Medicare & Insurance

There are some big changes happening in Medicare in the upcoming year. Changes are being made to make Medicare plans focus more on the policy holder. Read more about these changes on the "Upcoming Changes to Medicare in 2025" Article written by the Medicare agency, Medicare Advocates.

  Want to see how much Medicare Part B premiums have increased in the last (10) years or more - interesting.   FYI - thru 2023    The Balance - Current & Historical Medicare Part B Premiums  Wonder where we will be in the next (10 ) years?  Currently at $ 174.70 as the standard amount in 2024. And this is only for those standard premiums - people with higher incomes pay a higher Part B premium based on their income amount known as the Medicare IRMAA surcharge. (Income Related Monthly Adjusted Amount) And if a beneficiary is considered low income by a specific limit, their respective state pays the premium for them under some of the various Medicare Savings Programs .So I guess that comes from our state taxes.  

Can you switch from a plan G with Wellness to a plan G without wellness (or vice versa) without triggering underwriting?

I came back to update my previous posts about my efforts to change carriers from my Medigap Plan F from AARP/UHC to another company, but the posts are nowhere to be found. First question is, is AARP too afraid to let criticism appear?   To recap, for those who never saw it, I was replying to other posts (in my case) about using Maryland's new Birthday Rule to change carriers and/or plan levels. My DOB is Aug 10th, and my wife's is Aug 28th, which fell into the 30 period after mine, so we waited until then to attempt the switch.  That turned out to be a mistake. More on that toward the end. I made an appointment to talk to the S.H.I.P. people in my county to discuss the Birthday Rule.  They had never had an issue with anyone using it, even if their AARP/UHC Medigap plan had started before 7/1/2023, which someone at AARP had said made me ineligible.  Eventually I did get a correction and an apology from someone higher up at AARP. After settling on

AARP should be ASHAMED for promoting and participating with this so-called health insurance company! We are currently dealing with medical issues and need assistance with coverage questions. I called the "patient assistance" number on the insurance card and spent 45 minutes discussing the issue. I was given a reference number and was told they would contact the medical facility and get back to me. NEVER HAPPENED! When I called back the next day a new rep told me there was NO RECORD of the call, the issue and the reference number (which I confirmed on that call) did not exist!After another long call, put on hold etc., etc. I was led to believe they had the medical facility on the line and then I was magically disconnected.Even if that was true, which I doubt, they had my phone number and didn't bother trying to call me back. The medical facility had no record of hearing from them. I am sure these "reps" are not even in the US. A scam!SHAME ON AARP for allowing this.I just renewed my AAR

AARP / United Healthcare refused to accept and honor a claim I filed after AARP / United Healthcare Advantage recouped a $407.90 charge 16 MONTHS after they paid the claim submitted by my service provider. This happened during the time I was changing coverage from a United Healthcare Medicare Advantage Plan to a United Healthcare Supplemental Plan. I was never informed that my coverage had changed before the service was provided, continuing to believe at the time that I was still covered under my Medicare Advantage plan. United Healthcare steadfastly held that since the refiled claim and appeal was made more than 12 months later, the claim was denied, regardless of responsibility. I do not know whether Medicare Advantage deliberately or unintentionally waited 16 months to recoup the charge so that any subsequent claim would be denied. Either way the results are the same and I was stuck with the consequences of Medicare Advantage's two failures (1) to validate my coverage in the first i

A couple months ago I went through AARP to get a quote for long term care insurance.  I was directed to Agua Fria Financial Group that offers a New York Life package.  It all sounded fine until I was told that in order to go through the application and review process I would have to pay for the first month of coverage.  I could live with that, but then I was told by the rep that "All I need to be able to email you your application is your routing and account number you want the initial premium to come out of for you Long Term Care application."  They would take no other form of payment. It may be a perfectly reputable firm, but I find it odd that in these days of so many seniors being defrauded by giving out their bank accounts that an AARP recommended company would require that.  Does AARP know that Agua Fria is requiring bank account info up front, and that there is no guarantee that I would pass the review process, potentially losing the cost of a month

  Do you know the answer?   Can a person get Medicare benefits WITHOUT being eligible for any of the programs covered by Social Security - Retirement, Disability or Survivors Benefits?  

