Fax completed applications to: (847) 220-9280

AARP - Medicare Supplement Plans



AARP Medicare Advantage Complete Plus HMO-POS Plan

When you enroll in a UnitedHealthcare Medicare Advantage plan, the federal government pays UnitedHealthcare a set amount of money to provide your benefits. As one of the largest providers of Medicare coverage, AARP has the plans, provider partnerships and wellness programs in place to keep costs down and can offer more benefits than Original Medicare for a $0 monthly premium beyond what you pay for Part B.

AARP - Illinois Medicare Advantage Plan

 In-NetworkOut-of-Network
Monthly Premium
$0
Annual out-of-pocket maximum
$3,800
Unlimited
Preventive Care
Doctor Office Visits
$5 copay
$25 copay
Specialist
$40 copay (no referal needed)
$50 copay (no referal needed)
Annual Physical
$0 copay
40% coinsurance
Cardiovascular screening
$0 copay
40% coinsurance
Colorectal cancer screening
$0 copay
40% coinsurance
Prostate cancer screening
$0 copay
40% coinsurance
Breast cancer screening
$0 copay
40% coinsurance
Inpatient Care
Inpatient Hospital
$250 copay per day: days 1-7.
$0 after
$350 copay per day for unlimited days.
Skilled Nursing Facility
$50 copay per day: days 1-20.
$0 after
$175 copay per day: days 1-20.
$0 after
Outpatient Services
Outpatient surgery & hospital services
20% coinsurance
40% coinsurance
Diabetes testing supplies
$0 copay
40% coinsurance
Home health care
$0 copay
40% coinsurance
Lab Services
Laboratory tests
$17 copay
$17 copay
Diagnostic testing
20% coinsurance
40% coinsurance
X-rays
$16 copay
$21 copay
Emergency Services
Ambulance services
$200 copay
$200 copay
Emergency room
$65 copay
$65 copay
Urgent care
$30 copay
$40 copay
Additonal Services not covered under Medicare
Podiatry services
  • Foot care
$40 copay for 6 visits/year
$50 copay for 6 visits/year
Vision services
  • Glaucoma screening
$0 copay
$50 copay
  • Routine Exams
$40 copay, 1 per year
$50 copay, 1 per year
Hearing services
  • Annual hearing test
$5 copay
$50 copay
  • Hearing aids
$340 copay for each behind the ear aid
$390 copay for each in-the-canal aid
No coverage

Prescription DrugsYour Costs
Deductible
$0
Initial Coverage Stage 31-day retail supply 90-day mail order supply
Tier 1 - Commonly Used Generic Drugs
$3
$6
Tier 2 - Most Generic Drugs
$6
$12
Tier 3 - Brand Drugs
$45
$125
Tier 4 - Non-Preferred Brand Drugs
$95
$275
Tier 5 - Specialty Drugs
33%
33%
Gap Coverage
Once you and your AARP MedicareRx Part D drug plan have spent $2,970 for covered drugs, you will be in the donut hole. You will receive a 52.5% discount on brand-name and speciality drugs and a 21% discount for generic drugs.

The donut hole continues until your total out-of-pocket cost reaches $4,750. This annual out-of-pocket spending amount includes your yearly deductible, copayment, and coinsurance amounts.
Once you and your AARP MedicareRx Part D drug plan have spent $2,970 for covered drugs, you will be in the donut hole but pay the greater of a $2.65 copay for generic drugs and receive a 50% discount on brand-name and specialty drugs.

The donut hole continues until your total out-of-pocket cost reaches $4,750. This annual out-of-pocket spending amount includes your yearly deductible, copayment, and coinsurance amounts.
After the Gap
When you spend more than $4,750 out-of-pocket, the coverage gap ends and your drug plan pays most of the costs of your covered drugs for the remainder of the year. You will then be responsible for whichever is greater:
Generic Drugs: $2.65 copay or 5% coinsurance for your drug
Brand Drugs: $6.60 copay or 5% coinsurance for your drug
Tier 4 - Non-Preferred Brand Drugs : $6.60 copay or 5% coinsurance for your drug
Tier 5 - Specialty Drugs: 5% coinsurance for your drug
Summary of Benefits 
 


Medicare Advantage Eligibility

Before enrolling in a AARP Medicare Complete Plus Plan, you need to be sure you are eligible for a Medicare Advantage Plan.

