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.  

[k703721s]

In Colorado, my premiums went up 24% as did my husbands! It's not the best plan either, and we, of course pay Part D and Part B separately so it's pretty high. At this rate, we will be priced out at the time of our lives when we need it the most. Aren't there any regulations for United Healthcare? 

[AnneG775142]

 In California you have the legal right to change Medicare supplement plans annually for 60 days starting on your birthday,  WITH NO UNDERWRITING, so you don't have to qualify medically.   I have United Healthcare Supplement Plan G and will be changing to USAA.   This is because of United Healthcare's recent premium increases, and a disturbing story in today's New York Times about United Healthcare's legal bullying of those who call them out.     Finding myself very disappointed with AARP's partnership with United Healthcare.   I trusted AARP which is why I chose UH.

[GailL1]

@AnneG775142 

You might want to read the post I just made in this board on California’s proposed new law on Medicare Supplemental plans.

https://community.aarp.org/t5/Medicare-Insurance/CALIFORNIA-Senate-Bill-SB242-Medicare-Supplemental-... 

[SeanmraganR601889]

The State of CA wants ALL SENIORS ON A MEDICARE ADVANTAGE PLAN!!! It's communism! Those who have money will pay, those who don't must comply!

[TRL1111]

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@SeanmraganR601889 wrote:

The State of CA wants ALL SENIORS ON A MEDICARE ADVANTAGE PLAN!!! It's communism! Those who have money will pay, those who don't must comply!

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I don't think you understand communism.

[AnneG775142]

Got it, many thanks GailL1 - had no idea you are way ahead of me -

[GailL1]

@AnneG775142 

Well IF California SB242 passes, you will know why your Medigap premiums went up $ 40 just for this reason + more for usage or medical inflation.

And I am sure that it is $ 40 for just the current year like 2026 - maybe even more in later years - would just depend on the health of those coming into the Medicare Supplemental marketplace in this special enrollment period without underwriting.  

You can just keep switching your Medigap coverage  to the lowest cost plan - just like everybody else is gonna be doing.  

[wicheesehead]

My premium along with my wife was increased 30% this month. I have been a customer for 10 years, but not any longer. I got same supplemental benefits from another provider at a much lower cost.. Shop around

[GailL1]

@k703721s   The rules for Medigap plan (Medicare Supplemental plans) are all the same at the Federal level.  States have some prerogative about making it easier for people to switch plans or or switch insurers - I do not see that Colorado is such a state but you can: 

• Contact the Colorado State Health Insurance Assistance Program (SHIP) at 888-696-7213 for free, personalized help. .
• The SHIP personnel can explain the details of Medicare, while also giving you specific information about the plans available in your area of Colorado.

Medigap plans are affected by medical inflation and the use of the plan.  All Medigap plans are designed exactly the same way because the design comes from the Federal government but some plans have some extra benefits that may also have some cost in your premiums.  UHC and a few other insurers also offer a declining discount on their plans that begins to add to the premium cost after you have been on it for, I think, three years - 

Some states require their approval before a medigap plan rate increase takes effect.

Medigap coverage is not required but people do get them in order to protect themselves from a medical catastrophic event.  However, the more risk one is able to take on themselves, the less the premiums - A High Deductible Plan G is much less expensive in premium cost that a regular Plan G.  Even though once the deductible is met on the High Deductible Plan G (2025 - $2870), the two plans work identical.

Most all Medigap plans are getting more expensive in premiums irregardless of the insurer - perhaps some more than others - medical inflation, the number of people now using the plans - UHC is THE top insurer of Medigap plans but there are many others who also sell the plans - and like I said the plans are work the same, cover the same things; only the premium price differs.  

I did find this from 2023 that is a publication out of the Boulder County area - it should be the same as the rest of the state - but it is 2023, I could not find a more recent update.

Boulder County.gov - Medicare Supplement Insurance Policies in Colorado September 2023 

If the premiums get too expensive, you can switch but it will probably require underwriting and with perhaps a few months when any preexisting condition may not be covered - read Colorado’s state specific policy on this.

This is exactly why many people chose to go with a real good Medicare Advantage plan because they cannot afford the monthly premiums of a Medigap plan.  