FROM THE ARTICLE - SEE ARTICLE FOR MORE!!! 7 Medicare Changes You’ll See in 2025. Expensive medications? You’ll save thousands. Dementia or mental health care? More options. By Kimberly Lankford, AARP. Published August 26, 2024. You can thank the Inflation Reduction Act of 2022 for some of the biggest Medicare changes in the past few years — including a welcome reprieve from the high costs of prescription drugs. https://www.aarp.org/health/medicare-insurance/info-2024/medicare-changes-coming-in-2025.html

Recently I came upon an 86 year old beneficiary that was paying over $ 800 a month for her MediGAP plan.  The beneficiary had had this plan since 1st signing up for this coverage along with Medicare Part A & B.  Unreal, right - yes, but it could have been taken care of many years ago IF only the beneficiary was aware of the problem and the solution. This beneficiary was still on one of the MediGAP plans that had been discontinued from new sales many years ago.  So needless to say, those remaining in this plan were now older, most likely sicker and fewer in number.  So, that is part 1 of the higher premiums. The state where she lived had also passed some laws during past years concerning coverage under MediGAP plans - the state expanded the choices of MediGAP plans to those less than 65 years old and Medicare eligible because of a disability - this makes premiums higher in every plan affected because it is adding more risk to the insurer.  So that’

  I may have to have a large portion of the top of my ear removed due to skin cancer. Will Medicare cover reconstruction surgery afterward? I know I'm going to have major issues with missing half my ear. 

I'm posting this for my 87 year old Mother, who's a AARP member :).  She had been using a G6 CGM for a few years and switched Endocrinologists.  Her new doctor recommended a G7 Dexcom sensor and my Mom has only been having problems inserting the sensor.  It's recommended for the back of her arm, but she cannot hold the device and press the button to get it to activate.  She has my Alzheimer's father try to help, but he doesn't really understand, doesn't want to hurt her and also cannot press the button.  She was told she could try her belly, which she had been doing with the G6, but even that didn't work.  I'm curious to know if others (more elderly) have similar challenges and what may or may not have worked.  We were told that the G6 will eventually be discontinued so they won't want to put her back on that. I've asked if there's another supplier, like Libre, that she could try.  My Mom's ready to give it up alltogether and go back to nothing,

 I currently have the AARP UHC Plan G Medigap Policy. I have been hit with some hefty increases over the first year and a half of having the policy over 17%. If it wasn't for a previous condition I would most likely switch companies or plan. My wife is now coming up to Medicare and we have to get her a policy. I know a lot more now and was researching plans and history of rate increases. Most states have a website with a database to research rate price increases over time. When I went to our website in Florida to research I found that UHC does not show any rate increase history since 2017. All you see is asterisks. The reason that is noted is they do not show this information because of trade secrets. Amazing that they are hiding this information from consumers trying to research who to pick when the state has to approve it and is public knowledge. Example Mutual of Omaha shows their rate increase history.  remember once you sign up you can't get out of a plan unles

Hi. I have Kaiser Senior Medicare Advantage and am enrolled in the Silver & Fit free gym membership program offered under that plan. I am having issues getting Silver & Fit to add the gym nearest me to their list of locations for me even though that gym tells me they participate in the program. I find this very odd. If others here are enrolled in Silver & Fit, can you share notes on your experience with the program, in particular if you’ve had similar issues accessing a gym facility near you?Thanks so much for anything you can share. 

$450 for a prescription that other providers sell for $11 to $16? This is price gouging on a scale that sent Martin Shkreli to jail. I've got a new job and with it, new insurance, a high-deductible policy with an HSA for the first time. Under my old policy, I had been making $25 copayments for 90-day supplies of my one prescription. I had no idea what it might cost without coverage. When I refilled it for the first time under my new policy, CVS Caremark (my new insurer's only supplier of 90-day refills) called to authorize the sale at $450. I would not be eligible to make a $30 copayment until my deductible was satisfied. I was shocked, but I concluded that this must be the regular price for my prescription, a price I had never paid in full before. So, I agreed. Only later did I think to look at other prescription drug providers, even if my insurance would not cover them. For the same prescription, CostPlusDrugs.com would charge $16, delivered. Amazon Pharmacy would charge $11 with fre

I am 68; less healthy than I used to be; and worth less than I used to be.I did have Wisconsin Badger Care and Medicare a, b, and d.Recently, I did a renewal and I am NO LONGER eligible for Badger Care because my assets (less than $3,000) are 'too high'.Now I have NO dental or eye coverage.THIS seems ludicrous.  As we age our eyes and teeth and hearing worsen.  It's a given!I want to write to whom ever I can in local (state) government but - need to know who.I can manage but I can't imagine the 1000s of people that are affected by this.Seniors who have paid a life time of 'dues'.Help.

