Recent premium increase for United Healthcare coverages

[jphorenci]

I am absolutely appalled at the just announced price increases for United Healthcare coverage. The increase in RX (over 90%) announced during the last open enrollment was enough force me to make a change and now the supplemental health coverage increase (22%) is astounding. As their primary selling agent, you should anticipate my changing to another, more affordable carrier at my first opportunity and hopefully a boatload of others doing the same. Shameful, unjustified, heartless, and ridiculous. Shame on both you and United Healthcare.  

[GailL1]

@MichaelH904998 

It sounds like you don’t know what you have and what it pays for. 

So here are the plans - which one do you have?  From your description it sounds like Plan F or Plan G after you have met the Part B deductible - those are the most lucrative plans.  Most people are no longer eligible for Plan F but for those who had it, can keep it but premiums will continue to rise since there are no younger (and hopefully healthier) beneficiaries going into the Plan F.

Medicare.gov - Compare Medigap Plan Benefits 

Medicare pays 80% of Part B cost - the cost that they have negotiated, rather dictated to providers that accept assignment.

The remaining 20% is up to you to cover either out of pocket or with a Medigap plan up to its coverage limit of the plan (differs depending on the plan).  Plan F covers it ALL, Plan G covers it 
ALL once you have paid the yearly Part B deductible - in 2025, that is $ 257 for the year.

So say you needed chemotherapy - infusions of specific drugs on an out patient basis are covered by Part B = this could easily run $ 10,000 (Medicare price) or more a session cause it covers the infusion as well as the meds and say you had to have 2-sessions a week for 5 weeks - that’s $ 100,000 - Medicare would pay $80,000 - you are on the hook for $ 20,000 or rather your Medigap plan.

Part A expenses can even get higher - 

Medicare.gov - Inpatient Hospital Care Coverage 

Notice it says “per benefit period”  - possible to have multiple benefit periods in a year.  

So 1st it is $ 1676 - you pay or Medigap plan pays

This also covers associated Medicare rehab in a skilled nursing facility - so say you have to stay a total hospital +rehab days of 70 days - the last (9) of those is costing $ 419 a day - your cost would be $3771- you pay OR your Medigap plan pays.

Insurance is all about a WHAT IF - and as we get older, that WHAT IF become more like WHEN.

Only you can judge the value of your coverage to your pocketbook - want 1st dollar coverage (or as close as possible) then you will pay for this superior coverage.  OR IF YOU CAN you could switch to another plan or another insurer - see a local Medicare plan broker or your state’s SHIP counselor to see your options if there are any.

[MichaelH904998]

Good examples.   I know exactly what I have what I was looking for is examples of when the need really kicks in.  I appreciate those examples.  Can you please try to respect that others don’t know as much as you.  Your advice will be much more appreciated that way.  

[GailL1]

@MichaelH904998 

Just answering your questions to the best of my ability - I learned what I know by being on the system and reading about it on Medicare.gov and CMS and reddit.com.  I also try to keep up with changes that are made by CMS from year or year.  

But you are right, I probably do give off an air of discontent.  I am getting tired - I started doing this in 2008 and the beneficiaries may have changed but the questions remain the same.  So I am considering taking a break from these pages.  

Good Luck 

[TRL1111]

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@GailL1 wrote:

But you are right, I probably do give off an air of discontent.  I am getting tired - I started doing this in 2008 and the beneficiaries may have changed but the questions remain the same.  So I am considering taking a break from these pages.  

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I understand your discontent.  And in fact, this same guy chastised me for being disrespectful, too.

It does get tiring having to say the same thing over and over again.  In my case, it's that supplements don't have a nationwide open enrollment period.  The time I was called disrespectful, it was because I put in all caps "THE OPPORTUNITY TO CHANGE YOUR SUPPLEMENT DOES NOT CLOSE!" 

But what prompted it was that this person had said UHC raised their rates after the opportunity to change had closed, and I corrected him, and the very next day he said it again in that very thread, and also in another thread.

Not to mention how many people ask a question, and I ask for clarification, and they never come back.  It's not uncommon on the internet, but it seems like it happens a lot on these forums.

The only thing that keeps me going is the thought that there are people out there we never hear from who read these posts and actually try to learn instead of just complaining about their premium increase.  

[MichaelH904998]

OK but please come back as you know a lot.  You can bring joy and understanding to many.  Just approach your contributions as a gift, not a burden; recognize and hug yourself for helping others.  Think of that as you write.  Have a great evening.  

