Health

 Earlier this year, (2025), I signed up for the AARP Medicare Advantage (PPO) Plan from United Healthcare. I had some medical issues that would have made for a financial nightmare had I stuck with plain old Medicare. So far the UHC plan has been a lifesaver in both the quality of care and how much it costs. However, I just received the 2006 issue of the Medicare and You book and that plan is no longer being offered by United Healthcare. Well, it is but only if you live in Santa Barbara, which I don't, and at an increased rate. Since it was a PPO plan, many of my doctors are not in network in the available HMO plans that would fit my needs. Now I'm stuck with negotiating new insurance plans for doctors that are out of network with the HMO plans that will fulfill my needs. My team of doctors have been deeply involved with my case since about March, and it is really an almost impossible idea to start over with new doctors that are in network for any new plan that I select. In or

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II am currently on Medicaid but I am also eligible to start taking Social Security (62). If I take SS my income will disqualify me for Medicaid and I don't qualify for Medicare either. Where can I go to see what my insurance options are? Thanks, Gary.P.S. In the last 5 years I have had a Heart Attack, Stroke and Kidney Failure (AKI) I'm also diabetic and take 20+ pills a day plus 2 shots a week. I live in Illinois.

Have just received the Annual Notice from UHC.  What is the justification except a UHC money grab?  I've been with AARP B and D for many years with minimal usage for D.  This is the largest %age increase I've seen and the well-known competition now is far lower.  Who at AARP is responsible for selecting UHC - is this what's called  "fighting for health care"?

I've just spent 5 hours over several days with United Healthcare trying to get a vacation override for medication that I would have received but for the fact that I will be out of the country when it is fillable.  My doctor prescribed 3 30-day refills, and last week they told me they would fill 30 days worth that week, telling me I should call again today and it would not be a problem t o get another 30-day vacation override. When I called they told me that I needed to get another prescription from my doctor, which is the opposite of what they told me last week.  When I complained, I got nowhere with the "advocate" because they apparently have NO authority to do anything.  When I told her I wanted to elevate my claim to her supervisor, she told me that the supervisor would tell me the same thing.  When I said I didn't care and wanted to talk to the supervisor, she disconnected me. Dealing with United Healthcare is always maddening.  They seem to exist

With Medicare enrollment coming up, it brought my attention to these questions.My wife and I are currently enrolled in a Medicare Advantage Plan (MAP). I have begun to wonder if there are any benefits to switching to Original Medicare with Supplemental/Medigap insurance. But I have heard different things about moving from a MAP to Original Medicare. It is true that, if you are enrolled in a MAP, it is difficult (or impossible) to switch to Original Medicare with Supplemental insurance? If so, why?  

FROM THE ARTICLE. Lower prices on 10 drugs, new features in plan finder, no reenrollment in prescription payment plan? Check, check and check. By Tony Pugh, AARP. Published October 10, 2025. Key takeaways! [*] You’ll see lower prices on 10 popular high-cost prescriptions. [*] Misled by plan finder? You’ll have a chance to change MA plans. [*] Drug spending cap rises. Payment plan reenrollment is put on auto. [*] Original Medicare begins prior-authorization pilot program. Advantage plan pilot shut down; limits added to second program.new year will bring a new round of Medicare coverage, cost and policy changes that will affect each beneficiary differently, depending on their medical needs, income and other factors. To help you stay in the know, AARP lists some of the most significant changes that will shape your 2026 coverage. USE LINK BELOW TO READ THE ARTICLE. https://www.aarp.org/medicare/whats-new-in-medicare-2026/

Just checked the document for the 2025 changes for the AARP UHC Medicare Advantage plan.Got surprised!!Checked with UHC to confirm (Italics clip from the chat session with the UHC agent):2025 (next year)You pay a $0 copayment for covered preventive and diagnostic services.You no longer have coverage for comprehensive dental services.Platinum Dental RiderYou pay $54.00 a month for up to $1,500 per year for covered preventive and comprehensive dental services6:29 PMYou may check more plans with our sales team. Interesting that they are offering a $54 per month plan that only cover $1500!!!!

