Health

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/

Exercise is great for brain health — it helps people problem-solve, think clearly and boost their spirits. Read this article for five simple tips to make walking more enjoyable. All you need is your two feet and a pair of good walking shoes. Get more health tips at AARP® Staying Sharp® today.

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.

Focusing on calories alone may not give your brain the nutrients it needs to thrive. What we eat affects how we think and how we feel, and there’s evidence that consuming certain foods may help protect the brain. You can find recipes for these foods at AARP® Staying Sharp®.

Are YOU going to keep what you have had or shop around?  🤔 Take care,Nicole (Medicare Forum)

A glass of wine with dinner or a beer at a sporting event — how do these impact your brain health? Read this article to understand the latest research on moderate drinking and the impact it may have on the brain. Looking for more resources about staying healthy as you age? Visit AARP® Staying Sharp® today.

     After many reliable years with different Fitbit Fitness Trackers, I’m jumping ship.   Since the Google acquisition, Fitbits have become bricked.  Would’ve been a loyal Fitbit user for life, but I’m done.       Countless pairing, re-cyncing, 3-button push resets, changing clock faces, all just to get the Charge 5 to work per their instructions to everyone.  A Quick look at the discussion boards over the years, shows the mounting frustration with the company. Original Tech support jumped ship as they too, were fed up with the acquisition.  Now onto Amazfit.  I would’ve preferred Garmin, but the price point for Amazfit was the lure.  I don’t use trackers for sleep or calorie counts, mainly logging fitness, sporting activities, cardio tracking, steps, etc…Getting ready to set up and test drive this new Amazfit tracker. Anyone have any success with it?  Likes, dislikes? Or other trackers you like?

Many types of memory lapses are pretty normal. But if you’re concerned about memory loss, there are strategies and activities on AARP® Staying Sharp® to help sharpen focus and train your mind to retain information. Learn more about building healthy habits at AARP Staying Sharp.

BaltimoreSun.com- 09/02/2025 - Maryland market threatens to push more Medicare Advantage plans out of the state  So what would you do IF all or a big majority of Medicare Advantage plans disappeared in your state and you had to go on Traditional Medicare but access to a Medigap plan was out of reach financially? I am pretty sure that there will be a solution to this dilemma in Maryland - they have been dealing with it for a very long time but then again, maybe not.  Worth at least thinking about it if it might affect you and your benefits. I mean, beneficiaries would still have Traditional Medicare to go to and there would be a special guaranteed issue (SEP) period for a Medigap plan if one’s Medicare Advantage plan closes up shop in a state.  Course, some of the Medigap plans may be out of reach based on their monthly premiums but others may not be - like the High Deductible Plan G -  I urge ALL beneficiaries to review their [whatever] Medicare

Becker Hospital Review 06/30/2025 - CMS to add prior authorization for traditional Medicare services   This really isn't a big deal but I thought I would keep the beneficiaries here abreast of these new items that are being added for prior approval under Traditional Medicare.  Each is more specific in how it is described here in a simple fashion.  Your doc or specialist should know if any procedure you are having would need this extra step of OK because at present it is more of a test to see the results. from the link ~CMS has unveiled the Wasteful and Inappropriate Service Reduction model, a new Innovation Center initiative that will add prior authorization for some traditional fee-for-service Medicare services. Under the model, CMS will partner with companies specializing in AI and machine learning to test ways to provide an improved and expedited prior authorization process for certain Medicare services. Companies hired to manage the

Social connections have an amazing impact on our lives and well-being. Having strong relationships with friends, family and community members can provide emotional support, reduce stress and make us happier. Discover how to build lasting social bonds that will serve you well in the years ahead. Explore AARP® Staying Sharp® for more great information on building healthy habits.

From the NYT... UnitedHealth has threatened journalists, activists and a doctor with lawsuits, often invoking last year’s murder of Brian Thompson, the chief executive of the company’s health insurance division, to deter negative coverage. We should NOT be condoning Threats!   I am starting to look for another Supplemental Plan... As we have many choices for the exact same coverage and I personally will not pay for companies to act in a threatening manner.   -Bill 

Started getting phone calls yesterday - obvious robo-voice saying "Medicare has just released a new Inflation Relief Package for Texas".   Starts asking for age, etc. I suspect it is a new scam, phishing for information.  Has anyone else gotten these calls ?

 Because of my severe hip arthritis, riding over bumps has been very painful. Usually, I rest my spine against the entire back of the front seat and experience intense discomfort accordingly. But for some inscrutable reason, last week during a long ride to visit some friends, I just happened to inch my back forward, grabbing a door cubbyhole for support with my right hand and holding onto the seat belt strap with my left hand. Miraculously when any bump jostled the car, I felt no pain at all. SInce then, I have utilized my flawless new—found tactic. Nor do I wait for a bump to appear: During the entire trip, I keep my spine forward-- no backsliding allowed. How’s that for a home remedy!I’m sure that my spine now appreciates the relief, as does my wife. She no longer has to suffer my raucous growls and howls, at least in the car.

FROM THE ARTICLE. AARP Endorses Senate Legislation to Stop Medicare Advantage Plans’ Excess Billing.Bill would curb plans’ ability to inflate patient diagnoses, increase government payments. By Tony Pugh, AARP. *** There are 3 comments on the AARP website. Stop by to add yours. **? Published July 16, 2025. AARP is backing bipartisan congressional legislation designed to stop Medicare managed-care plans from inflating patient diagnoses to boost their payments from the federal government.This practice from privately run Medicare Advantage plans, called “upcoding,” is expected to increase the cost of care for Medicare Advantage plan enrollees by $40 billion this year, compared with the cost to cover similar patients in original Medicare, according to the Medicare Payment Advisory Commission. USE LINK BELOW TO READ THE ARTICLE. https://www.aarp.org/advocacy/medicare-advantage-excess-billing/