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.  

[TRL1111]

---

@CBtoo wrote:

I never said it was free. I said factoring in what you paid prior to retiring is taking into account sunk costs, money that you can’t get back regardless. 

---

Plus it's just silly.  Under this thinking, people who get $2,000 a month in social security don't really get $2,000 because that number needs to be reduced by what they paid in taxes in order to get that $2,000.  

[Tonster521]

 @TRL111, The math you referenced is why many young folks do not agree with the SS Program. Many believe they will obtain better outcomes from simply investing their FICA payroll taxes over their working career. And for savvy folks who may compound their investments over time, this is true. At any rate, I suggest that you review the Greenspan Commission's findings from 1981 through 1982. You can find their Report at the SSA website. It is the basis of the 1983 Amendments to FICA aka Social Security. FYI, the SS Trust was projected to reach zero ($0.00) by August 1983. President Reagan formed a bi-partisan Commission headed by Allan Greenspan to develop solutions and save the SS Program. Prior to 1984, SS Benefits were not taxable. The reasons vary. However, one reason was that workers already paid federal income taxes on their earnings and then were subject to FICA payroll taxes on such earnings. That view changed in 1984 after the Greenspan Commission noted that SS benefits were funded 50%/50% by employee/employer. Because the employer did not pay federal taxes on their 50%, that shortfall was shifted to the SS Beneficiaries receiving SS payments if their income exceeded certain thresholds. This provision (50% taxable) was agreed upon rather than an "exclusion ratio" which is the approach you reference. In other words, your SS Benefits are not income until such SS Benefits exceed your FICA payroll taxes. It should be noted that any federal income taxes obtained via the 50% tax approach is returned to the SS trust and not directly kept by the U.S. Treasury. So, folks with other income that exceed the thresholds established in 1983 are, in effect, repaying their SS Benefits back to the SS Trust via the federal income tax provisions. So, there are a number of approaches to consider. First, will you and/or your survivor live long enough to exceed the amount of FICA payroll taxes that you and your employer(s) have paid during your working career. Second, you need to adjust the amount of SS Benefits paid to you by the amount you may be required to repay the SS Trust via the federal income tax provision. The time periods will vary from person to person, but generally, most receive their FICA payroll taxes back within 5 to 10 years. Based on income, approximately 50% of the folks are repaying the SS Trust every year via the federal income tax provision. In 1993, the federal income tax was increased from 50% to 85% of SS Benefits taxable. If you elect to do a thorough analysis of your situation, it will require a mathematical approach. If you use a future value approach using the time value of money and a reasonable discount rate of 5%, many never receive their FICA payroll taxes including employer(s) FICA taxes back over their lifetime. This does not include the federal income provisions which may make it even more difficult to recoup.

[TRL1111]

---

@Tonster521 wrote:

At any rate, I suggest that you review the Greenspan Commission's findings from 1981 through 1982. 

---

I'll pass, because it has nothing to do with how the increases in Medicare supplements are affecting people's budgets during retirement.

[CBtoo]

Lots of people take into account sunk costs for many things which makes no sense. Regardless of your sunk costs, if your income level says you get $2000/mo gross when you retire that is the size of the check minus whatever is taken out (for example B, etc.). 

I also (and this is an aside to this thread) the people who decide to take SS at 62 (who don't have to for other reasons) so they are more likely to get everything back they paid into it aren't thinking either. If you don't have other sources of income it would make more sense to wait to get the higher amount at 70 (if you can afford to wait) as you may well need that higher amount later when you can't earn extra income. You may never get back everything you paid in, but having a higher monthly income would certainly be helpful to many.

[kasyy]

however - as in my case - many people (myself included) do not want to wait to full retirement age.  We're tired of working after working 40+ years - taking SS at 62 made lots of sense for me while I worked a small job and kept contributing to the tax "fund".  I am now 78 and it worked for me!  Not trying to say it's best for all - but certainly works out in many cases.  But we saved while working so we had our "IRA nest egg" to help.  I know it can't work for all but it sure worked for us!  JMHO

[CBtoo]

I agree with you. The argument used here for advantage plans is exactly what so many agents will say. They are healthy now. They can't afford the premiums. And then how the heck will they afford the out of pocket? Sure they can use a system (if there is one locally and if it is decent) who won't send you to collection, then sue you and cut off care if you don't pay, but most systems will do that. Also more systems are requiring you to pay your co-pay before they will see you. The Cleveland Clinic system (top hospital system in the country) is doing exactly that (they have sent several emails telling us if we don't pay they will reschedule our appointment).

And when they are not healthy and actually sue their care then they may not be able to switch to a supplement and so will be screwed with huge out of pocket. Of course agents get paid a huge amount more selling advantage plans then supplements + D.  Of course medical underwriting exists precisely so the supplements don't just have only sick people on them (which drives the costs up thus the premiums up). The problems exist for people who make too much to have medicaid with their medicare but not enough to pay high medical bills (typically people 135-400% of the poverty line have the most trouble paying medical bills).

With the added issues of limited networks, often no out of state care and much higher maximum out of pocket for out of network care (if it is even covered) the so called "advantage" plans are really more like disadvantage plans.