[ClaudiaP763758]

I agree the increase was totally unexpected. I expected a $10-25 mo increase. I recd 2 increases totaling $55 month.  I cannot afford this along with all the other cost of living increases we are all experiencing.  I am switching to Cigna.  Cost savings goes from$170 mo w UHC to$115 mo with Cigna. My broker said most of his clients are doing the same if they are able based on health.  Coverage is the same with exception of losing Silver Sneakers 

[CBtoo]

How are you having 2 increases at once? D can't increase except Jan 1. With UHC supplements you do get 2 increases a year - one based on age as the discount you get decreases each year as you get a year older, and the June 1 across the board increase that accounts for inflation, use, etc I guess if you have a June birthday you'd get two increases for June (or one bigger one). 

My G premium increases for June 1 was only a bit over 9%. 

[pf75974628]

My G premium went up by $64 or 25% this month (June).  At first my brain didn't compute what I was reading.  I thought there must be a mistake.  

[kredman60]

My premium went up $9 in January and my June premium one up $40 so that's more than one increase in a year.

[GailL1]

@kredman60 

Perhaps you got hit with the AARP UHC declining discount on your 3rd (I think) anniversary - the beginning of more to come.  Then the one in June was the medical inflation/usage/ build reserve increase.  As the usage in a Plan increases, insurers have to replenish and restore the amount that they keep in reserve to pay the claims.  

With million of seniors now with Medicare and many with the same plan as you have, they are using it for their care - Part A and Part B - and as they (and you) get older,  they may use it even MORE.

[TRL1111]

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@CBtoo wrote:

and the June 1 across the board increase that accounts for inflation, use, etc

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FWIW, my across-the-board-increase happens in July.  It's 15% this year, was 13% in July 2024, and 7% in July 2023.

Early next year will be the first time the age-related discount goes down, and that will result in a 5% increase.  So it will be a 20% increase if you add the impending across-the-board increase and the increase early next year due to my birthday.

[CBtoo]

So the across the board increase month must vary by state, but there is one each year for everyone independent of the age related discount decrease for supplements. 

[TRL1111]

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@ClaudiaP763758 wrote:

Coverage is the same with exception of losing Silver Sneakers 

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Is a gym benefit important to you?  If so, in my area a company called MedMutual includes Silver Sneakers with all of its supplements.  The network seems to be a little smaller than UHC's Renew Active, but there's a lot of overlap.  

It's possible your broker doesn't contract with MedMutual.  I went to medicare.gov and did a search for supplements in my zip code, and the results include ALL supplements available to me.

[WendyK644630]

Why should we be charged for their attorney fees and security lapses? When are Americans going to wake up and support medicare for all instead of being gouged by profit greedy United health??

[GailL1]

@WendyK644630 

Why not - it is a cost of doing business just like the claims that are paid against the policy.  Premiums for Medigap plans are based on usage utilization, the rating method - be that community rated or age related and medical inflation.  

However since UHC is such a big insurer their cost of doing business is also done by type - be that a Medicare plan of Medicare Advantage or financial protection in a Medigap plan against Traditional Medicare because there is NO limit to your our of pocket cost under the Trad. program.

Or an Employer Group health plan OR an employer Retiree plan or a Medicaid MCO plan - and UHC is within ALL of these insurance marketplaces.  

Protecting  employees does span the gamut of their vast types of coverage. Whereas legal fees could be somewhat isolated as to the type of product having the legal need.

You know what would keep your Medigap premiums down -

1.  Accept more of the risk yourself course that means picking a Plan N or a High Deductible Plan G rather than a regular Plan G - a high deductible Plan G has very low premiums less than a $100, perhaps $ 60 a month.  Once you meet the deductible (2025 - $ 2870 and this includes Part B deductible and Part A deductible) - it performs just like the regular Plan G for the rest of the year.

2.  Everybody STOP using their plan - course that also means STOP using your Medicare.  

3.  If age related rating - STOP getting older

Now for some of these yes, I am being factious.  

[FrBobWags]

   United Health Care's multi-billion dollar profits are proof positive that it is long past time that "for profit" health insurers go away.  And the BS excuses for their sins should also go away.  The only thing preventing Medicare for All with full health care benefits for all Americans is the equally disgusting millions of dollars paid to our "elected representatives" from the "taxes" we pay to private insurers for our health care.   Oh, and then there is the other special gift given to private for profit insurers ....the big scam mistakenly referred to as Medicare "Advantage"  which is neither Medicare nor of a long term advantage to anyone other than insurance agents, advertising firms, and their accomplices  who have robbed traditional Medicare of millions upon millions of assets and made the final years of our most vulnerable seniors a financial and emotional nightmare.    A day will come when this obscene non-system is consigned to "the ash-heap of history."  That day cannot arrive soon enough. 

