Medicare & Insurance

A mere 19% after 12.7% last year.  This is not what I expected based on what I knew when I signed up.  Posting this here as reference as a follow up to my post on the 2024 increase.  

I recieved a letter in mid june 2020 stating that UHC had sent me a check for $522.68 for overcharges on my drugs purchased through OPTUMRX and my local pharmacy that has never been cashed. They included a form to have OPTUMRX and UHC re-cut a check for the $522.68 and it was sent on july 1,2020. They said that once it was recieved, it would be processed and re-issued in 7 - 10 business days and I should recieve it in 30 days thus I should have recieved by mid-august. It is now mid-september and still no check, just a runaround when I inquire when check was sent and when i should recieve. I have now contacted the Attorney General in the State of Nebraska's medicare fraud division to file a formal complaint. I had UHC- AARP medicare complete HMO and was getting all my statements to my current address thru December 2019 when I moved my coverage to Humana medicare HMO. As of today, September 15, 2020, I have not recieved the refund check for the overcharges on the OPTUMRX perscriptions.

 I thought AARP was supposed to watch out for seniors but am starting to think it is a scam. I had to join AARP to take out the UHC Plan G+ in Sept 2024 and was paying $147.29 and rec’d a letter today saying my premium is going up to $166.66 starting in Sept 2025. Who is advocating for us? I am already penalized for being a widow who lives alone with no other person in my home having UHC.  Does UHC always jack up the premiums after your first year to this extent? I will be 68 in June with no chronic health issues.

FROM THE ARTICLE: What happens when my Medicare premiums are higher than my Social Security check?You may find your benefit payments zeroed out — and that you owe money for Part B. By Linda Dono, AARP. Reviewed by Stephen Richardson. Published April 10, 2025. More than 100,000 people who have close to the 10-year minimum amount of work necessary to receive Social Security benefits can find themselves with a Medicare Part B premium bigger than their monthly Social Security payment.The result? They won’t get a check. USE THE LINK BELOW TO READ THE ARTICLE: https://www.aarp.org/social-security/faq/high-medicare-premiums-smaller-check.html

Under the Biden Admin, the cost of insulin was reduced to $35 a month.  Under the same policy, the cost of the drug Eliquis was scheduled to be reduced in Jan 2026.  Will this reduction still be implemented or has the Trump Admin taken away this much needed relief from high priced medicines?

I am searching for a Medicare Part D plan that includes Wegovy or another semaglutide in their 2025 formulary for a diagnosis of pre-diabetes.  After weeks of intermittent searching I have found NO useful information from any source.  The MyMedicare plan search tool doesn't help.  The clock is ticking on the enrollment period.  I'm hoping someone in this community may know any of the following:a Part D plan that includes Wegovy or other semaglutide in their 2025 formulary;for which diagnoses Wegovy or other semaglutide is covered in that plan;at what level of coverage;whether pre-approval is required.Any links to useful sites or documents would be also be much appreciated. Thanks for your help!

Given the current litigation and press about United Healthcare and their propensity to delay and denial care, how can AARP continue to support this company?

Over the past year we have had our auto insurance through AARP and the Hartford, paying $2,497 for two vehicles. It is renewal time and our Agent tells us that The Hartford has decided to increase their rates across the tri-county area in south Florida. Our renewal policy increased $690 annually. This, in spite of our clear driving record. My agent also tells us that it is a strategy the company has taken to reduce risk. They know that X% will drop them and switch to another company. They also know that Y% will continue with them and pay the higher rate, offsetting the lost revenue. So the insurance company, in the end, is able to maintain revenue with a smaller customer base and thus reduce their exposure to risk. Great plan for the company unless the value of X turns out greater than expected. Although I think the Hartford is a top notch company I am one of the X's and am switching to another well regarded company with similar coverage, including accident forgiveness, payin

  I recently was interested in buying a $100,000 LTC policy funded by my IRA and was told that I needed to wire the $100,000 before the insurance company would send my my contract and benefit information. Is this normal? They are a well known company but I just couldn't imagine sending the money without a contract.

