Learn How AARP Health Plans Work and Coverage

What AARP Health Plans Are and How They Work

AARP Health Plans are insurance products offered through UnitedHealthcare that are marketed specifically to people aged 50 and older. These plans are designed to help cover medical costs that can become more common as people age. It's important to understand that AARP itself is a membership organization, but the actual health insurance is provided and managed by UnitedHealthcare, a major insurance company. When you purchase an AARP Health Plan, you're buying insurance from UnitedHealthcare—AARP is essentially a partner that helps market these plans to its members.

Get Your Free Guide to Online Doctoral Degrees →

AARP Health Plans come in several forms, including Medicare Advantage plans, Medigap (supplemental insurance), and long-term care insurance. Each type works differently and covers different things. For example, Medicare Advantage plans are an alternative to traditional Medicare Part A and Part B, while Medigap plans work alongside traditional Medicare to cover costs that Medicare doesn't pay for. Understanding which type of plan might be relevant to your situation requires knowing where you currently stand with Medicare or other health coverage.

The way these plans work depends on your age and current Medicare status. If you're already on Medicare, you may be able to switch to an AARP Medicare Advantage plan during certain times of the year. If you're not yet on Medicare but approaching age 65, you might explore what options will be available to you. These plans operate through networks of doctors and hospitals, meaning your costs are typically lower when you use providers that are part of the plan's network.

AARP Health Plans use a cost-sharing model where you pay a monthly premium, and then you share the cost of healthcare services with the insurance company. This means the insurance company doesn't pay for everything—you'll have out-of-pocket costs like copayments (fixed amounts you pay for specific services), coinsurance (a percentage of the cost you pay), and deductibles (amounts you must pay before insurance starts covering costs). Each plan has different cost-sharing amounts, so comparing plans side by side is important.

Practical Takeaway: Before looking at AARP Health Plans, determine your current health insurance status. Are you on Medicare? Are you turning 65 soon? Do you have employer coverage? Your answers will tell you which type of AARP plan might be worth exploring and when you could potentially enroll.

Types of AARP Health Plans Available

AARP offers several distinct types of health insurance products, each serving different needs. The most common types are Medicare Advantage (also called Part C), Medigap (supplemental coverage), and long-term care insurance. Additionally, AARP offers dental and vision coverage as standalone products. Understanding these categories helps you know which plan type might address your situation.

Get Your Free Guide to Senior Fitness Discount Programs →

Medicare Advantage plans through AARP are complete alternatives to traditional Medicare. If you enroll in a Medicare Advantage plan, you use that plan instead of traditional Medicare Part A and Part B. These plans typically include prescription drug coverage (Part D), dental, vision, and hearing benefits built in. According to the Centers for Medicare & Medicaid Services, about 28 million Medicare beneficiaries were enrolled in Medicare Advantage plans as of 2023. Medicare Advantage plans usually have lower or zero premiums compared to Medigap plans, but they involve network restrictions—meaning you may pay more if you go to doctors or hospitals outside the plan's network.

Medigap plans (supplemental insurance) work differently. They work alongside traditional Medicare Parts A and B to cover costs that Medicare doesn't pay. For instance, Medicare covers 80% of doctor visits after you meet your deductible, but you're responsible for the other 20%. A Medigap plan can cover some or all of that 20%, depending on which Medigap plan you choose. There are ten different Medigap plans (labeled A through N), each with different coverage levels and different premium costs. Medigap plans don't include prescription drug coverage, so if you choose this route, you need to enroll in a separate Medicare Part D prescription drug plan.

Long-term care insurance through AARP helps cover costs if you need extended care due to illness or age-related conditions. This type of insurance can help pay for nursing home care, assisted living, or in-home care services. Long-term care insurance is different from health insurance—it specifically addresses the cost of ongoing care services rather than medical treatment. These policies can be complex, with various coverage amounts and waiting periods before benefits start.

AARP also offers standalone dental, vision, and hearing plans that can be purchased separately. These are not health insurance plans but rather specific coverage for services that Medicare typically doesn't cover. For example, traditional Medicare has limited dental coverage, so many people purchase a separate dental plan to help with routine cleanings, fillings, and other dental work.

Practical Takeaway: Make a list of what healthcare services matter most to you. Do you want dental and vision coverage? Are you concerned about prescription drug costs? Do you want low monthly premiums or predictable out-of-pocket costs? Your answers point toward which type of AARP plan might be worth exploring.

Coverage Details and What's Typically Included

The specific coverage in an AARP Health Plan depends on which plan type you're considering. For Medicare Advantage plans, coverage typically includes hospital stays (Part A), doctor visits and outpatient care (Part B), prescription drugs (Part D), and often dental, vision, and hearing services. However, coverage details vary significantly between different Medicare Advantage plans offered through AARP. One plan might cover routine eye exams and glasses annually, while another plan might offer dental cleaning twice per year with low out-of-pocket costs.

Learn About Medical Conditions and Social Security Disability →

It's critical to understand what "coverage" actually means. When a plan covers something, it doesn't mean you pay nothing. It means the insurance company will help pay for it according to the plan's terms. You'll still have copayments, coinsurance, or deductibles depending on the specific service and your specific plan. For example, a plan might cover a doctor visit with a $25 copayment, meaning the insurance company pays the remaining cost, but you pay $25 each time you visit that doctor.

Medicare Advantage plans have an out-of-pocket maximum, which is a limit on how much you have to pay per year for covered services. In 2024, the maximum out-of-pocket limit for Medicare Advantage plans cannot exceed $7,550 for in-network services. Once you reach this limit, the plan pays 100% of your covered in-network services for the rest of the year. This is an important protection that limits your financial risk.

Medigap plans have different coverage structures. They're designed to cover the "gaps" in Medicare. For instance, Medigap Plan G covers your Medicare deductible, coinsurance, and copayments, with very few out-of-pocket costs. However, Medigap Plan A offers less coverage and lower premiums. The trade-off is straightforward: plans that cover more of your costs have higher monthly premiums, while plans with lower premiums leave you responsible for more costs.

Prescription drug coverage is another important element. Medicare Advantage plans include prescription drug coverage, so your medications are covered under one plan. With Medigap, you need a separate Part D drug plan. Different plans cover different medications at different costs. Most plans use a formulary, which is a list of covered medications. If your medication isn't on the formulary, you'll either need to pay more out of pocket or work with your doctor to switch to a covered medication.

Network coverage is crucial for Medicare Advantage plans. These plans contract with certain doctors, hospitals, and pharmacies. When you use in-network providers, you pay the plan's cost-sharing amounts. When you use out-of-network providers, you typically pay more or sometimes the plan doesn't cover the service at all. Emergency care is usually covered even out-of-network, but routine care requires using network providers.

Practical Takeaway: Gather information about your current doctors, medications, and healthcare needs. Research whether your current healthcare providers are in-network for the specific AARP plan you're considering. If your doctor isn't in-network, that could be a significant factor in your decision.

Costs Associated with AARP Health Plans

Understanding the costs of AARP Health Plans requires looking at multiple types of expenses. The main cost categories are monthly premiums, deductibles, copayments, coinsurance, and out-of-pocket maximums. Each type of cost works differently

Free Guide to Finding Your Planet Fitness WiFi Password →