Medicare Supplement Benefit Plans - Chapter 4, 2018 UnitedHealthcare Administrative Guide

AARP Medicare Select Benefit Plans

This Medicare Supplement product is available only to AARP members who reside within the service area of a participating hospital in our Medicare Select network.

What is Medicare Select?

Medicare was not designed to cover all health care expenses incurred by older adults. 

  • Medicare Supplement plans cover many of the out-ofpocket costs that Original Medicare (Part A and B) does not cover, which can provide consumers with a greater sense of security.
  • Medicare Select plans offer consumers the benefits of a standard Medicare Supplement plan at a lower price. Unlike a standard Medicare Supplement plan, Medicare Select requires members to use a network hospital to receive their full benefits.

Members must use a network hospital for inpatient services. They can seek services from the network physician of their choice and retain full Medicare benefits. 

Network hospitals agree to waive the Part A Inpatient Hospital Deductible ($1,316 in 2017). While your hospital waives the Part A Deductible, your hospital still receives the remaining reimbursement from Medicare, which is about 90% of the total charges on average. UnitedHealthcare reimburses all other Medicare-eligible expenses not paid by Medicare other than the Part A deductible amounts waived under the terms of the hospital agreement. UnitedHealthcare reimburses these expenses directly to the hospital helping to remove the risk of bad debt collection. You can arrange for automatic deposits or reimbursements. 

UnitedHealthcare uses these savings to offer a Medicare Supplement plan with a lower premium. If an insured member receives inpatient services outside of the network, they may use their Original Medicare (Part A) benefits. However, the member is responsible for the Part A deductible that would have otherwise been paid for by UnitedHealthcare, unless:

  • The services were emergency related
  • The service was not available from a participating hospital
  • The member was more than 100 miles from home

**No prior authorization for medical services is required.

 

Medicare Select Plans C & F

These Medicare plans reduce member expenses by providing coverage for: 

  • Part A inpatient hospital deductible 
  • Part A inpatient hospital coinsurance for days 61-90 in a Medicare benefit period
  • Part A inpatient hospital coinsurance for days where lifetime reserve days are used 
  • Part A eligible expenses for a lifetime maximum of 365 days after all Medicare Part A benefits are exhausted 
  • Part B coinsurance
  • Part B deductible
  • Daily coinsurance for days 21-100 for Skilled Nursing Facility stays 
  • Part A and B blood deductible for the first three pints of un-replaced blood 
  • Foreign travel emergencies 
  • Hospice and respite care copayments and coinsurance 
  • Part B excess charges for Medicare approved services (Select Plan F only)

Claims Submission Information

To submit a claim electronically, please contact your  Clearinghouse and provide our Electronic Payer ID. Our Electronic Payer ID is 36273. This number is specific to AARP Supplemental and Personal Health Plans. 

To submit a Part A or Part B claim via mail, send a standard billing form along with a Part A or B Remittance Advice to: 

UnitedHealthcare Insurance Company
P.O. Box 740819
Atlanta, GA 30374-0819

Free Medicare Education for Your Staff and Patients

Medicare Made Clear (MMC) is our public service campaign that gives consumers the information they need to select a Medicare benefit plan that is right for them. 

Consumers can easily access important information on topics such as the parts of Medicare, enrollment timing, what’s covered (and what’s not) and what they need to know to make good choices on our reference website MedicareMadeClear.com.