[GailL1]

@CBtoo 

The Cleveland Clinic reversed their decision within days after making it - 

Cleveland.com- 05/28/2025 - Cleveland Clinic reverses ‘pay now’ co-pay policy  

[Tonster521]

 @gail1 I wonder if the Hippocratic Oath had anything to do with the reversal. Can you imagine asking your employer to pay you before you perform any work?

[CBtoo]

As I use the Cleveland Clinic I'd I'd imagine it was patient blow back and too many cancelled apts as patients didn't come prepared to do that. That causes income loss. I'd guess they were motivated by income loss.

There, local to me (CC is not local to me), a medical system that requires (or at least tries to require) prepayment of the copay before you are seen. They don't turn you away though if you don't pay but they apply a lot of pressure. All four systems want prepayment but they won't turn you away if you don't. However 3 of the 4 systems will refuse to see you if you never made your prepayment and it is in collection and you don't have a payment plan you are sticking with. 

[CBtoo]

Glad the hear that however they didn't send out an email telling us that - just 2 or so emails telling us they were going to do it. 

[GailL1]

@kasyy  Nope - I am a senior just like others here - that’s the choices we have.  

Original Medicare with or without one of the Medigap plans OR a Medicare Advantage plan which come in all shapes and sizes and which can be changed every year.

Like I said Medicare Advantage plans come in all shapes and sizes - and different star ratings too.  With various total out of pocket cost - 

I do not have a problem paying for some of my own healthcare. Many beneficiaries have spent their whole life working under an employer health insurance plan that worked similar to a Medicare Advantage plan so the concept is not foreign to many Medicare beneficiaries.  They are use to paying co-pays and co-insurance and are use to networks and prior approvals and follow their total out of pocket cost so this type of coverage is not foreign to them.

That’s the reason we have choices - if a beneficiary wants a Medigap plan, get one.  The 1st dollar coverage ones have now been rendered obsolete to new purchases by CMS but there is the next best one - Plan G where one only has to pay the $ 257 (2025) PART B deductible.  So pretty close to 1st dollar coverage still and if you want that type of coverage, your premiums will reflect this.

[MichaelH904998]

What state are you in.  Arizona had a 19.57% increase for us.  I don't see how this can just be the cost of drugs as we don't have the UHC Part D plan.  Those drugs would only be in hospital drugs.  

Further for transparency, my wife had an emergency room visit.  It was about $10,000 gross, written down to $2,500 for Medicare.  AARP thus paid about $500.  We are paying roughly $3800 for the coming year the equivalent of roughly 7.5 ER visits.   I am not sure what to make of this as with increasing premiums won't I still be covering my costs when I am older.  

[GailL1]

@MichaelH904998 wrote  . . . . my wife had an emergency room visit.  It was about $10,000 gross, written down to $2,500 for Medicare.  AARP thus paid about $500.  We are paying roughly $3800 for the coming year the equivalent of roughly 7.5 ER visits.

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

The Medicare negotiated rate with this ER was $ 2500 and they pay 80% of this figure or $ 2000 - leaving you $ 500 to pay either out of pocket or by your Medigap plan.  YourAARP UHC plan paid the $ 500 - so you had NOTHING out of pocket.

Sounds like you have a Plan F or maybe a Plan G and you had already paid the $ 257 Part B deductible (that’s the only different in Plan F and Plan G - the Part B deductible in 2025 is $ 257.00.

Now what if the Medicare approved cost had been more?  Your plan F would have covered it all - maybe even more than your annual premiums.  Now if this happened with millions of seniors in the plan - and the AARP UHC plan paid all the differences - your premiums will go up. 

[MichaelH904998]

Missing the point.  I am wondering if it’s worth it to have a plan.  Describe some people that are really benefits from their Supplemental Plan.  How many Doctor and hospital visits are needed for the insurance to make sense.  I am probably not asking this well but maybe you get my drift.  

[pf75974628]

Each year I do an analysis of my medical care and the cost of it without insurance.  I have been very healthy so even though the premiums were greater than going without insurance, I still liked the results.  With the premiums raising regularly by substantial amounts, it is becoming less attractive to deal with AARP and UHC.  I have more frequent health care visits but the premium is raising even faster.  In another 10 years I will have to go on the dole, priced out of home and comfort for greedy insurance companies.  

[CBtoo]

If you have original medicare but don't have a supplement and don't have an advantage plan then you have unlimited 20% out of pocket. If you stay reasonably healthy your entire life you might come out ahead/be able to afford your copays. BUT if you don't you may fail medical underwriting (unless you live in one of the states that don't do that and you can switch plans once a year without it) and then not be able to get a supplement. Then your only choice would be an advantage plan and those have huge out of pockets. 

Also Medicare A has a pretty big deductible for hospitalizations (too lazy to google it but it is over $1600). Supplements usually pay that too (or part of it depending on the supplement you have). 

I've had several cancers. For one I had 4 rounds of chemo (had to quit it as it was killing my bone marrow, was supposed to have 6 rounds). The insurance negotiated rate was a bit over $178,000 for that chemo. If all I had was B it would have cost me around $35,600 in copys. Um nope. I could only pay that if they accepted Monopoly money. 

[SeanmraganR601889]

Yep.  You never know when the "fall" will occur.  Mine cost 40K Sooo glad I had a supplement!

[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]

---

@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.  

---

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]

---

@CBtoo wrote:

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

---

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]

---

@ClaudiaP763758 wrote:

Coverage is the same with exception of losing Silver Sneakers 

---

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.