Finance / Your Medicare Advisor

AARP Branded Medicare Advantage Plans Do Not Rank Among the Best Scorers

 

The Affordable Care Act (“ACA” aka “Obamacare”) will bring new opportunities and challenges to health care consumers. With more people receiving coverage on the individual market, they will need to find ways to select health plans that meet their needs. Consumerism in the Medicare market predates Obamacare with choices of Medicare Advantage and Medicare Prescription Drug plans. In light of the movement toward individual choice, HealthPocket decided to look at the effect of brand awareness on decision making and focused on one well known and widely used branded Medicare Advantage program. We found that plans bearing the AARP brand in the Medicare Advantage market on average fall short of the industry in two measures of plan quality.

This report looked at 578 Medicare Advantage contracts with a particular focus on the government’s star rating and the overall opinion of the plan based on a survey of enrollees in that plan. The goal of this research is to compare how one of the strongest brands in the industry, AARP and its endorsed carrier, UnitedHealth, perform in these high level quality metrics compared with the universe of plans.

The Medicare Advantage program has been successful in many ways, including enrollment. There are now 14.4 million people enrolled in Medicare Advantage plans, and that figure has grown by almost 10 percent since 2012.1 Medicare Advantage market share represents over 28 percent of the Medicare eligible population.2 By contrast, the insurance industry reports that 10.2 million people had Medigap plans, which supplement benefits to traditional Medicare, at the end of 2012. This marketplace doesn’t show the same growth pattern seen in the Advantage market.3

Consumers have complex choices to make when deciding between traditional Medicare and Medicare Advantage. Once they conclude that an Advantage plan can best meet their needs, they then have to navigate an array of options available to them. There is much research regarding the paradox of choice and consumer decision making generally.4 One specific study of the Medicare Advantage market showed the market within a particular region generally grows when choice is limited to fewer than 15 plans, but could in fact shrink if choices become too numerous.5 The article expressed particular concern that beneficiaries with cognitive challenges could miss better plan opportunities because of having too much choice.

The Medicare plan quality star rating system is a key factor in helping enrollees differentiate plans. The rating provides a one to five (actual results start at 2 stars) scoring system for Medicare Advantage Plans.6 The overall rating reflects treatment, preventive care, and customer satisfaction collected on the Medicare Advantage plan. Consumers who are interested in poring through more detail can find sub-ratings on the Medicare plan finder website7 and on HealthPocket’s Plan Details page for each Medicare Advantage plan.8

Researchers are finding evidence that the star ratings are beginning to move market share toward the higher rated plans.9 However, HealthPocket also wanted to see the effect a brand might have on Medicare Advantage market share. Because choices can be so numerous in the Medicare Advantage market, a consumer might fall back on a basic comfort level that a known and trusted brand can provide a good choice. Research also indicates that some older people select from among fewer choices based on brand awareness.10

Background

UnitedHealth is the leading market share carrier for Medicare Advantage, with a reported market share of nearly 21 percent in February 2013.11 Humana has the second largest market share at nearly 17 percent. AARP branded plans are described on the AARP Member Advantages website12 as being structured the following way: “The AARP® MedicareComplete® plans are insured through UnitedHealthcare Insurance Company and its affiliated companies, a Medicare Advantage organization with a Medicare contract. UnitedHealthcare Insurance Company pays royalty fees to AARP for use of its intellectual property.”

Market share reports do not tend to break out AARP’s share from the rest of UnitedHealth’s, but a Congressional report in March 2011 stated that AARP branded plans then had an 11 percent market share and non-AARP branded UnitedHealth plans had an additional 7 percent market share.13

Star Ratings

The chart below compares the average star ratings for AARP Medicare Advantage plan contracts with the remaining universe of Medicare plan contracts: The data shows a significant oversupply of AARP contracts in the 3 and 3.5 range, while few AARP contracts reach 4 and none reach the excellent range of 4.5 and 5. In fact, only 8.5% of AARP plan contracts exceed 3.5 stars. Averaging all contracts with ratings excluding AARP, the average score equaled 3.47, while the average for the AARP contracts equaled 3.27.