Renew Active has fixed its website, so supplement holders no longer have to log in to their UHC account and do two-factor verification just to see which gyms are available to them. UHCrenewactive.com now has a drop-down menu where you pick your fitness network (e.g. Advantage or supplement).  Yay!  Plus the interface on the Renew Active site is massively easier to use than the one accessed by logging in to my UHC account. Supplement holders now have an easier time finding gyms, and people with Advantage plans can see what gyms would be included if they switch to a UHC supplement, or change to an Advantage plan that includes premium gyms. None of this brings back Club Pilates or Stretch Lab, of course, but at least I can look for gyms without wanting to tear my hair out.  And people can be informed customers when choosing a UHC supplement or Advantage plan. Unfortunately, it's not working on my Firefox, but it does work on Chrome.

 We paid for Medicare PART A or Medicare Hospital Insurance during our working years via a payroll tax currently at the rate of 1.45% for the employee and matched by the employer.  This is on all earned income.  But this Trust Fund is running out of money.  So what are we to do for this portion of Medicare to preserve it - probably the only solution is to up the payroll tax rate for those working - but also perhaps it is to review these benefits and cut back on them when we can.  Medicare Advantage plans already do this so perhaps it is time for traditional Medicare specifically  Medicare Part A to become more managed-care-like or at least make sure that the medical need is there under Part A Medicare. What else could we do?  Cut doctor pay even more?  Cut payments to hospitals and Skilled Nursing Facilities?   Each part of Medicare is different - in what it covers and how it is funded - so it is best to take each part and discuss

I trusted AARP to only "endorse" an insurance provider that would be sensitive to our increasing need for complex medical treatment as we age. Turns out AARP has failed us. UHC is literally killing me by trying to tell my heart specialist what he should be prescribing rather than what he wants to prescribe. This not a simple generic replacement for a brand name. They literally want him to select from 4 drugs that do not treat my HCM in the same way. AARP - you should be ashamed to make UHC the insurance provider that you are associating with - we trusted you & you clearly are making decisions based on something other than the quality of the organization in serving the senior population. 

  We pay for Medicare Part B or SMI Insurance (Supplemental Medical Insurance) by premiums which are either paid or deducted from our Social Security Benefit.  The amount we pay in premiums are based on our income.  Lower income beneficiaries have their premiums paid for them by their state if they meet the eligibility guidelines in income and assets; therefore these lower income beneficiaries actually have their premiums paid by YOU, the state taxpayers.  The majority of beneficiaries pay a premium that is equal to 25% of the cost of the program.  Higher income beneficiaries based on their higher income pay a premium that is higher in a percentage of coverage from 35%, 50%, 65%, 80% to 85% of the program cost instead of the standard 25% (these higher premiums are known as IRMAA or "income related monthly adjustment Amounts and these are very high.   The remainder of the Part B cost are covered by our government's general fund - meaning it adds t

FROM THE ARTICLE - SEE ARTICLE FOR MORE!!! Open enrollment for Part D and Medicare Advantage plans begins Oct. 15. By Kimberly Lankford, AARP. Published September 27, 2024. Average monthly premiums for Medicare Part D and Medicare Advantage plans will decrease in 2025, the Centers for Medicare & Medicaid Services (CMS) announced Friday. The average monthly premium for a stand-alone Part D prescription plan is projected to be $40 next year, a decline of $1.63, almost $20 annually. https://www.aarp.org/health/medicare-insurance/info-2024/drug-plan-premiums.html

FROM THE ARTICLE: By Kimberly Lankford, AARP. *** There are 2 Comments on the AARP website. Stop by to add yours. *** Published June 16, 2022.➡️ Updated January 24, 2025. ⬅️ No the infamous donut hole — when Medicare beneficiaries with Part D prescription drug coverage had to pay 100 percent of their drug costs until they reached a certain threshold — has closed.Also gone is the less intense but still steep coverage gap, which occurred when you and your drug plan reached $5,030 spent on covered medications in 2024 and you had to pay up to 25 percent of the cost for covered drugs, more out of pocket than in your initial coverage period. USE THE LINK BELOW TO READ THE ARTICLE: https://www.aarp.org/medicare/faq/donut-hole-coverage-gap.html

On my Medicare Claims and Medicare Summary, a service is not covered and Medicare States I may be billed / am responsible for $0. This is with a Medicare Contractrated Provider.  Stanford is taking the amount I am not responsible per Medicare and billing my Medicare Supplement Plan  - AARP UHC, which I was told by a Medicare rep is a violation of Medicare, and an investigation is supposedly being opened.  Of course, UHC wont pay it since Medicare isnt covering it. UHC states on their statement I may be responsible for charges unpaid. So Stanford says I must pay. I have tried everything you can think of to remedy this.  Any Ideas? 

