Q29: How are out-of-network claims processed in the AT&T Group Medicare Advantage
(PPO) Plans?
Whether your provider is in-network or out-of-network, your provider can submit claims to
UnitedHealthcare online. If needed, the UnitedHealthcare claim address information is
provided on your UnitedHealthcare member ID card. UnitedHealthcare processes claims
payments for out-of-network providers in compliance with all federal regulations.
AT&T Group Medicare Advantage (PPO) Plan Changes
Q30: The letter I received from AT&T mentions an impact on the AT&T Group Medicare
Advantage plan (MAPD) due to changes in funding for Medicare Advantage Plans by
CMS. Can you provide more detail?
Each year in the spring, the Center for Medicare and Medicaid Services (CMS) releases a
notice outlining the Federal government's funding for Medicare Advantage Plans, as well as
details on any adjustments in funding methodology for the following plan year. Typically,
these published funding levels are in line with estimates made by Medicare Advantage
carriers, including UnitedHealthcare. For 2024, the funding provided by CMS was materially
different than what was estimated by UnitedHealthcare, and by other carriers. As a result,
UnitedHealthcare required some changes to be made to the AT&T MAPD Plan in order to
retain the same premium for the 2024 plan year.
It is worth noting that these CMS changes in funding affect all Medicare Advantage Plans,
including group plans (like the AT&T MAPD Plan) and individual plans (like the Medicare
Advantage Plans you may see at the Retiree Health Exchange). As a result, while there may
be some small changes to the AT&T MAPD Plan in 2024, it continues to be a very attractive
plan offering, especially compared to individual Medicare Advantage or Medigap plans that
are available through the Retiree Health Exchange or on the individual market.
Q31: Can we expect additional changes to the AT&T MAPD Plan beyond 2024?
UnitedHealthcare generally does not know the full impact of CMS funding on the AT&T MAPD
Plan for each plan year until closer to open enrollment for that plan year (e.g. in the fall of
2024 for plan year 2025). Any annual adjustments, if needed, will be communicated at that
time. This process is very similar to the annual changes to Medicare Advantage plans on the
individual market.
In addition, as a result of the Inflation Reduction Act (IRA) passed by Congress in 2022,
additional mandated changes will be made to all Medicare Advantage plans in 2025 - the
AT&T MAPD Plan as well as all Medicare Advantage and Part D Prescription Drug plans on the
individual market. This includes a yearly cap of $2,000 on out-of-pocket prescription drug
costs. The exact effect of this and other IRA changes to the AT&T MAPD Plan in 2025 are
unknown at this time but will be communicated closer to open enrollment in 2024, as more
information from CMS is released.