The highest scoring plans across their average contract scores were nonprofit health plans, including Kaiser (7.9 percent market share, but still an average contract score of 4.93), Gundersen Lutheran Health System, Baystate Health and HealthPartners Inc.) However, for profit plans also had higher average contract scores than AARP, such as Humana (3.4) and Aetna (3.65.)

Members’ Overall Rating of Plan Results

HealthPocket also looked at how the branded AARP Medicare Advantage plans fared compared with the industry in how the plans were rated by a survey of their members. The chart below shows how the AARP plans compared with the remainder of the plans in the industry with respect to members who rated the plan highly.

The industry average for all plans excluding AARP for this response was 86 percent of members rated the plan highly, while AARP’s plan contract average was 83 percent. Perhaps more importantly, the AARP plans top out at 86 percent, while the rest of the industry has 62 plan contracts at 90 percent or higher and tops out at 95 percent.

Implications for Consumers

A lot of factors drive consumers’ decisions regarding their health plan purchase. They will be heavily motivated by cost, including premiums, copays, deductibles and maximum out-of-pocket expenses. Many will want to make sure that key physicians participate in their plan and that specific health care facilities are in a plan’s network. Therefore, quality should play one important role in a mix that contains other factors. At least with respect to Medicare Advantage quality scores and consumer satisfaction data, the AARP branded plans are not top performers. Yet they are successful in achieving strong market participation. Fortunately for consumers CMS, the Medicare plans’ regulator, has done an excellent job of releasing data to the public and on its own plan finder website. This allows easier comparison of plans and brings plan quality into the mix for consumer decision making. Being able to see actual ratings and customer satisfaction might provide enrollees sufficient peace of mind to look beyond the brand in determining health plan selection.

METHODOLOGY

Data on attrition, complaints and star ratings were taken from 2013 CMS Medicare Part C Performance Data tabulations.14 The data was based on contract numbers, which can represent multiple plans. UnitedHealth contract numbers were compared against Medicare Advantage plan landscape data to determine which UnitedHealth plans carried the AARP brand. Medicare Advantage contract plans that were either too new or had insufficient data to a have star rating or overall plan rating were eliminated from this review. The remaining plans were not adjusted for market share.15 This study did not consider premium costs or other plan details. All analysis assumes the accuracy of the underlying government data. While every effort was made towards a representative collection of plans, HealthPocket makes no representation that every plan within the Medicare Advantage market was included in this study. Percentages are rounded according to standard industry practices.

AUTHOR

Steve Zaleznick, Executive Director for Consumer Strategy and Development at HealthPocket.com, completed this survey analysis.

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Yankeetraveler
6 months ago

I will never go with a Medicare Advantage Plan. If you have and expect almost perfect health until death then Part C is the way to go. I myself plan ahead and hope for the best but plan for the worst therefore Part G in my state may be a bit more expensive but in the long run the coverage is phenomenal! Part D is only 15 dollars a month so I pay the entire year right up front and unless I hit Tier 3 and 4 my copays are only 6 dollars. Tier 3 and 4 have a deductible but other aspects of the plan kick in to offset the majority of the deductible. My wife works in the healthcare industry and has seen some really scary things in terms of people getting screwed or mislead with the Part C Medicare Advantage plans….at least in this state. My broker also helped guide me away from the advantage plans as well. I tried to contact someone through AMAC for information but never ever did I get anything. My insurance broker that handles all of my other insurance needs contacted me prior to my 65th birthday and was a Godsend. I get parts A, B, D, And G for 300.00$ a month.

steven p anderson
4 years ago

I turn 65 in January 2017. I am trying to compare costs between a Kaiser plan and the AARP United Healthcare plan. Kaiser rates higher in quality but I am unsure what a dollar to dollar comparison would be. Are there any links to sites that compare rates?