[kasyy]

For the love of god - that last paragraph is amazing!  Are you selling advantage plans??  IF "many people choose to go with a real good Medicare advantage plan because they cannot afford the monthly premiums of a Medigap plan" , then how on earth will they pay the thousands and thousands they will be responsible for a hospital stay.  Do the math whoever wrote that silly little response.  Pushing people  into these scam advantage plans only makes the problem bigger and much worse.   I have done the math.

[MargaretS512549]

My thoughts exactly. Also the MA plans cost us the taxpayers $2.5K more for every person enrolled in MA.

[GailL1]

@MargaretS512549 

Not any more - see my last post - lots of changes since 2024 - checks and balances now seem to be inplace. 

Still has not affect on Medigap plans - geeze how did we get off on Medicare Advantage plans when the discussion is about Medigap plans - completely different situations . 

[pf75974628]

I have done comparisons using my previous health care records.  How many times have I seen a doc or been to a clinic?  Have I had a major illness or surgery?  I look up the copays and deductibles and concluded for my situation that a regular supplement is best.  But I have friends who find that a similar analysis indicates that an Advantage plan is best.  But the proof is in the experience.  One of our major facilities no longer takes some Advantage plans because of their sky high denial rates.  That means that the hospital is footing the bills for people who have insurance but can't pay out of pocket.  The hospitals are forced to refuse such plans.  Overall, it weakens small hospitals in small communities and makes the threat of closure much more possible.  When analyzing plans, ask about their denial rates and decide if your local facilities can survive those denial rates.  I want to keep the local hospital and clinic.   

[zooeyhall]

 I live in a rural area, and many smaller community hospitals in my state do NOT take Medicare Advantage plans.  Precisely for the reasons you mention.

[TRL1111]

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@pf75974628 wrote:

One of our major facilities no longer takes some Advantage plans because of their sky high denial rates.  That means that the hospital is footing the bills for people who have insurance but can't pay out of pocket.  

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Can you explain what you mean by that?  

[GailL1]

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@TRL1111 wrote:

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@pf75974628 wrote:

One of our major facilities no longer takes some Advantage plans because of their sky high denial rates.  That means that the hospital is footing the bills for people who have insurance but can't pay out of pocket.  

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Can you explain what you mean by that?  

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LOL - if what @pf75974628 said was true the facility would be breaking federal law- No facility that accepts Medicare can refuse care based on the ability to pay - The way pf75974628 put it, it would also apply to those who have OG Medicare but pay their part out of pocket - they too might be unable to pay - but in those cases, CMS has a rule as to how any provider or facility can pursue “Bad Debt”. 

@pf75974628 is incorrect - if providers or facilities stop doing business with any particular MA plan it is only because they do inot like what they have negotiated with the MA plan and thus what they are paid by the plan. 

But it may go further than that in many cases - the hospital facility may be contemplating setting up a MA plan of their very own especially if they have successfully bought out many of the surrounding providers.

Personally, when speaking about care denial when it comes to prior approvals - not much of it is actually denied especially if the  provider supplies the necessary info to support the care.  This is currently being enforced with a procedure by CMS - and not just for MA plans - OG Medicare too. 

I believe that we will get to the point where certain treatments are gonna be prior approved by a plan be that plan MA or OG Medicare and we are testing this already in 5-states with some treatments.

[CBtoo]

Gail you said, "No facility that accepts Medicare can refuse care based on the ability to pay - " That is incorrect. They can't refuse EMERGENCY care based on inability or pay or if they don't have insurance or only have out of network insurance, etc. They can refuse other care.

Accepting any form of medicare means that the system is required to have a financial aid program for the uninsured or under insured. HOWEVER that does not mean someone will qualify for it. It depends on the rules of their financial aid program (which can vary - locally for all systems here you can only get financial aid if you have no insurance and are at or below the poverty line for your family size).

Facilities can refuse to be in network with advantage plans. That means if you have one of those "not accepted" medicare advantage plans and choose to be treated there you may well be responsible for the entire amount (depends on whether your particular plan does pay some out of network charges or not, some do and some don't). Further if you don't pay they can sue you for the money and fire you as a patient. When you are fired as a patient you can only go to their ER and not be turned away. You can be refused treatment otherwise.