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FROM THE ARTICLE. A second set of 15 medications are on the bargaining table now. Those lower prices will debut in 2027. By Tony Pugh, AARP. Published October 06, 2025. Key takeaways![*] The government bargained with drug makers to lower prices.[*] 10 drugs initially chosen. Most ended up at least 50% off.[*] Another 15 medicines will be added to the list for 2027.After years of preparation, the first 10 Medicare Part D–covered drugs selected for price negotiations will be available to beneficiaries at reduced cost in 2026.A prescription drug law passed in 2022, which AARP supported, required the Secretary of the Department of Health and Human Services to negotiate with drug companies for lower prices on 10 popular brand-name, high-priced drugs with no generic equivalent or biosimilar competitors. USE THE LINK BELOW TO READ THE ARTICLE. https://www.aarp.org/medicare/first-medicare-negotiated-drug-prices-debut/

Good Morningi am looking for any information about AARP Sponsored FOREMOST MOBILE HOME INSURANCE. Hopping to hear from someone that is a policyholder and their experience with this company.thank youMark

When looking over a plan, make sure to note how your part of the coverage is described:  Big difference when it says “co-insurance” instead of  “co-pay” .That seems to be another place where some of the changes are taking place. Also, remember there is the installment payment option for those on really expensive meds - a way to soften the blow even with the $ 2100 deductible for 2026.  The installment payment option for Medicare Part D is called the Medicare Prescription Payment Plan (MPPP). This voluntary program, available starting in 2025, allows eligible Medicare Part D enrollees to spread their out-of-pocket prescription drug costs across the calendar year instead of paying the full amount at the pharmacy. You must opt into the plan by contacting your Part D plan sponsor and setting it up with them.  Medicare.gov - What is the Medicare Prescription Payment Plan? It does help in managing your [high] drug cost and there is no charge for this benefit.

September 2024 my premium was $223.60. In Oct 2025 it will be $271.87. Plus, as I live in the DC area, I will lose access to Johns Hopkins drs and hospitals. Although based in Baltimore, they run two major hospitals near DC and have the strongest network of doctors. Johns Hopkins dropped UHC due to poor coverage. 

FROM THE ARTICLE. Premium Tax Credits Keep Marketplace Health Coverage Affordable for Adults Ages 50–64. By Olivia Dean, AARP Public Policy Institute & Jane Sung, AARP Public Policy Institute. Published September 09, 2025. Millions of Americans, including many ages adults 50–64, depend on private health insurance from the nongroup (individual) market, often through state and federal health insurance Marketplaces. These individuals lack affordable employer-sponsored coverage and do not qualify for public programs such as Medicaid or Medicare. Federal premium tax credits, including enhanced tax credits, have been critical to making Marketplace health insurance affordable for older adults, who face premiums up to three times higher than those for younger adults. Read the full report. USE LINK BELOW TO READ THE ARTICLE. https://www.aarp.org/pri/topics/health/coverage-access/premium-tax-credits-marketplace-health-coverage-affordability/

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Have you EVER read, listened to or viewed the Medicare .gov Publication of “MEDICARE and YOU”?  Cover to CoverIt covers all the Parts of Medicare and how they work for you based on your choices.   It covers how a Medigap plan works with your choice of Traditional Medicare.   It also covers how benefits a covered by Traditional Medicare specifically. If you pick a Medicare Advantage plan (every year) [Medicare Part C] as your choice in how you get your Medicare benefits, do you sit down and read your Explanation of Coverage from your selected insurer?This covers how you get your Medicare Benefits under the Medicare Advantage option and what you pay for specific covered services - specifically and for this chosen insurer. If you do one or both of these things - does it help with your understanding of the Medicare program? Same thing would be true of Part D -Standalone plans if you are using Traditional Medicare - PDP (Prescription Drug Plans)Included Part D

FROM THE ARTICLE. AARP is fighting for a permanent extension of savings that lower the price of Affordable Care Act coverage. By Miriam Cross, AARP. Published September 19, 2025. Charlene Sterlace is feeling the pinch of higher health insurance premiums already.The 60-year-old New York state resident has purchased insurance since 2019 through the state’s health insurance Marketplace enacted under the Affordable Care Act. She remembers her rates plunging during the pandemic when Congress enacted new tax credits. “I was so grateful,” she says. USE LINK BELOW TO READ THE ARTICLE. https://www.aarp.org/advocacy/aca-tax-credits-expire/

