What to know about UnitedHealthcare and Part D plans

UnitedHealthcare (UHC) is a private insurance company that offers several types of Medicare plans. These include Medicare Part D plans, which provide prescription drug coverage.

UHC offers different prescription drug plans, which vary in terms of their coverage, exclusions, and costs. This article discusses these options in more detail.

Glossary of Medicare terms

We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:

• Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.

• Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.

• Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.

• Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.

General Part D rules

Each Part D plan has a formulary, which is a list of covered drugs. All formularies contain at least two medications in each of the commonly prescribed classes, including both brand-name and generic drugs.

Formularies vary, so before choosing a plan, a person may wish to ensure that it covers their particular medications.

All Part D plans exclude drugs in specific categories, except in certain circumstances. These include medications that promote the following:

• weight loss or weight gain

• hair growth

• fertility

• relief of erectile dysfunction

• relief from cough or cold symptoms

Part D plans also exclude over-the-counter drugs and nutritional supplements.

In some cases, generic drugs may cost more than the brand-name equivalents. In these situations, UHC Part D plans sometimes exclude high cost generic drugs.

Medicare resources

For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.

UHC Medicare plans

UHC sells four types of Medicare plans.

Medicare Advantage

Medicare Advantage, or Part C, provides the benefits of Original Medicare, including the inpatient hospitalization insurance of Part A and the outpatient medical insurance of Part B.

Some UHC plans include prescription drug coverage and extra benefits, such as dental, vision, and hearing care.

Medicare Part D

Medicare Part D plans offer coverage for prescription drugs and are available to people with Original Medicare.

Part A covers the medications that someone receives during a hospital stay. Part B covers limited drugs, including those that a doctor or healthcare professional must administer.

Therefore, if a person needs take-home prescription drugs, they may wish to consider a Part D plan.

Medigap

Medigap is Medicare supplement insurance. The plans pay up to 100% of the out-of-pocket costs of parts A and B.

UHC Medigap plan options include:

• Plan A

• Plan B

• Plan G

• Plan K

• Plan L

• Plan N

If an individual first became eligible for Medicare before January 1, 2020, they can also opt for Plan C or Plan F.

Special Needs Plans (SNPs)

SNPs are types of Medicare Advantage plans that tailor benefits, medications, and providers to the healthcare requirements of individuals with certain chronic diseases.

There are three types of SNPs:

• Dual Eligible Special Needs Plan (D-SNP): This is an option for people who qualify for Medicare and Medicaid.

• Chronic Special Needs Plan (C-SNP): This is an option for those with severe or disabling chronic conditions.

• Institutional Special Needs Plan (I-SNP): This is an option for people who live in a skilled nursing facility.

UHC prescription drug coverage

UHC offers two choices for Medicare enrollees who need prescription drug coverage: Medicare Advantage plans and Part D plans.

Medicare Advantage plans

If a person prefers an all-in-one health plan, they can get prescription drug coverage with one of UHC’s Medicare Advantage plans that include this benefit.

UHC’s Medicare Advantage plans with prescription drug coverage have $0 copays on hundreds of prescription drugs.

Part D plans

If someone has Original Medicare and needs a stand-alone prescription drug plan, they may choose a UHC Part D plan. These plans do not work with most Medicare Advantage plans.

The company offers low premium plans for people who do not take many prescription drugs. They also sell higher premium plans for those who take multiple prescription drugs.

Example costs

UHC Part D costs vary among plans and areas of the country. Using the UHC plan finder tool and the ZIP codes below, the following table shows specific examples of some costs to expect from January 2025.

Help for Part D costs

Although Part D can provide substantial help with prescription drug costs, the expenses can still mount, particularly for people who take several medications.

Individuals with limited income and resources may qualify for Extra Help, a program that helps pay for Part D costs for eligible individuals.

In 2025, when someone’s yearly out-of-pocket drug costs reach $2,000, they will automatically get “catastrophic coverage,” even if these payments are made on another person’s behalf through the Extra Help program. This means that they will not need to pay any further out-of-pocket costs for Part D-covered drugs for the rest of the calendar year.

Summary

Costs of UnitedHealthcare Part D plans include deductibles, copays, and monthly premiums that vary among plans and areas of the United States.

A person who does not take many prescription medications may benefit from a low monthly premium plan. In contrast, someone who takes multiple medications may find that a higher monthly premium plan is a more suitable option.

Before deciding on a policy, a person may find it useful to look carefully at all costs to ensure that the plan meets their needs.

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