Medicare & Insurance

Yet another newflash study reaching the same conclusions. The risk of being trampled by the MA cash cows herded by Wall Street is greatest for those most in need and least able to react. The original article is behind a paywall but summarized in the second (along with editorial comment.) As always and especially in healthcare, YMMV. Medicare Advantage Plan Disenrollment: Beneficiaries Cite Access, Cost, And Quality Among Reasons For Leaving. Health Affairs Vol. 44, No. 6: Payment Policy, Medicare Advantage & More Churn and Burn: Why Medicare Advantage Patients Walk Away. American Council on Science and Health

Well let’s see if the government can make a difference without all the draconian rules and regulations -   KFF Health News 06/24/2025 - 5 Takeaways From Health Insurers’ New Pledge To Improve Prior Authorization  Sounds like an ultimatum from Government -  “So either you fix it or we’re going to fix it.”Worth watching how it develops in the next few months -  

Humana, the second-biggest Medicare insurer, has told congressional staffers that it will support moves that would curtail billing practices worth billions in extra payments to the industry, according to staffers and a document viewed by The Wall Street Journal. The stance by a leader in the Medicare Advantage business—in which insurers offer privately run Medicare plans—represents an important development in a growing debate over how the companies are paid in the $460 billion program. This is from an article in the WSJ to which I do not have free access but am taking the same info from Reuters which has some of the same info - read either to which you have access. Now what is the best way to get all the insurers onboard?  Support - just saying. WSJ 06/05/2025 - Humana to Back Curbs to Medicare Advantage Billing Practices(Healthcare) Reuters 06/05/2025 - Humana to back curbs to Medicare Advantage billing practices, WSJ reports  (Business)

24 months in and my supp G premiums up 18% cumulatively.  The starting point was outrageously high. Not a prior 'age discount' related increase. .  The reason(s) explained via scripted included 'rising healthcare costs, increased utilization'...etc,   Providers and insurers system broken vertically and horizontally, and this UHC plan is at the head of line. Open enrollment, goodbye UHC

I would love to thank Aarp reduced prescription drug program. My eye doctor recently wrote a prescription for an eyedrop which naturally fell under my deductible with my prescription drug program. The medication would’ve cost me $186 for a small bottle of eyedrop. I then went to a brand-name pharmacy Where initially the price would’ve been $334 had they not had prescription drug program I went to good RX, which offered a generic prescription for between 60 and $70 which was not available. I then went to Aarp and made a phone call and spoke to a young lady who told me the same medication Through the reduced Aarp prescription drug program would cost me $75.15. It’s just amazing the way that the cost for the same prescription can vary so much and this actually needs to be looked into. I would love to thank Aarp for all the great work. They’re doing For the seniors as well as the money that they are saving seniors so they do have a choice whether to take a medication and or eat and or just

If you use a different address on your medicare enrollment form than is listed with social security, will the medicare enrollment be denied? Also if they do deny the enrollment, do you have to appeal? These questions assume that you otherwise meet the qualifications to enroll and the denial would be based only on the information mismatch.

Hi. I'm 61 and newly divorced. I'm about to get kicked off my ex-husband's healthcare plan and I'm overwhelmed with trying to figure out ACA. The free state help offices are booked past the date I need to start. Where can I go for help? Thanks.

I saw some dialogue in a previous post regarding this subject. It looks like the potential exists for a double premium billing the 1st month that you receive social security benefits with the Part B premium auto-deducted. I reach FRA this month and get my first check next month (July).My last quarterly Medicare payment covers me thru the end of July.My understanding of my benefit payment next month is that my SS benefit is paid in arrears.But the Medicare premium deduction is in advance.That means my June SS check I receive in July is paying for my July Medicare premium. Am I understanding this correctly?If so, it appears that would create a double premium payment for the month of July. I'm sure I'm not the only one this has happened to and wonder if SS/Medicare addresses it. Thanks. Chuck 

 “.. . . when Medicaid was created in the 1960s lawmakers did not include work requirements because it “never dawned on anybody that able-bodied people who work would be on Medicaid.”   CMS Administrator Dr. Oz Mehmet Now, we are asking these ABLED-BODIED Medicaid beneficiaries to either work 80 hours a month or volunteer or take care of a low income needy loved one or go back to school in order to preserve their ACA Expanded Medicaid benefits.   In listening to CSAN’s Washington Journal this morning during the open forum call in - I could not believe the people that are scared to death they would be losing their MEDICAID benefit even though they are on the program by being a low income elderly, blind, or disabled, a low income child, a low income pregnant woman and then the newborn for at least a year in most states (maybe in all by now).  They will not -  I get so tired of our legislators confusing the ignorant public with this ”name” recogniti