I’d say this is a good move and one that should benefit those with a Medicare Advantage plan - but remember they do have 30 days to make any changes from the date they are aware of them.  Providers can go in and out of network at different times since their contracts with the insurer are signed at different times.   When seeing a new provider it is always a good idea just to double check with their office that they are providers in your insurance network group - that’s for any kind of insurance - even Traditional Medicare.   ModernHealthcare.com 09/18/2025 - CMS orders Medicare Advantage plans to disclose provider networks My access to this ModernHealthcare source is limited so I am posting it only as a summary but also I am posting the CMS final rule that is in the Federal Registry - From the Modern Healthcare link -Medicare Advantage insurers will be required to submit provider directories to the Centers for Medicare and Medicaid Services next

Fierce Healthcare.com 09/17/2025 - Johns Hopkins, UnitedHealthcare officially end talks after failing to come to terms on new contract  Negotiations went nowhere so they are ending it -from the link [copy paste] Hopkins providers have been out of UnitedHealthcare’s network for an estimated 60,000 patients, mostly in Maryland, but also in Washington, D.C., and Virginia, since Aug. 25, the Baltimore Banner reported. Those 60,000 patients will have to find new providers or pay higher out-of-pocket costs to continue to see their doctors and get care at Johns Hopkins hospitals. Johns Hopkins Medicine spans more than 50 total care locations, including six hospitals, and serves patients in Maryland, Virginia, Washington, D.C. and Florida. Both parties are warning patients that Johns Hopkins’ hospitals and other facilities are now out of network for enrollees in UHC’s employer-sponsored commercial plans, Individual Family Plan, Medicaid and Medicare Advantage

FROM THE ARTICLE. By Leigh Purvis, AARP Public Policy Institute. Published September 17, 2025. Medicare Part D plans have been subject to numerous changes and challenges since the program was implemented in 2006. In some ways, plans appear to have responded similarly; however, they have also diverged in important ways. The long-term trends highlighted in this report also suggest that recent Part D plan market changes reflect a confluence of factors. Future efforts to reform Medicare Part D should reflect the reality that Part D plans are increasingly distinct and ensure that Medicare beneficiaries retain the ability to choose the coverage option that works best for them. Read the full report. USE THE LINK BELOW TO READ THE ARTICLE. https://www.aarp.org/pri/topics/health/coverage-access/stand-alone-medicare-advantage-prescription-drug-plans/

Paying attention to the positive may ease stress. How to start? Create a “three good things” practice as a first step. Get more health tips at AARP® Staying Sharp® today.

FROM THE ARTICLE. The Big Choice: Original Medicare vs. Medicare Advantage.Which path you take will determine how you get your medical care — and how much it costs. By Dena Bunis and Kimberly Lankford, AARP. Reviewed by Xavier Vaughn, MPH.Published July 01, 2020.➡️[*** Updated September 08, 2025. Key takeaways![*] Original Medicare has many parts. Medicare Advantage is all-in-one.[*] Original Medicare lets you use any doctor. MA is more limited. ​[*] Both must provide same care. MA costs differ from original Medicare.[*] Original Medicare goes anywhere in U.S. MA has geographic limits.[*] Many states’ Medigap rules make leaving Medicare Advantage hard. USE LINK BELOW TO READ THE ARTICLE. https://www.aarp.org/medicare/original-medicare-vs-advantage/

 This is just a reminder for anybody that currently has a Medicare Advantage Value-Based Insurance Design (VBID) Model this year.  They are ending this program in 2025.   Some of the design features may not be lost since enrollees who choose to remain in MA will likely be able to access many of the same benefits after VBID’s termination (e.g., transportation to medical appointments, healthy food assistance), because many elements of the VBID model have become benefits that can be offered in the MA program. The SSBCI  ( Special Supplemental Benefits for the Chronically Ill ) is continuing and also allows MA plans to offer similar interventions to those available under the VBID model. MA plans will be able to leverage similar pathways and help enrollees maintain access to supplemental benefits that meet their needs.  For a SSBCI plan, from what I understand, there will be a specification that the specific chronic illness - one or more -  

Watch your mail to make sure that you are still gonna be covered by any state Medicare Savings Program - part or full Medicaid coverage - that you currently have or for any advice notifying you that have to re-apply. Medicare.gov - Medicare Savings Programs  These are for the 2025 income / resource limits.  The income and resource limits (in states where there is a resource limit) change every year but will not be known for 2026 until the Spring.     

Fall is the recommended time to get your FLU and COVID vaccinations for the upcoming season.  Previously, there was no issue with scheduling this at the local pharmacy.  With current political environment and rumors of negative impacts of vaccinations in general, people are having a hard time locating available site to get a COVID vaccination this fall.  I would like to get a sense of how wide spread this issue is and your concerns around this situation.