Contributor ⭐⭐

AARP Medicare Advantage from United Health Care is gone

Forum|Forum|11 months ago
September 17, 2025
23 replies
34971 views

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 order to find a way to not lose my Advantage coverage, I have been researching the Medicare Continuity of Care policy that guarantees that I can keep my current doctors if Medicare, the new plan, and my team of doctors all agree to the Continuity of Care policies. And even if they all do, the Continuity of Care policy only guarantees that I can take advantage of this for 12 months.

As most people already know, dealing with Medicare and insurance is a complicated procedure. Now that I'm forced to make a change that involves more than a couple of doctors, and at least two different health insurance providers, and their underlying groups, well... my head hurts at how complicated it has suddenly become.

I'm posting this info here for the sake of all AARP UHC PPO plan participants as a warning that they better start looking for a new Advantage plan. Soon. It's also a message to AARP that you need to stop promoting this plan, as it no longer exists.

G

GailL1

Yes, this is going to be a year of change, especially for PPO MAPD plans. This isn’t just UHC that is making this decision to pull from some PPO plan areas. It is industry wide and insurers will be making their individual decisions as to where they are offering MAPD plans and what type. It has always been this way - that’s why there is the AEP every year.

ANNAUL Open Enrollment (AEP) for 2026 plans begin on October 15 and goes to December 07.

Medicare.gov - Explore Your Medicare Options

You can change Medicare Advantage plans - once the new 2026 plan designs have been uploaded into the Medicare database sometimes around the 1st part of October, you can see what plans by whatever company are available to you in your zip code and then check their network and their drug formulary to see if any of them fit well for your needs and sign up for the one that does.

OR since your MAPD plan is going away, this also opens up a Medigap special enrollment period (SEP) for you if you want to go back to original Medicare with a Medigap plan. You might also have another option. to get a Medigap plan if you want to go back to original Medicare. If it has been less than 6-months since you picked up Medicare Part B - you maybe still in your Initial Enrollment Period and the switch from a MAPD plan to original Medicare with a Medigap plan without underwriting is still available to you.

I have to run now - but you do have options and time to make the decision. Just like other insurance, Medicare MAPD plans can change and there is never a once and done in this marketplace - you can change based on your needs and what plans are available,

T

TRL1111

Community Champion ⭐

@jskyer wrote:
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.

Can you explain why your issues would have made for a financial nightmare with traditional Medicare?

Usually that's the "best"coverage if paired with a supplement--once you meet your Part B deductible, everything's covered at 100%, and there are no networks to deal with.

E

evrytan

Contributor ⭐

I already see that Medicare advantage cuts many services that were included this year plus is raising the co-payments a lot. So, actually is not going to be any increase.

G

GailL1

@evrytan

And some plans are just going away altogether. And some insurers are leaving the marketplace altogether.

Because of many changes that CMS is making to control certain aspects of Medicare Advantage plans

preapproval methodology and time restrictions to get it done faster
tighter controls on risk assessments methods
requirements that networks be adequate per CMS definition
(to name a few off the top of my head) - maybe others too

and because

the insurers share of the cost has increased under the Prescription Drug coverage that is within their plans,
the discontinuance of some of the extended benefits in regular MAPD plan designs which are now only covered under some of the dual eligible special needs plans

there is definitely a change in plan designs and cost.

Many PPO MA plans are leaving regional plans and premiums are being recalculated as well as standalone PDP plans.

The most important thing a beneficiary can do during this AEP ( Annual Enrollment period) for PDP and MAPD plans is to review all those that are available to them and pick the best one based on ones needs or depending upon their state rules, determine if going back to Traditional Medicare (with a Medigap plan) might be a better move for them.

IMPORTANT: If a MA plan to which a beneficiary is participating leaves your area, and one wants to go back to Traditional Medicare, this cancellation of MA coverage opens up a guaranteed issue special enrollment period for a Medigap plan without underwriting.

Beneficiaries need to understand their options and many times that involves knowing what the federal and state laws say about Medicare plans. So if a big move is gonna happen, beneficiaries may want to solicit help from a knowledgeable local Medicare plan broker or a State Health Insurance Plan representative (SHIP). But act ASAP cause they are all gonna get booked up this year based on all the changes.

J

jskyerAuthor

Contributor ⭐⭐

Update: After spending way too much time online and on the phone over the last day or so I learned that in spite of the fact that Medicare has already delivered the 2026 edition of "Medicare and You", nobody knows what's going on. Insurance companies, medical providers, even Medicare itself has admitted that until October 1, they will all be in the dark about what changes to plans will actually be implemented. I also learned that many plans may have to drop some long term conditions from the plans they offer. Apparently the list of conditions, and treatments, that Medicare will no longer support are part of some of the presidential Executive Orders that have been recently signed. And nobody will know, or will admit to, what those changes are until October 1.