Ian Anderson
4 years ago

I have used Kaiser Medicare Advantage for 11 years. Really pleased with their service and preventative care. Includes drugs and RDs. I get my eye exams at Kaiser but buy my glasses at Costco. No premiums for my plan but $50 co-pay for doctor visits.

Concerned daughter
5 years ago

My mother, a 70yo Washington Co Ohio teacher was coerced into a Medicare Advantage plan through STRS last year when she retired. She was told this was a supplemental policy that would cover the additional 20% of Medicare remainders. In addition, she was further upsold for the “best policy”.

Last week (her first claim) she had an accident where she fell and had 2 compound fractures in her leg and required immediate surgery. The hospital told us she had poor coverage and was denied anything past a 6 hours post surgery stay. She was sent home BY AMBULANCE without any follow-up, unable to stand and care for herself whatsoever. I was told if she had Medicare alone, she would’ve had more coverage and options for hospital care, physical therapy and rehabilitation. When contacting AETNA we were given the run-around, was told the coverage was there and blamed the surgeon’s report that she had 25% weight restrictions on her leg, so they couldn’t help her. The hospital and doctors said “why would she even need therapy and care if she didn’t have restrictions?” I know they are not in business to send people away without care. Furthermore, I know the hospital and surgeon both tried multiple avenues to get her into in-home therapy, rehabilitated clinics and other methods of physical therapy, but was continuously denied.

George Fernsler
5 years ago

I took the United Medicare Advantage PPO plan in NY for several reasons-1. It was the only PPO Advantage program for NY not charging extra to enroll for basic PPO in-network services (probably because AARP got their deal to exclude their money-train partner from extra regs and fees from Obama Care law) 2. They claimed a large PPO network (but i find the claim exaggerated. Most nearby doctors will not participate, because they are so nickel and dime sticklers to exact rules and details to avoid paying their portion from Medicare.} 3..They offer a dental plan premium, which amazingly needs only to be active and paid for those months that you plan to see a dentist. It can be turned off and on, if you no longer need heavy dental coverage. 4. It offers a vision plan supplement.
5. Most importantly to me it offers in-network audiologist coverage -AND ability to get hearing loss adjusted good hearing aids (from their small subsidiary manufacturer) at $300 per ear rather than the typical $2000 plus per ear, not otherwise covered by any medicare related insurance that I know of. These may lack all the many possible extra features (such as wind noise suppression and extra very fine tuning to any specific loss) available in the top-of-line aids, but are nevertheless high quality tuned digital aids suitable and affordable for persons of all hearing loss levels, including profound loss. Some lower quality digital aids are available on-line for as little as $150, but may have limited tuning options and may need non-recommended self-tuning especially for atypical loss patterns, But some can help greatly with even profound loss typically in high frequency voice sounds,
Hearing aids may fall out of the ear and be lost – very scary if it is a $2000 or $3000 aid, not pleasant at a $300 cost and a new audiologist visit. I found it satisfactory to replace one lost $300 aid with an on-line one for $150 and no new audiologist visit -at least temporarily.for my severe loss in high frequencies.
I will remain with the UHC Medicare Advantage PPO plan for reasons 5, 1, 3 and 4, despite my frustration with their poor customer service, very poor communication about denied benefits, nickel and dime about tiny details to ensure coverage and consequent limited in-network coverage.

Carl Krockenberger
5 years ago

if you don’t like your Advantage plan get on a Medicare supplement (medigap). If you lost your group you get 63 days to make a change or just wait until Oct 15-Dec7th
quote a Plan N. the projected Part B deductible for 2017 is 204 (labs xrays doctor etc,) once met up 20 on doctor visit 50 er. there are no network limitations other than the doctor or hospital has to accept Medicare. If Medicare no pay neither with the insurance company

Mike
5 years ago

AARP United Health Care Medicare Advantage plan is my third advantage plan. I don’t plan on ever leaving United Health care.the other plans I had I was refered toand first I couldn’t find any doctors that took them I had to go to a teaching school to get a doctor.plus with both of them their copays and prescription drugs prices skyrocketed. My copays and drug prices dropped, personally I’m very happy with AARP Medicare Complete Advantage plans.