What you are talking about is original medicare. If a facility accepts original medicare then they can't refuse to treat you. HOWEVER if you don't pay they can do the same thing as already discussed above,

What IS required is that they have a financial aid plan for those who can't pay. Those plans can have income per family size conditions, etc. This doesn't mean that if you can't pay you will qualify for the financial aid plan as that depends on the financial aid plan rules. The only condition is that they have one, not what the details are.

Further if you have no insurance, are out of network, etc. they are allowed to require that you pay X dollars up front before they will treat you and, unless it is an emergency, they can turn you away if you don't do that. 

Often due to the high maximum out of pocket that many advantage plans have, if people need a lot of health care some end up being unable to pay. Those who are, for example, poor enough may have medicare and medicaid (called being dual eligible) and that saves them from huge medical debt. Everyone else who can't afford to pay their share as determined by the plan end up with issues and eventually can be sued and fired as a patient. 

EVEN if someone qualifies for the financial aid plan that does NOT mean care is free or almost free. It just means they will charge you less. If you don't pay you will suffer the same consequences.

There are a few health care systems that will send you to collection and nag you until the statue of limitations runs out (but, for example, MD Anderson Cancer Center, by state law, has no statue of limitations - there may be other systems  that don't too) but not fire you as a patient or sue you. If you know you can't afford your bills you will have using your medicare and don't qualify for their financial aid program OR can't afford what you still have to pay even if they accept your medicare plan, it would be prudent to only use systems that won't sue you or fire you as a patient for not paying.

[GailL1]

@CBtoo 

Not if the ER facility accepts Medicare - If so, they are under the EMATLA and must give ER care to anybody to the extent that they are stabilized.

HHS.OIG.gov - The Emergency Medical Treatment and Labor Act (EMTALA) 

[CBtoo]

See my first paragraph with EMERGENCY care in CAPS - That is precisely and exactly what I said - that they have to give emergency care to anyone regardless of insurance (including medicare) or lack there of, citizenship or not, etc. They can deny care under certain other circumstances - see my post you are replying to. 

[GailL1]

Whoops - Sorry - got an awful headache.  To be clearer, we are talking about Medicare - so a provider or a hospital - inpatient or outpatient - can refuse to see a beneficiary if the beneficiary’s Medicare plan is out of their network.  But if they are a OG Medicare provider that accepts assignment, they cannot refuse to see a beneficiary purely because they think they cannot pay for their part of the cost.  Now a provider can refuse to see them as a patient if they are limiting the number of Medicare patients they are seeing.  But not for their ability to pay - because Medicare does reimburse a certain amount of their bad debt as long as they follow the rules of what they have to do to try to collect.

[CBtoo]

You said, "Now a provider can refuse to see them as a patient if they are limiting the number of Medicare patients they are seeing.  But not for their ability to pay - because Medicare does reimburse a certain amount of their bad debt as long as they follow the rules of what they have to do to try to collect."

That is NOT true for many (but not all) systems once someone has gone to collection for what they still owe after medicare has paid and paid towards the unpaid bills out of that program.

Three of our four local systems - all of whom accept medicare and most, but not all, advantage plans - will sue you and cut off care if you are in collection for more than 3 months.

Your local hospital systems may not do that, but locally they do. They do have to see you even if you have bad debt and been in collection for 3 months after care has been cut off for one month after care is cut off (due to patient abandonment laws) but after that they can deny you care except in the ER. And locally they do do that to people. Lots of people. Even employees (the local systems' rules apply to everyone, not just medicare patients).

It all depends on the system's rules for what they do about patients (including medicare of any flavor) with bad debt that has been unpaid for however long is in their rules.

[pf75974628]

My premium went up by 25% this year.  So I pay part B plus the deductible for a Plan G, I pay for a prescription plan and also pay for a separate dental plan in addition to the Medigap policy.  Managing my health expenses is the most expensive thing in my budget including housing and a car.  I'll soon be priced out of health care except for Part A which I suspect is nearing the chopping block too.  I have friends with conditions they can't get treatment for because their Medicare Advantage plans have denied them.  I don't want an Advantage plan because the advantage goes to the companies denying treatment.  I believe that UHC is determined to move people from Medigap plans to Advantage plans because they want to increase their profits.  At the expense of the nation's retirees.  