I believe there is a place where many beneficiaries will have some agreement in Medicare Reform and it is one that the Senate is currently looking into - it would involve NO cuts to benefits for beneficiaries.  POLITICO 06/05/2025 - Medicare is a target as Senate GOP faces megabill math issues  from the link:   Senate Republicans are currently discussing folding in language that would target overpayments to privately-run Medicare Advantage plans, which enables older Americans to buy private plans offering health coverage. It would help them recoup tens of billions of dollars, and it’s an idea that has also attracted bipartisan interest. … . . House lawmakers briefly floated the idea of overhauling Medicare Advantage into their version of the megabill but it failed to gain traction, as a band of House moderates is deeply uncomfortable with the concept of touching Medicare — even if it is in the name of slashing “waste, fraud and abuse.” Yes, there

For Medicare Supplemental plans, regardless of the insurer - your premiums can increase due to several different factors - some are policy specific (#1 & #2), others are based on market, usage and legal requirements (#3).  1. The (YOUR) Explanation of Coverage - this will explain any declining discount schedules and set amounts of increases, if applicable based on the policy.  This is the contract with the insurer.2. How your Medigap plan is rated - Community RatedAttained AgeIssue Age3. The (Your) State Dept of Insurance cause in most states, the state received the info for the premium increase from the insurance companies like amount of claims (amount paid out), amount of premiums paid in, and amount that is kept in reserve per the law and their forward looking requirements that may already be in the pipeline.   Do these increases all have to happen at the same time?  NO (#1 & #2 ) goes by your specific data - your Medigap insuranc

I am a senior, AARP member, a pharmacist, and still working in a hospital oncology department. I have been specifically working in oncology for around the last fifteen years. Unfortunately, as we get older, our chances of having a cancer diagnosis increase.Elderly Medicare patients that have worked their entire lives and paid into the Medicare system are now being denied treatments that are part of standard, specific to their disease state protocol, better tolerated by their age group, and life extending just because they are now requesting that certain genetic markers be present before approval. Most of these are immunotherapy treatments, one being Keytruda. FDA has approved these medications for several types of cancer because they have been shown to work, and the tumors are seen as highly susceptible to immune attack. These medications have been added as a part of the treatment protocols for these cancer types.The cancer treatment medications are part of specific protocols

To my fellow Senior Citizens, to those who have loved ones on Medicaid (parents in nursing homes), to those whose children receive CHIP, and to all Americans who expect healthcare once they reach 65, It appears the Republican budget bill awaiting a vote soon in the House of Representatives has the potential to cut a half TRILLION dollars from MEDICARE in addition to gutting Medicaid, the Children’s Health Insurance Program and the Affordable Care Act. I am attaching information below. You can Google for yourself. You may be interested in the links to the Congressional Budget Office analysis.https://democrats-budget.house.gov/news/press-releases/cbo-confirms-gop-budget-bill-triggers-medicare-cuts

If you go to a pharmacy and they hand you a prescription then tell you it cost $160, you have the choice of handing it back.  NOT WITH OPTUM RX.  Website said no co-pay.  Prescription recieved then credit card bill arrives with $160 charge.  Called Optum RX.  They will not accept any return nor issue any refund.  Called Regions Bank to dispute charge.  They refused to accept dispute but charge penalties and interest while reviewing my case and reported a late payment to credit bureaus.  The whole experience has been BAD!!!

Do you know your State law involving switching or picking up a Medigap plan AFTER your initial enrollment period. IF NOT - you need to review them to see what effect they have on you and your specific situation.

With the new public information concerning UHC practices, will AARP reconsider its partnership? Seniors depending on your recommendations now know that they may be faced with devastating decisions made by this provider

I recently switched my homeowners and car insurance to the Hartford through Aarp and have saved about $2700 per year with better coverage.  I had my sister Mary look into it and she's saving about $5400 per year. I seriously can't believe I didn't take advantage of this opportunity much  earlier.  