Cherie
1 year ago
Reply to  Mike

In reviewing plans for my parents, I recently reviewed United Healthcare and asked the rep at the end of our phone call how they are able to charge so much cheaper than anyone else. He told me that, because they are the largest insurer, they get massive kickbacks. I automatically knocked them off the list because, IMHO, those massive kickbacks are what helped them to become the largest insurer and it is not fair to the other companies. We will be going with Aetna.

Barbara mayer
5 years ago

My mom 87 has ARPP MEDICARE COMPLETE. She had a fall and needs in home physio therapy. I called United Healthcare and had them give me providers. None would except I called 6 providers and the rep at United Healthcare called 6 and not one provider on their list accepts ARPP MEDICARE COMPLETE because of the WelMed. Now I can’t find a physio therapist for my mom…I told the United Healthcare rep this was unacceptable and why they have these providers on there list…all he said was I’m sorry but he didn’t know who else to call. TOTALLY OUTRAGEOUS.

Carl Krockenberger
5 years ago
Reply to  Barbara mayer

Insurance is risk based on the premium you are willing to pay. She is best off looking for an independent agent they are suppose to represent several companies not just one. She can get out Oct 15-Dec.7 for a Jan 1st effective date. Get her on a Medicare supplement AARP offers a guarantee issue PLan N or a couple hundred. Part B deductible for 2016 $166 proposed going up to $204 once met doc visits up to 20 ER 50. that premium would be worst case as there may be other companies that would offer a lower premium. HMO’s have limited networks. Advantage plans as a whole have big Holes in them. IE Surgery 20% ouch stay away!

Cyndi Kurland
5 years ago

The prescription program is not only significantly mo re expensive than other pro grams, the mail order cost was MORE EXPENSIVE buying through local drug stores I called Optum RX to ask why that is and why a drug that is a tier 2 drug everywhere else is a 4 tier drug with them.
The pharmacist I spoke with said the insurance company sets the prices.
In other words, UHC is charging more for medication to make up for the commissions it pays to AARP.

Cyndi Kurland
5 years ago

I have read that AARP actually receives a commission for each product sold. The TV ads stating that United Healthcare is only product to carry AARP’S name confers approval when it really means that that is the only company willing to pay them a commission.

Cherie
1 year ago
Reply to  Cyndi Kurland

In reviewing plans for my parents, I recently reviewed United Healthcare and asked the rep at the end of our phone call how they are able to charge so much cheaper than anyone else. He told me that, because they are the largest insurer, they get massive kickbacks. I automatically knocked them off the list because, IMHO, those massive kickbacks are what helped them to become the largest insurer and it is not fair to the other companies. We will be going with Aetna.

GIL
5 years ago

I am all for capitalism and making a profit but when a company is so deceitful as to send out a letter telling you that nothing has or will change for the next year and then increase prices by 3X I can only call them lairs and worse. I guess a significant change would be raising prices 10x. Open enrollment is at the end of the year, funny how they sent out that letter telling us that their would be no significant changes so we would not shop around for a better deal. AARP Medicare Supplement Plans – United Health Care has done this to my mother. Both of these despicable companies got into bed with OBAMASCARE and the OBAMASCARE exchanges now that they are losing money. United Health Care has chosen to back out of the exchanges and are looking to recoup their money any way they can, fast. If you are asking me why my mother went with two know companies that were in cahoots with OBAMASCARE, it was my brother who set it up, not me.

Let me try to explain what they explained to me. Yes nothing has changed all the pricing is the same except the categories have now changed. For example: Drugs in category “A” are 3 dollars a month. Drugs in category “B” are 10 dollars a month. We had category A drugs that are now changed to category B drugs. So we are getting the same low low prices, it’s just that all the categories have changed. It is still deceptive. It is OBAMASCARE.