[ksbradley21]

My bill is 230.74/month and is now going up $47! And I’m not sick! And I have Medicare premium I pay. I don’t understand how this is justified. A 20% hike for some of us is way more than scary. Going up to $277.24 till February then going up to $287.98! 
I go once every three months to the doctor and and my office visit without insurance would be far less than three month of premiums. Just staggering. 
id like to know why this much of a jump in my plan F? Oh, and this is AFTER "discounts". 

[WendyG151486]

How about one regular doctor`s visit per year, no meds, no problems? $287.98/month.

[TRL1111]

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@WendyG151486 wrote:

How about one regular doctor`s visit per year, no meds, no problems? $287.98/month.

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Since you're healthy, you can switch supplements any time you want.  Or is $287.98 not that much different from other supplements available to you? 

If there aren't any significantly lower, you could switch to a high-deductible plan, and assume some of the financial risk yourself in exchange for much lower premiums.

[CBtoo]

The rate you pay depends on what the costs are for everyone in your "risk group", plus administrative costs, if you have UHC the nearly 5% to AARP, etc. This grand total is then divided by everyone in that risk group and that dictates the rate for everyone in that risk group "block". It means those who are healthy right now are paying the same as those who are not healthy. Of course you have no idea if for your life you will always be in the "healthy" subgroup. In that respect it is sort of like employer health insurance. All the employees are in the same plan and share the overall costs of health care for the entire group. If we charged by how healthy or unhealthy you are many would not be able to afford health care if they got really sick. Not to mention you don't know if your health will hold until the day you die.

[TRL1111]

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@ksbradley21 wrote:

id like to know why this much of a jump in my plan F? 

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It is no doubt at least in part due to the fact that Plan F isn't accepting enrollment by anyone under 70 years old, so the people with Plan F are not only aging and presumably filing more claims (which results in increased premiums), their claims are not being offset by younger people who presumably don't have as many claims, so a Plan F's overall claims experience will typically increase faster than with other plans that are still open to younger enrollees.

You said you're not sick (although you go every three months to the doctor), so I assume you can pass underwriting (if you're in a state that allows it).  Shop for a new plan.  Switch to Plan G if the premium is lower enough to make up for the Part B deductible you'll have to pay, and maybe even if it isn't if you want to get out of the Plan F pool while you still can.  Or get a high-deductible plan, since your healthcare costs are low.

But be aware that all supplements are being hit hard by inflation and increased claims (people getting treatment that was put off during Covid, and people whose health was compromised during Covid and are suffering the effects of it), and supplement premiums go up to account for it.

[PilarH946312]

I have plan G and it’s going up around 20%, to $269.21 a month, that is $ 43.69  increase! That is not much better than plan F. This is very upsetting and I’m disgusted 🤢!!!

[SteveD198726]

 I just got hit with a 22% increase in my Medigap premium from AARP. This is a lot more than the annual 3% discount reduction. The letter says it's due to increasing costs of healthcare, but I suspect it's because UHC stock is in the crapper! My state allows switching plans for 60 days starting in birth month, but I'm worried that another company might not provide good service. Other than rate increases, I haven't had any problem with UHC/AARP coverage as long as Medicare approves a claim. Any suggestions, anyone??

[CBtoo]

ALL supplements are required to pay if Medicare pays so that isn't an issue. If you have an advantage plan that is a different issue. 

[kh22372029]

The prices keep going up because their CEOs and other management make over 2 million dollars per year. My husband has plan G which increased in Jan, May and now June. I have Plan N and my increases came in Jan, Feb, and now June. Every year there are 6 increases we must deal with. I am done and will go with a different Company. If this keeps up you won't have any SS to pay the outrageous premium.

[PeterL240115]

Just started Medicare in 2022 and UHC supplement premium has gone up almost 25% in just 2.5 years. And in my state I can't switch without underwriting, and I've had cancer in the past. So - I'm stuck! UHC made 22 BILLION in 2023 (so much more than other insurance companies) and when this plan was selected in 2022 - no idea premiums were going to ramp up this fast. Really not reasonable that there is no control on rate hikes. 

[GailL1]

@PeterL240115 wrote 

Really not reasonable that there is no control on rate hikes.

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

Your state is the one that can exert a premium hike review but it will probably stand because of what this coverage actually represent which is 

1.  It is OPTIONAL coverage - you are not required to have any Medigap (Medicare Supplemental coverage) - not by the Feds and not by any state.