As a result of all the changes taking place next year because of the Inflation Reduction Act and other rule changes, it is gonna be MOST important to review your Part D and Part C plans for 2025 so that you are assured they meet your health needs in the best possible ways in 2025. The new plans will be available around the 1st week in October for open enrollment between Oct 7 and December 7.   Premium hikes as a result of these changes are expected - get more; pay more.  In fact, some or all of the zero premium Part D plans might just go away.  There will be formulary changes, so check your medication needs against the newest list from the drug plans.  You can also do this on the Medicare.gov site.  Tier classifications might change on the meds you are taking, so check that too as well as any special considerations like “prior approval” (PA) or “quantity limits” (QL) or step therapy (ST).   Your total out of pocket will change ( $ 2000 for 2

I understand healthcare costs have increased, however to dupe citizen's into buying a supplemental healthcare plan then changing the terms of agreement and increasing the monthly premiums mid-year sets a precedent that is fraudulent. As a company who puts their name behind an insurance career, I hope you will re-evaluate your allegiance with United Healthcare. 

Today I received my new premium notice breakdowns with due dates and noticed the premiums were $200 higher!My Policy is set to renew this week and according to the declarations page, they raised my dwelling coverage $177,000! When I called to get an explanation of why, he went into a canned sales pitch about how high construction costs are to rebuild! The new dwelling they have for me is the current market price!!!Also, there was NO prior notice of the raise.I just filed a complaint with NYS Dept of Insurance.Check your Policy!

If you are still working at 65 and have delayed signing up for all the parts of Medicare because you have Employer Group Coverage,  some changes ahead may disqualify your plan.  Then the late enrollment penalty would apply because the employer plan no longer meets the equal to better (credible) benefits offered in Medicare.    Kiplinger.com - A Medicare Upgrades Could Disqualify Your Private Plan What a mess - somebody just forgot about this when writing all the new Part D rules.     

31% over last year. ($800) No tickets or accidents. Perfect credit. Disappointed in Hartford and the AARP.  Enough said.

I don't understand the big deal about the new hearing aid directive. AARP should be fighting for hearing aids to be covered by Medicare. Since we need the hearing aids as we age, it is insane for Medicare not to cover this. Why is AARP silent on this topic but make a big deal for over the counter ones. Just another way to take advantage of the aging population. 

FROM THE ARTICLE - SEE ARTICLE FOR MORE!!! 64 Medicare Prescription Drugs That Are Getting More Affordable. The coinsurance rates for certain Part B medications are being lowered temporarily. Here’s why. By Rachel Nania, AARP. Published July 03, 2024. Some people with Medicare will pay less for their prescription medications from July 1 to September 30, the U.S. Department of Health and Human Services (HHS) announced.   The agency identified 64 drugs — used by more than 750,000 Medicare enrollees annually — whose prices have risen faster than the rate of inflation. Under the prescription drug law passed in 2022, the coinsurance rates for these medications will be adjusted to match the inflation rate, meaning some people with Medicare could pay less out of pocket through September. What’s more, the makers of these drugs will face penalties for the price hikes in the form of a rebate to Medicare. https://www.aarp.org/politics-society/advocacy/info-

 Is AARP involved in any work or discussions with Congress to eliminate the Doughnut Hole in Medicare?  It costs seniors, who are quite vulnerable, money that we can not afford to lose. Congress MUST eliminate this sinkhole that we seniors can not afford to pour money into.  I write to my elected officials constantly, yet no one does anything to address this abomination of a rule.

To: United Healthcare, Optum, the South Carolina Department of Insurance, AARP, BBB, Current & Prospective Future Enrollees in AARP UHC Medicare Advantage Plans I am writing to make the entities above aware of the experience that my wife and I have had with United Healthcare (UHC) and Optum over the past 3 ½ years relative to their Medicare Advantage Plans. To say the least, it has been a VERY frustrating and disappointing experience.   When I retired in January 2021, my wife and I enrolled in one of the AARP United Healthcare Medicare Advantage Plans offered in South Carolina, where we live. I retired as an executive with over 40 years in the managed healthcare industry, so I am very familiar with Medicare Advantage plans and how they are supposed to work. (The company from which I retired is not currently licensed in the state of South Carolina). My prior Group Plan coverage terminated on January 31, 2021. As I have said over and over again to representatives