Just spent over an hour with customer care and NY Life AARP... i login and it says there is no account associated with my contract number. i go through 2 people and the last one is working with someone higher. after spending 45 minutes only focusing on ME, i told him, we have tried 2 browsers and 2 computers, it is not on my end, it is on YOUR END. Oh, i just got a letter to change my beneficiary info, has my contract number right on the letter. anyone else having problem with the server on their end not finding your info?  He said he can see it, but i used to make webpages, sure, i can see anything and everything, but others cannot, the problem in on my side, server side. thanks for any positive help. He did put in a special ticket on it and said they will call me. i will be looking at other insurance or maybe a funeral account. at 65 my premiums are getting up there and that money would add up pretty quick. 

Why are you guys still in bed with UHC? When the killer of their CEO becomes a folk hero, shouldn't you folks get the hint that maybe the partnership with UHC might be a bit toxic? Are you folks that tone-deaf?Not a good look for you, that's for sure. I'm looking for Medicare and dental supplement plans, but your partnership with a company that uses AI to deny claims, that has the highest denial rate in the industry, gives me pause. Will you be partnering with other providers than UHC soon? I'd like to know.

 I was looking at the premium history for my AARP/UHC Plan G, which I've had for 3 years. I was surprised to see a 5% increase on my plan anniversary, because 3% was always in my head as the adjustment due to age that I agreed to when I signed up for the plan. I put a pencil to it. The 3% is the amount the discount declines, which actually results in a 5% increase in premium the first time it's applied. Here's the math. For simplicity, let's assume the "community rated" premium is $100 a month; this is the number the discount is applied to. Let's also assume that $100 premium stays the same over time, which of course isn't the case because premiums are allowed to increase due to increasing costs of providing the plan's benefits (caused by plan utilization, inflation, etc.). But for these purposes, keeping it at $100 will help illustrate what happens. I signed up for my plan when I was 65, at which time I was getting a 39% discount, resulting in a premium of $61

  I do believe that there are UHC Medigap policies that are outside of the ones that are endorsed by AARP - wonder what the difference is in coverage and premiums.  Of course the [whatever] plan coverage would be the exact same since that part if under Federal law but are there other differences?  Wonder about the premiums.  Just thinking out loud - I may try to find out - Anybody interested in the results?

i  i turn 65 in two months. i am fully employed and plan on working another year and not taking social security until then. I am currently covered by my wife's employer insurance which is really good and reliable. anyway, we don't plan on leaving this situation for another year. everyone says i should enroll in part a but I am concerned that if i do our insurance will question why i am not using it. I don't want to call attention to this and would rather not opt for medicare at all at this time (because I expect the benefits to be greatly reduced OR the employer would question my participation and drop me and/or us). any pointers? thanks e.s.l. 

My wife and I are on an ACA plan. In June I move to Medicare. Will my wife be able to move to a new ACA provider (preferrable) or choose a different plan with the current provider? My health is worse than my wife and the plan we chose was based on my issues. I know the plan cost will change with just my wife but we would like my wife to go to a cheaper plan. I want to be as informed as possible before I start making calls.

Just got notice from UHC on new rates starting in June '25 and Oct '25,TWICE this year again, like previous years. June increase is $18, for next 4 months. Oct increase is another $7.60, till May 2026. The arguments/concerns posted by TimS766530 Contributor  in 10-2024 still remain RELEVANT.I'll be exploring other options for Medigap, as I hardly ever use the UHC policy I have now. Why enrich the C-suite at UHC?

Hello Folks,I have a situation that is very atypical, as far as I can tell. I am a US citizen since I was born, even though I was born overseas – due to having a US citizen father who worked abroad for most of his life. My mother is not a US citizen, both my father and mother lived overseas for most of their life (father still lives overseas to this day).My father and mother divorced many years ago. Many years after the divorce, my mother started to receive Social Sec (small payment every month) and Medicare Benefits while living overseas due to have been married to my father. My mother is in her 80s now; and few years ago, I sponsored my mother to come to the US (i-551 or green card).Currently, my mother receives a small Soc. Sec payment every month and is enrolled in Medicare Part A and Part B. However, I have to pay every month for her medicare supplemental plan (Part F). Normally, if you sponsors someone (a parent) to come to the US, you would be considered liable (as a sponsor) fo