😟

G

GailL1

@jskyer wrote. . . . . After spending way too much time online and on the phone over the last day or so I learned that in spite of the fact that Medicare has already delivered the 2026 edition of "Medicare and You", nobody knows what's going on. Insurance companies, medical providers, even Medicare itself has admitted that until October 1, they will all be in the dark about what changes to plans will actually be implemented

=========================

[ME] There are all kinds of warnings and instructions in the pages of the 2026 “Medicare and You” booklet preceding the listing of the MAPD, SNP or free standing Part D plans which MAY BE in your area - it says specifically to (1) check with the insurer to make sure the plan still exist (2) check the updated plan for the new formulary -

The AEP does not start until 10/15 and although most insurers have pretty much nailed down all their details in their 2026 plans by late Sept - they actually have until Oct 1 to provide it to beneficiaries either on their website or in the mail - that is IF, the plan is going to continue at all.

That’s why there is an AEP for Medicare Advantage plans and Free Standing Part D plans - so that all the changes that are occurring as a result of a CMS new rule or specific changes to the insurer’s plan design like formularies and networks.

==============

@jskyer wrote . . . . I also learned that many plans may have to drop some long term conditions from the plans they offer. Apparently the list of conditions, and treatments, that Medicare will no longer support are part of some of the presidential Executive Orders that have been recently signed. And nobody will know, or will admit to, what those changes are until October 1.

==================

[ME] That is a big accusation without any details or back up - care to elaborate what you are talking about because without some factual explanation, you are just spreading misinformation.

So PLEASE explain what you are talking about here.

J

jskyerAuthor

Contributor ⭐⭐

GaiL1 - Thank you for posting that info. I understand all that, and I have started the investigative procedures you describe. In fact, to answer your questions, I understand that while most insurers may have nailed down the details of their 2026 plans, they have not posted any of these into the systems that their customer support teams can access. I have been told, by those customer support teams, that they will not be able to refer to anything beyond 2025 until October 1, when the insurers actually reveal those changes to them. My comment about Medicare, and the related Advantage insurers, being forced to cancel some long term care coverage came to me via the United Healthcare customer service rep I talked to yesterday. I had called them to inquire about the disappearance of my 2025 plan from the 2026 Medicare directory. I wanted to know what my options are going to be come October 15 so that I can organize my coverage. That AARPUHC customer service rep is the one that informed me that some of the long term coverage options provided by all insurers are likely to be cancelled due to executive order outlining health cost cutting measures. Since this information came to me from what I consider a reliable source, I don't believe I am spreading misinformation. If the information I am posting here is in fact incorrect, I would appreciate it if someone who actually knows a different truth would post it here so I could move forward with confidence that I'm following the right path. Until then, I believe that until October 15, nobody is going to be able to provide the answers I'm looking for.

J

jskyerAuthor

Contributor ⭐⭐

UPDATE:

Yes, it's true that UHC is dropping almost all of their PPO Advantage plans. But... After WAY too many hours on the phone and online I have found out a couple of things. And, being stupid, I discovered that none of this information was available to me prior to October 1, when the 2026 Advantage plans were revealed to both the public, the provider support people and online.

The AARP UHC PPO plan is not the only AARP plan that UHC offers. In fact, according to the person I spoke with today, AARP is involved with most of the UHC Advantage plans. Both PPO and HMO.

I learned that UHC offers two AARP HMO plans that beat the cost of the AARP PPO plan that is now being discontinued. Plus, I learned that pretty much all my PPO selected doctors and specialists are already in the healthcare groups that the HMO plan works with. After 1-1/2 hours on the phone with a UHC support person today, I have learned that, at least for me, the two plans that make the most sense as a replacement for the PPO plans that are being discontinued are...

CA-004P

CA-19

CA-19 offers a $35 discount on Medicare payments but offers a bit less in exchange for what it provides.

I've contacted a couple of other Advantage plan providers and based on my needs and the differences in competing plans, the CA-004P plan makes the most sense to me.

IMPORTANT! Do your research NOW. Once October 15 rolls around and it becomes time to make changes, the wait time on hold to talk to a support person could be hours. Talk to them NOW and you can get everything set up for the change prior to October 15 and then all you have to do is let them know you're ready to make the move.

L

larry3rv

Contributor ⭐

Problem is, HMO do not offer the same level of care and greatly limits the specialists one can see, often resulting in long way to see one of the few specialists covered.

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