Understanding AARP Supplemental Insurance and Medicare
Medicare is comprised of several parts, each covering different medical expenses. Original Medicare includes Part A (hospital insurance) and Part B (medical insurance), but it does not cover most prescription drugs. This is where supplemental and prescription drug plans come in. AARP offers several types of Medicare plans through UnitedHealthcare, and it is crucial to understand the difference between them to ensure comprehensive coverage.
AARP supplemental insurance policies, also known as Medigap plans, help fill the “gaps” in Original Medicare. These plans cover costs like copayments, coinsurance, and deductibles that Original Medicare does not. However, by law, Medigap policies sold after 2005 cannot include prescription drug benefits. This means your AARP supplemental plan will assist with hospital and doctor visit costs but will not cover your medications.
The Role of AARP MedicareRx Part D Plans
For prescription drug coverage, beneficiaries need to enroll in a separate Medicare Part D plan. AARP, through its partnership with UnitedHealthcare, offers several stand-alone Part D plans designed to cover prescription drug costs. These are not bundled with the supplemental insurance policies but are purchased and managed separately. This structure allows for more flexibility, as you can choose a Part D plan that best fits your specific prescription needs, independent of your Medigap policy.
AARP's Part D Plan Options
As of 2025, AARP offers two primary stand-alone MedicareRx plans through UnitedHealthcare: AARP Medicare Rx Preferred and AARP Medicare Rx Saver. Each plan has different features, costs, and benefits to consider.
- AARP Medicare Rx Preferred: This plan generally offers more extensive drug coverage and often features a $0 annual deductible in most states. It is well-suited for those with higher prescription needs who prefer predictable costs. The plan uses a tiered formulary to manage costs, with lower copayments for preferred generic drugs.
- AARP Medicare Rx Saver: This plan typically has lower monthly premiums but comes with a higher annual deductible. It can be a good option for those who qualify for Medicare's Extra Help program or who have minimal prescription needs. Like the Preferred plan, it uses a tiered formulary with varying copayments based on the drug tier.
Understanding Drug Tiers and Costs
All Medicare Part D plans use a formulary, or list of covered drugs, which are organized into tiers. Your out-of-pocket costs, such as copayments and coinsurance, depend on which tier your medication falls into.
- Tier 1: Preferred Generic Drugs
- Tier 2: Generic Drugs
- Tier 3: Preferred Brand Drugs
- Tier 4: Non-Preferred Drugs
- Tier 5: Specialty Drugs
Prescription costs will vary based on your plan, the drug's tier, and whether you use a preferred network pharmacy or mail-order service like OptumRx, which is affiliated with UnitedHealthcare.
Combining Medigap with a Part D Plan
To have full medical and prescription coverage, many AARP members pair their UnitedHealthcare-administered Medigap policy with a separate AARP MedicareRx Part D plan. This strategy ensures that gaps in Original Medicare are covered by the Medigap policy, while medication costs are covered by the Part D plan. It is important to remember that these are separate enrollments, and you will receive separate bills for each plan.
It is also essential to compare plan options during the annual enrollment period to ensure your coverage is still optimal for your needs. Prescription drug lists (formularies), premiums, and other costs can change from year to year.
Comparison: Medigap vs. Medicare Part D
| Feature | Medigap (Supplemental) Plan | Medicare Part D Plan |
|---|---|---|
| Primary Function | Covers out-of-pocket costs from Original Medicare (Parts A & B), like deductibles and coinsurance. | Covers prescription drug costs. |
| Prescription Coverage | Does NOT cover prescriptions for plans sold after 2005. | YES, specifically covers prescription drugs. |
| Enrollment | Separate enrollment from Part D plans. | Separate, stand-alone enrollment. |
| Policy Provider | Provided by private insurers like UnitedHealthcare (AARP). | Provided by private insurers like UnitedHealthcare (AARP). |
| Networks | Generally allows you to see any doctor or hospital that accepts Medicare, with no network restrictions. | Utilizes a specific pharmacy network to offer the lowest costs. |
| Cost Structure | Monthly premium to fill gaps in Original Medicare. | Monthly premium, annual deductible, copayments, and coinsurance based on drug tiers. |
Navigating Your Coverage Options
Choosing the right Medicare coverage can be complex. If you are an AARP member or considering their plans, here are key steps to take:
- Assess Your Needs: Make a list of all your current prescription medications. This will be vital when comparing Part D plans and their formularies.
- Understand the Distinction: Recognize that an AARP supplemental plan and an AARP MedicareRx plan are two different products with different purposes. You need both for comprehensive coverage of medical services and prescriptions, respectively.
- Compare Plans: Use the plan comparison tools on the AARP or UnitedHealthcare websites to see which Part D plan best covers your specific drugs. Pay close attention to the formulary, premiums, deductibles, and copayments.
- Review Network Pharmacies: Ensure your preferred pharmacy is part of the plan's network to maximize your savings. For potential savings, also consider Optum Home Delivery through UnitedHealthcare.
- Utilize Medicare Resources: For impartial information and enrollment help, visit the official Medicare website [https://www.medicare.gov/drug-coverage-options] to research Part D plans and other coverage options. This is a critical step for informed decision-making.
Conclusion
In summary, your AARP supplemental insurance, while excellent for covering many of Original Medicare's out-of-pocket costs, does not cover prescriptions. For medication coverage, you must enroll in a separate AARP MedicareRx Part D plan through UnitedHealthcare. By combining these two types of plans, you can build a comprehensive and reliable healthcare package that protects you from both unexpected medical bills and high prescription drug costs. Taking the time to understand this distinction and research your options will ensure you have the coverage you need for a healthy future.