  age 67 female.   Enrolled in 2023 , $84 a month     2024  $96 month . 2025  $113 a month

My wife turned 65 April 30 and wanted the supplement plan g she previously had an advantage plan,signed up for plan g, was approved coverage starting August 1st 2024, requested disenrollment in advantage plan, was not disenrolled requested disenrollment July with application, disenrolled August, disenrolled Sept, disenrolled Oct and disenrolled Nov was not disenrolled even after hours on the phone saying I was disenrolled. The favorite tactic is to say advantage plan cannot see the supplement plan and vice verse to call them. Contacting CMS was told they do not have jurisdiction over Medicare. I Paid the $153 extra per month August thru December 2024, for the plan g. I was told I had to wait for the annual enrollment period, they could not understand there is a window when you turn 65 to join and I was well within it. Finally Jan 1st 2025 advantage plan was terminated.   As a result and countless hrs on the phone I am left with $1600 or more in copays plan g would not pay. They al

     NPR.org 03/07/2025 - Walgreens agrees to be acquired by private equity firm for almost $10 billion    Change is always pretty inevitable - sometimes you just have to do what is necessary to stay afloat.   from the link ~  A buyout to take the drugstore chain private would give it more flexibility to make changes to improve its business without worrying about Wall Street's reaction. The company has already been making some big changes as it seeks to turn around its business. Walgreens has been a public company since 1927.

  I think the Center for Medicare and Medicaid Services should cut their losses on this one - If they have NOT won the case by now maybe they should stop wasting money with continuing it.  Perhaps they should just stick to making the instructions for assessing higher risk patients clearer to all the insurers that participate in Medicare Advantage plans.   Continuing the case over and over when several ruling have already been made to vindicate the insurer is WASTEFUL spending on the part of the government (CMS). KHN 03/04/2025 - UnitedHealth Wins Ruling Over $2B in Alleged Medicare Advantage Overpayments  from the linkThe Justice Department’s years-long court battle to force UnitedHealth Group to return billions of dollars in alleged Medicare Advantage overpayments hit a major setback Monday when a special master ruled the government had failed to prove its case. In finding for UnitedHealth, Special Master Suzanne Segal found that the DOJ ha

Since I am moving, I need to switch Medicare C plans. Will the Part D out-of-pocket limit be reset to $2,000 when I switch to a new plan, or does the prior value carry over? Will the $450 drug deductible I paid to first plan be applied to new plan's out-of-pocket limit?

 I received a phone call from 978-802-3052 claiming to be United Healthcare AARP wanting to speak to my dad.  I am his POA, and my cell number is listed on the account.  It was a voice activated survey, and I said I would not answer the questions.  Then I turned around and called the number back, and they said 2 names are associated with this number. Is this (dad's name)?  Mom is also associated with the number for UHC AARP, so it seemed like they really were from UHC AARP.  The questions only asked for dad's birth year which is public information.  Everything else was health oriented about his pain level, days of exercise, mental well-being, ability to meet needs, etc.  Weird thing is, dad has had dementia for years, and the questions did not make sense for a person with dementia.  At the end of the call, it said, if you have any questions, call UHC at 800-523-5800. That is the UHC AARP Med Supp customer service number. I called and spoke t

FROM THE ARTICLE: Congress Faces March 31 Deadline to Extend Medicare Telehealth Coverage.Benefit for home-based care begun during the pandemic will expire without lawmakers’ action. By Susan Milligan, AARP. Published February 27, 2025. Unless Congress acts before March 31, millions of Medicare patients who have been able to use telehealth as part of their medical care since 2020 will lose coverage for the pandemic-era benefit starting in April.The coverage has been a boon for those who have difficulty getting to an office to see a doctor, including older adults living in rural areas or with mobility problems. Caregivers strapped for time to transport their loved ones also have benefited. USE THE LINK BELOW TO READ THE ARTICLE: https://www.aarp.org/health/medicare-insurance/info-2025/medicare-telehealth-coverage-deadline.html

Between  January 01 and March 31 every year, a beneficiary can CHANGE their Medicare Advantage Plan. Look for the heading of Medicare ADVANTAGE OPEN ENROLLMENT at this site -Medicare.gov - Medicare Open Enrollment 01/01 - 03/31  So if you don’t like the MA plan you have now, your can change to another MA plan during this period.    

  Do you routinely monitor and verify your Medicare usage on your Medicare Summary Notices ?  If for no other reason than to verify the charge is yours?