Theodore Wynn
5 years ago

I need a Dental plan that cover root canal work that have been abused and now need work done.

George Bailey
5 years ago

You refer multiple times to the chart below on Advantage Plans. So where’s the charts???????

joe vazquez
6 years ago

please is united ppo is better than humana ppo in Tampa Fla

Jennifer
6 years ago

This is so frustrating. Insurance companies discriminate against those under 65, and on Medicare due to disability. Between the Medicare cost ($104), Part D ($50), and BCBS supplement ($605), I cannot afford this.

Thinking of enrolling in a Medicare Advantage Plan, but have been told by BCBS that if I leave them, no insurance company has to ever pick me back up, if I want to have a Medicare Supplement in the future?

Cat Tilley
5 years ago
Reply to  Jennifer

Jennifer, if you go with a Medicare Advantage plan, you can save yourself a lot of cash. Many plans are ‘zero’ premium, meaning that your Medicare deduction (the $104 you mentioned) will pay for the plan & you’ll have great health & drug coverage. ‘Supplements’ are ripoffs, and since you’re paying Part D, you’ve met the need not to pay a penalty for drug coverage.

Honestly, I don’t know who your insurance broker is, but that person is looking out after THEIR interest, not yours. $655 extra cash is a lot of money over the course of a year. You need to do what’s right for you, not an insurance company, and most every area has a ‘zero premium’ policy that includes drug coverage. Even if you had to pay a little extra for one to meet your needs, you’re still saving. Get yourself a broker that specializes in Medicare Advantage plans.

I’m disabled myself & have had Medicare Advantage since I was Medicare eligible in 2008. Only one year I paid extra for a plan (Advantra Freedom in 2012) & that was only $23/monthly. Basically it works just like am employer plan (sometimes better), the only thing that affects some, but not all members, is there’s a coverage gap, otherwise known as the ‘donut hole’, that one falls into. Yet one can climb out of that for half per year of what you’re paying total.

That information may be true about BCBS in regards to leaving them, yet Medicare Advantage has been here for 10+ years & will likely be here to stay. And one thing for sure……your premiums mentioned will surely increase every year, while your Medicare ones moves a little at a time (none if no raise). Unfortunately, those who sign up for Medicare beginning January 1 will pay half again what we do, over $150/month, and some higher than that (those with a spouse who is a high earner).

Good Luck & remember, do what’s right for YOU!

Cat

Carl Krockenberger
5 years ago
Reply to  Cat Tilley

You have weigh the premium versus risk.If you buy an Advantage plan they can have max out of pockets of 6700-10000 for year. (this is not counting your Rx coverage). If you have medicaid an advantage can help you with some additional benefits. If you have Medicare only and want to get an Advantage plan remember you get what you pay for. Limited networks, High co-pays.some plans 20% for surgery ouch-with a max of pocket $6700. $605 a month for a supplement seems kind of high. I sell the stuff so plan F maybe 130 a month. Plan N maybe 90. You pay a good premium to minimize risk. If you are over 65 and have health issues and you can afford a Medicare supplement (medi-gap) get that. Maybe 605 a month is group plan and you have Rx dental glasses included. still seems high. unless you have a Major Rx need. If you have a good agent he can help you run the numbers

I’m impressed, I should say. Really rarely will i encounter a weblog that’s both educative and entertaining, and without a doubt, you’ve hit the nail within the head. Your notion is outstanding; the problem is something not enough individuals are speaking intelligently about. I will likely be quite happy that I came across this inside my search for some thing concerning this.

SallyMJ
6 years ago

Kaiser Medicare Advantage plan has ranked 5 stars for more than 5 years.