[GailL1]

@pf75974628 

If you had to pay for Part A rather than your premiums being paid during your working years, It would be $ 518 a month for 0 - 19 Medicare credits or $ 209 a month for 20 - 39 Medicare Credits.  

Why don’t you switch plans to one that is cheaper in premiums?  Depending on your state and your health, you may of may not have to go thru underwriting.  You can switch anytime so you could at least do some research with either your state’s SHIP office or with an independent Medicare Insurance Broker that represents a lot of different insurers for a MEDIGAP plan.

The High Deductible Plan G has a (2025) deductible of $ 2870 - that will be made up of everything you pay for Medicare except your Part B premiums - but once that has been reached, the rest of the year it works just like your Plan G.

The High Deductible would be the sum of the Part B Deductible, any of the 20% the Medicare does not pay for Part B claims, IF applicable the Part A deductible or charges - ANYTHING that you pay for your Medicare claims up to the deductible amount of (2025) $ 2870 - then after that, for the rest of the year, it works just like your Plan G now.  

So you would always be limited to the High Deductible Plan G amount every year - many of the people I know that have it have NEVER reached this HD amount. They just pay whatever they use but just never reach the HD amount plus as a trade-off their premiums for the High Deductible Plan G are very cheap per month - like less than $ 60 - $ 70 a month or lower - I cannot be specific cause this is insurer and state specific so you would have to check in your state and do the math based on your health and claims.

There are many other Medigap plans to choose from - every insurer may not carry some of them - in fact, I know in some states AARP-UHC does not offer the HD_G plan.  

Medicare.gov - Compare Medigap Plan Benefits 

Rule of thumb - the more risk you are willing to take for your health, the lower your premiums.  If you want 1st dollar coverage  for everything except the Part B deductible like you have now - then that is what you are now paying for - 

Yes, they will all increase in premiums through the years but some not as much as others.  Up to you where and when you want to spend those medical bucks.  

[TRL1111]

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@pf75974628 wrote:

I believe that UHC is determined to move people from Medigap plans to Advantage plans because they want to increase their profits.  At the expense of the nation's retirees.  

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If you object to how they operate, then why do business with them?  UHC isn't the only supplement provider out there.  There's no reason for you to continue to line their pockets.

[NorCalMom]

I'm in the same boat. Medigap G went from $118 - $165 - 191$ and I've only been on it since 4/24. My medical is way more expensive now than when I worked. I think retirement is going to go into the history books as a failed American dream. 

[GailL1]

@NorCalMom 

I will ditto what @TRL1111 said - most likely during your working years your employer was covering the lion share of your health insurance premiums.  

I was always self-employed when I worked and premiums were way, way on up there - thousands of dollars a month for me and my husband (both self employed).  

You also have Plan G - the most lucrative Medigap plan sold to current beneficiaries.  Pays everything except the Part B deductible - $ 257 in 2025.  If you want 1st dollar coverage for everything - inpatient and outpatient - then you are paying for that coverage.  Other Medigap plans would be cheaper in premiums but you would have some other expenses.  The more risk you are willing to take for your health, the cheaper your premiums - plus some other companies might also be cheaper for the SAME benefits.

Medicare.gov - Compare Medigap Plan Benefits 

[TRL1111]

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@NorCalMom wrote:

I'm in the same boat. Medigap G went from $118 - $165 - 191$ and I've only been on it since 4/24. My medical is way more expensive now than when I worked. 

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Are you taking into account the amount your employer paid toward your health insurance?  Actually, do you even know what that was?  Most people don't, and it's a shame that people don't realize how much their employer-sponsored plan actually costs.  

Your Medicare is costing you about $375 a month, with a deductible of $257, and no network limitations.  I'd be shocked if you added how much you and your employer paid toward your premium and it totaled less than $400, never mind not having a network, preapproval requirments for procedures, and a deductible that low.