2.  Medigap is NOT health insurance - it is financial protection insurance for those with Traditional Medicare - since Trad Medicare has no cap on a beneficiary’s out of pocket cost, not annually and not lifetime, so this is coverage helps or prevents a catastrophic financial medical event under Traditional Medicare./

3.  Federal law ONLY covers what is within the various plan - state law covers the rest of the regulations like:

• who can be covered and how if the Medicare beneficiary is under 65 years old,  
• whether or not there is any extended guaranteed issue rights to buy or switch policies without underwriting after the IEP, 
• the amount of any reserve that has to be put away for claims management 
• perhaps what rating method is used by all insurers in the state - community rated, attained age or issue age.

Medigap rates are determined by

• usage in the plan (yours and others) and that is gonna be pretty high in certain plans (most popular currently - Plan G) and since most beneficiaries are members of the huge numbers of the baby boomers or earlier generations and they are gonna be high healthcare users - 
• the amount of risk that the insurer has when state law extends the guaranteed issue period without underwriting - since this allows those who might be older or older and sicker to enter other plans without underwriting which does let the insurer adjust premiums for health risk if they so desire.  Aren’t you glad you don’t have this in your state - your premiums would be even higher.
• whether or not those less that 65 and are on Medicare due to a disability are allowed to buy any Medigap  plan rather than no plan or a restricted plan like one of lesser coverage.

In a way, CMS uses Medigap coverage to control healthcare cost in Traditional Medicare.  They do this by cancelling the sale of certain (more lucrative) Medigap plans since it is a fact that people use more healthcare when they have no or a very small out of pocket cost.  They have done this through the years with Plan like Plan J or Plan F and others - and could do this in the future with Plan G or others.  When a plan has this type of (closed) book no new younger and healthier are allowed to buy into the discontinued plan but those who have them can stay with the plan but that just means that this group is getting older and possibly sicker and the premiums after a few years just sky-rocket. 

There are things that one can do to keep premium cost to a minimum - one thing is to accept more of your own risk.  IOW, choose a High Deductible Plan G instead of a regular Plan G - Once the annual high deductible is met (in 2025, I believe the deductible is $2870 and that does include the Part A and Part B deductibles), the HD-G plan performs exactly like the regular Plan G.

If I were you and you have some health conditions and are in a state where there is no extended guaranteed issue periods, thus you would be exposed to underwriting and/or an exclusionary period of an pre-existing condition (like 6-month), I would at least sit down with a trusted local Independent Medicare insurance broker - one that represents MANY insurers- and ask about switching to another insurer with perhaps a different plan - one where you accept more of the risk - and see just what might be offered.  These agents are different than those of UHC - they are not captive agents - they also know their insurers and the ones where they think you may have a chance of changing, what the premiums would be with underwriting and what if any exclusionary period there would be.

DO NOT BUY A MAPD plan if you don’t want one - make that clear.

Otherwise, yes, you are stuck in your current plan - and IF and WHEN the premiums might be TOO expensive your only other choice is Traditional Medicare without a Medigap (not wise) OR switching to a MAPD plan of a higher rating with broad coverage in networks and an additional out of network coverage (PPO).  Remember a MAPD is Medicare managed care.

Good Luck.

[PeterL240115]

Thanks. I do understand these issues but uncontrolled premium hikes was not an issue when I selected UHC. As for high deductible - it does not include Part A deductible, but is another choice. If I wanted to go thru underwriting. Thanks again. 

[CBtoo]

Your premium goes up on your birthday month due to the declining discount. You are lucky. You have 5 more years of discount than I do. Then the premium goes up once a year in June. If you have a June birthday you get a double hit.

Cancer and UHC medical underwriting - solid tumors if you are cancer free for 3 years (so ONLY had check ups and they code it as cancer in remission) OR 5 years for a blood cancer (same coding rules) - if your situation fits that you are good to go as far as cancer goes. 

There are other conditions that affect underwriting and whether or not you pay "normal" prices (Tier 1) or a higher price (Tier 2). 

If you have an agent who helped you sign up call them and ask for a copy of the medical underwriting questions. I managed to pry that list out of united health care underwriting dept. 

Here is a video that is still accurate for UHC underwriting questions. 

https://www.youtube.com/watch?v=t2F9QV3SbsI&t=120s

[TRL1111]

I've read reports of people with Advantage plans have multiple surgeries but still not meeting their out-of-pocket maximum.

My impression is that it's usually cancer treatments that end up costing the member big money, because coverage for cancer treatment is generally through coinsurance, and not a copay--the Advantage plan pays 80% and the member pays 20%.  The drugs that get administered by a provider for cancer treatment (e.g. chemotherapy) can be obscenely expensive, and the member is responsible for 20% of that.