James A. Bailey
6 years ago

I currently carry my Medicare through AARP/MedicareComplete insured through UnitedHealthCare and they have been my Medicare provider since I started in 2011. Last month I received a bill for three months back coverage of Medicare Part C. I called the Customer Care department and inquired about the bill. I was told that UnitedHealthCare, starting in Feb. 2015, now required all its customers to carry Part C. I ask what Part C covered and the agent was either unwilling or just did not know what Part C covered. I informed the young man that since I did not want nor could I afford the additional cost of Part C. He informed me, rather rudely, “it makes no difference if you want Part C or not, we require you to have it and if you refuse to pay the additional cost we will drop you from our coverage ad you will fall back into straight Medicare which does not cover as much as you receive with out plan”. Thinking that this rather brash young man did not know what he was talking about I called and spoke with three different agents who more or less told me the same thing and not one of them could/would tell me what Part C covered.
Is it legal for UnitedHealthCare to require that all of their customers to have Part C at at an additional out of pocket cost? This seems to me to be nothing less than extortion. This would be similar to a department store calling you and telling you if you did not purchase a certain item they carried in their store they would cancel your credit card.
It also seem strange to me that UnitedHealthCare waited until after the closing date for being able to switch to another medicare provider to notify their customers of this alleged requirement. Again is this legal? Can they, out of thin air, and with no advance notice. require all of their customers to pay for Part C?

Carl Krockenberger
5 years ago

Part C (Advantage plans) are Not required to have as this is a Medicare replacement. You don’t lose your medicare benefits but rather are enhanced. On the other hand Plan D for your Rx is not required either. However, If you don’t take it you will pay an additional premium of 1% more per month for every month you don’t have it past your enrollment period. Another wards about 34 cents more per month in addition to base cost of the Rx plan you pick.
If this agent told you that you are “required” to buy Anything you are being grossly misinformed.
IF you are in this situation you can call Medicare and file a complaint against the company and most often be able to switch plans.
All plans have a ” summary of benefits” everything you need to know is in that booklet. As with UHC or maybe some other companies they have a 20% co-pay for surgery that can get real expensive. I would speak with the provider prior to get an idea of your costs if you have surgery pending.
Insurance companies train their agents to do the “right thing” so that it why its best to go with an “independent agent” as they will shop for you. If you go with a “captive agent” you will mostly get sold on a plan that may or may not be good plan for you.

Thomas DeLoach
6 years ago

Is there a more current blog with 2014 or 2015 comments. Is there a viable UHC alternative in SC? Too late for this year but would like to plan ahead.

liz
6 years ago
Reply to  Thomas DeLoach

looking for insurance in Mississippi seems this state does not have reduced rates like some of the others, I am 81 yrs old and going to dropped my BSBS with my previous employer (its self funded) and does not pay enough for the 20% it is suppose to. My months payment does not compare to what they are paying, time for a new supplement any help please
thx

Katherine B.
6 years ago

I just turned 50, I am now on Medicare for a major disability. I have to pay 500.00 per month to get coverage. United Health Care doesn’t like it but the government makes them take us young ins who cost a fortune.

Golden Rule /UHC has always paid my bills and covered most everything.

CAROL YOUNG
6 years ago

OMG! I’m shopping in California for my 81 year old mom who lives off of S.S. Need I say, Very limited income? Who and what do I believe? I’m ready to pull my hair our of my head and to think I am not a stupid person who has access to this information. What would she think and do with all of this (if she had access, which she doesn’t). Anybody have an idea where I should start? I thought all of this was supposed to be so EASY??

Dan Benson
6 years ago
Reply to  CAROL YOUNG

The National Council on Aging is a Non-Profit 501(c)3 organization that can provide a lot of information – for free. http://www.ncoa.org/ They can help but do not will not tell you which insurance to get because they do not work for insurance companies.

I believe they have local chapters in all states. The one in Orange County California ( http://www.coaoc.org/ ) has periodic seminars, online help and telephone consultants. If you have questions, they can help. If you don’t know what questions to ask, they can help. Still, it is all too confusing, even for those of us who are college educated.

Barbara
6 years ago

When I signed up for United Healthcare Medicare Advantage Plan the agent said I needed a cancer policy as well because if I get cancer more than once, it will not be covered by the plan. So, an extra $21.26 per month for the ‘cancer policy.’ Seems kind of wierd to me!?

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