[Tonster521]

@TRL1111 Many folks do not know how much their employers pay for health insurance. Moreover, they do not realize that the cost of health insurance is part of their overall compensation. As you may not know, employer report the average cost of health insurance on an employee's W2. Because I do taxes for a small group of people, I see amounts that can exceed $14,000 per year for Family Coverage. Most of those larger costs are related to Government Plans (i.e., teachers, law enforcement, Federal, State, County, etc.). Moreover, many of the Government employers require little or no contribution. So, the costs, for the most part, are paid by the taxpayers. When very little is deducted from one's paycheck, it leads many folks to believe that health insurance is not a big cost.

With regard to Medicare, I believe your estimate of approximate $375 per month is low. You may be only considering the monthly contributions for Part B, Part D, and Part A, if any. As GaiL1 pointed out, Part A may cost as much as $518 per month for folks with under 20 Medicare credits. This is in addition to the Medicare Part A deductible of $1,676 and co-pays of $419/day for days 61 thru 90. If you need to use Lifetime Reserve Days 91 thru 150, the co-pays are $838/day. Rather than calculate various "what if" scenarios, just use $518 per month for Part A. This is much easier than calculating 1.45% Medicare Tax imposed on your Earnings throughout your career. For example, you earned $2,000,000 over a 40 year career and paid $29,000 in Medicare Part A taxes. Keep in mind, employers would have also paid $29,000 in Medicare Part A taxes for a total of $58,000 over that 40 year career. We only pay on average 25% of Part B Medicare costs or for 2025 in most case $185 per month. The current estimate of Part B for 2025 is $740 per month. The Federal Government covers the other $555 per month (on average). This is a Welfare Benefit provided by the Federal Government. There are additional costs to consider for Part D. However, there are way to many schemes with various costs. So, for this post, I am simply omitting Part D costs since Parts A and B ($518 and $740, respectively) add up to $1,258 which is significant. I have not tried to guess or add deductibles, co-pays, and coinsurance to the above amounts. The bottom line is Medicare costs are pricey. Folks with Medigap Plans need to add the monthly costs for their Plan to the above totals. Folks without Medigap Plan coverage are self insuring and are taking a huge risk that may be expensive than buying a Medigap Plan. Hope this helps.

[TRL1111]

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@Tonster521 wrote:

With regard to Medicare, I believe your estimate of approximate $375 per month is low. You may be only considering the monthly contributions for Part B, Part D, and Part A, if any. 

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I simply added $185 (Part B premium) + $191 (her Plan G supplement premium).

The poster didn't complain about Part D costs, so I didn't address them.

Since she compared her costs under Medicare to what her employer-sponsored plan cost her, I assume she has enough work credits that she's not paying a Part A premium. And I didn't go into Part A copays because she has a supplement that covers that.

The only thing she mentioned was the increasing premium for the supplement, and Medicare plus her supplement is $375/month.

But I'll point out that she previously posted that she has a condition that requires yearly tests, and those cost over $100,000 a year. I think paying $4,500 a year (Part B premium + Plan G supplement plus $257 Part B deductible) is a smoking good deal for $100,000 of expenses, and that's only those tests--if someone is getting tests that cost $100,000 a year, then they probably have other medical expenses, as well.

[Tonster521]

@TRL1111 You missed the cost for Part A which is paid from your earnings while working. Maybe you think it is free, but it is not. In fact, it is expensive for most folks. Part A requires payments of 1.45% from both you and your employer. I used $2 million for a career earnings which is essentially $50 K per year for 40 years. Folks with a mathematical aptitude may be able to adjust the numbers I used to their own unique situation. So, rather than accumulate the Medicare Part A taxes that one pays over a working career and elect to use a time value factor (i.e. 2.5%, 3.0%, or even 0.0%) for each period of time, I suggested to use the current cost for Medicare Part A which is $518 per month for folks with less than 20 medicare credits. It should be abundantly clear that folks who work long periods of time (35 years and more) and pay medicare Part A taxes have a greater cost for Medicare Part A. Many folks have 40 years or more of Medicare Part A tax payments. You need to account for those Medicare tax payments as well as the payments for Part B and a Medigap Plan, if elected. Also, there are folks that pay Income Related Monthly Adjustment Amounts (IRMAA) for Medicare Part B (and Part D). Their amounts are greater than the $185/month Part B premium.