To be eligible, you must:

  • Be entitled to receive services under Medicare Part A and/or enrolled in Part B
  • Reside in plan service area in the state of Illinois. This includes Cook, Kane, and Will Counties ONLY
  • Not have End-Stage Renal Disease

If you are enrolled in a Medicare Advantage HMO, PPO, or POS plan, you may only receive your Medicare prescription drug benefits through that Medicare Advantage plan.

You may not enroll in a Medicare Advantage Plan if you already have you have a Medicare Advantage Plan until open enrollment.

If you are eligible and live where AARP Medicare Advantage Plans are available, you should decide which enrollment period is right for you.

Enrollment Periods


Annual Enrollment Period*

  • Any time between November 1st and December 7, 2014
  • Coverage begins on January 1, 2014
  • Use this time to enroll in a Medicare Advantage Plan for the first time or to switch plans

*Dates subject to change after January 1, 2014


Initial Enrollment Period

The Initial Enrollment Period (IEP) is the period of time when a Medicare beneficiary is first eligible to enroll in a Medicare Advantage Plan. Instances of IEP include:

  • Eligibility due to turning age 65. This 7-month IEP includes the three months before a beneficiary's 65th birthday, the birthday month and the three months after the birthday.
  • Eligibility based on being under age 65 and on disability or being diagnosed with End Stage Renal Disease. The IEP depends on the date the disability or treatments begin.

The effective date is generally the first day of the month after AARP receives the completed enrollment request.


Special Enrollment Period

There may be select circumstances when you can enroll outside of the initial and annual enrollment periods. Below is a list of some, but not all, of those circumstances:

  • A move outside of the plan's approved service area
  • Entering or leaving a qualified institution, such as a nursing home
  • Enrolling in, or disenrolling, from a Medicare Advantage plan (medical and drug benefit)
  • Becoming eligible for low income subsidy assistance
  • Becoming enrolled in Medicare or Medicaid

To obtain more detailed information on a Special Enrollment Period, including enrollment and effective dates, please contact a AARP MedicareRx Product Specialist.


Late Enrollment Penalty

Part D Penalty - If you do not or did not join a Medicare drug plan when you first became eligible and didn't have other creditable prescription drug coverage**, you may have to pay a late enrollment penalty of 1% for every month that you were eligible for Medicare but did not have creditable prescription drug coverage. This penalty would be added to your Part D plan premium, and the penalty amount could increase every year. You may also have to pay a penalty if you had a break in your Medicare drug coverage or other creditable drug coverage for at least 63 days in a row.

  • To avoid paying the Part D penalty: join either a Medicare Advantage or a Medicare Part D plan when you first become eligible (called the Inital Enrollment Period*), and do not go more than 63 days in a row without a Medicare drug plan or other creditable coverage.

*The Initial Enrollment Period for Part B consists of the month of your 65th birthday, the three months before, and the three months after the month you turn 65.

**Creditable prescription drug coverage is coverage that is expected to pay on average at least as much as Medicare's standard prescription drug coverage (eg. coverage from an employer or union).

Please visit the Social Security Administration website for more information.

After You Enroll


After Enrollment

After receiving your completed enrollment form, AARP will send you:

  • An acknowledgement letter within 10 days of receiving your enrollment form
  • After your enrollment has been approved, AARP will send you another letter no later than ten (10) calendar days from receipt of CMS confirmation of enrollment, or by the last day of the first month of enrollment, whichever occurs first
  • Approximately two weeks after receipt of your ID card, AARP will send your Welcome Kit. This package will include your Evidence of Coverage along with everything you'll need to know about being a member of AARP
  • A confirmation letter with your member identification card and the date your coverage will be effective
  • Your AARP Plan Welcome Kit, which includes your Evidence of Coverage and everything you'll need to know about being a member

Evidence of Coverage

The evidence of coverage (EOC) is a detailed document that explains the plan rules associated with AARP Medicare Advantage Plans. This document, together with your enrollment form, riders, coverage and the amendments that we may send to you, is our contract with you.

The EOC explains:

  • What is and is not covered by AARP Medicare Complete Plus HMO
  • How to get your prescriptions filled
  • What you will have to pay for your prescriptions
  • Your rights and responsibilities