiums and out-of-pocket costs varies. The availability and actual costs may vary based on location, plan selected, and other factors.
Medicarescope Plans also can have their own premiums, copays, and coinsurance, as well as their own deductibles. Also, most people are required to pay their Medicare Part B premiums in addition to Medicare Advantage premiums. Medicare Advantage plans also impose out-of-pocket maximums for covered health care services for each year.
Medigap policies are available for paying a separate premium. Medicare states that premiums can vary based on the policy, location, and other factors. You also have to pay the Part B premium.
Part D premiums also differ depending on the plan, and how much you actually spend for prescription drugs will greatly depend on your specific medications and pharmacies.
Consider the total amount you spend annually on health care instead of just, “what is the cheapest premium?”
Compare before you select a plan:
- Monthly premiums
- Annual deductibles
- Copayments for primary and specialist visits
- Hospital costs
- Prescription expenses
- Out-of-pocket limits apply if there are any, which are listed as Maximum out-of-pocket limits.
- Dental, vision and hearing benefits
- Professional networks and providers; hospital networks
- Coverage while traveling
- Prior authorization requirements
Suppose that one plan is a bit higher in monthly fees, but offers the specialists you like and lowers your monthly medication cost on medicines you use frequently. Another plan may offer a lower premium, but generates a higher out-of-pocket cost upon receiving care.
Hence, it is important not to base your decision solely on a premium.
How to Choose the Right Coverage for Your Needs
When you start by considering your health care habits instead of marketing, health insurance does not seem so difficult to compare.
Start by listing all of the doctors, specialists, hospitals, and medications that are important to you. To calculate each plan, run each one against that list.
- Always consult your doctors! When Medicare Advantage is under consideration, check if providers of choice are in the Medicare Advantage network.
- Review every prescription. Don’t base your decision on whether a prescription is covered. Review all drugs with the current costs and uses in the plan’s formulary.
- Select an approximate year of use. Do not make your decision solely on a healthy month. Think about the costs of regular visits, tests, or hospital visits if you needed them.
- Think about travel. Those with frequent interstate travel might prioritize the availability of providers more. Original Medicare typically provides coverage for beneficiaries who choose to use providers throughout the country that accept Medicare; Medicare Advantage is a different story since these services have networks.
- Understand enrollment timing. The start of your Medicare enrollment period is usually 7 months: three months before your 65th birthday, your birthday month, and 3 months after. There may be exceptions to this information. Not enrolling at proper times means that coverage gaps or late enrollment penalties could result.
Lastly, check coverage options annually; the coverage you have now may not be the best fit. Benefits, provider networks, drug formularies, and an individual’s health care needs may change.
Frequently Asked Questions
Does AARP directly provide health insurance?
No. The AARP is not an insurance company providing insurance for its Medicare-branded products. AARP Medicare Plans are underwritten by UnitedHealthcare, and the eligibility, availability, and terms of a plan may vary from product to product and location to location.
Do you have to be 65 to join AARP?
The age to join AARP is 18 years old. But certain benefits/insurance products have their own eligibility requirements.
Can someone under 65 get an AARP Medicare plan?
Most people qualify for Medicare at age 65, but some qualify at a younger age if they have a disability, ALS, or End-Stage Renal Disease (ESRD). A plan’s eligibility criteria involve Medicare eligibility and other specific plan requirements.
Is AARP Medicare Advantage the same as Medigap?
No. Medicare Advantage is another means of getting Medicare coverage through a private Medicare-approved plan. Medigap policies complement Original Medicare to help with some out-of-pocket costs of Original Medicare. Medigap is not available to pay for Medicare Advantage plan expenses.
Does AARP Medicare coverage include prescription drugs?
This will vary based on the plan. Most Medicare Advantage plans offer drug coverage, and standalone AARP Medicare Rx plans offer Part D coverage. Medigap policies sold today don’t include prescription drug coverage.
Conclusion
When one looks at AARP-related health coverage aside from AARP membership and the health insurance products themselves, it makes more sense. Plans available through UnitedHealthcare that feature the AARP could feature Medicare Advantage, Medicare Supplement, or Medicare Part D prescription drug plans, and availability, cost and eligibility vary.
Non-eligible persons may have to consider employer coverage, spouse coverage, the ACA Marketplace, COBRA coverage, or Medicaid and other individual plan options. Don’t opt for coverage simply because it says it’s from the AARP, or that it’s the cheapest available as you see advertised, but instead compare doctors, prescriptions, your total use of services, and your travel requirements and what those will cost you. That additional comparison can assist you to uncover coverage that aligns not only with your healthcare needs but also with your finances.