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.  

[CBtoo]

In my state G costs less than HD-G if you reach the max out of pocket  (which I would due to health issues). What goes on is state specific.

Whether or not you can switch without medical underwriting is state specific (yes I know you said you'd pass). 

Looking at which companies don't all of a sudden accelerate increases more than other companies (and in the last 3 years increases for almost all companies for supps have been higher than in the past) matters as you don't want to get potentially trapped in a plan that starts our low and then dramatically increases prices as you reach a certain age. If you then don't pass underwriting (if your state requires it you are up a creek),

[jo85336578]

CBtwo, I don't expect to see gynormous premium increases in HD-G and hope to stay away from G plans and their huge increases forever. I want to switch to my HD-G while I can still pass medical underwriting. Remember, my current numbers show that even under "worst case scenario (an infinite number of both Part A hospital stays as well as an infinite number of Part B provider visits),"  my HD-G plan would cost less than G. 

[jo85336578]

Gail,

I appreciate your analysis of my comparison of my Plan G premium for 2027 vs. BCBS's HD-G premium. Somehow you directed your answer not to me but jphorencl. 

And my G plan is with AARP/UHC. The point I was making is that assuming that I pass medical underwriting for NC BCBS's HD-G plan and ever want to switch from the BCBS HD-G plan into a regular G plan, NC BCBS will welcome me into another of their medigap plans without medical underwriting. That sounds like a valuable safety net if my health were to go south. btw,  the NC BCBS plan I'm discussing is only available to legal residents of North Carolina. (Everyone should do their own research before taking action.)

[GailL1]

@jphorenci 

I apologize to both you and @jphorenci for getting the addressee wrong - I corrected it.  The only excuse I have and which, it seems,  I am using it more and more everyday - I AM OLD !  So Please forgive me 🤓  

Still sounds to me like you should try and see what NC-BCBS says - you aren’t gonna get the same consideration from AARP/UHC unless your state legislates it. 

A really good broker (BCBS - NC affiliated) might be able to tell you pre-underwriting of your chances; at least a good guess based on their experience.  

I use to have a list from a broker I knew of the conditions that are a complete “NO-WAY” and other that were “WELL, MAYBE”  But right now, I have no idea where I filed it, if I did, in my document folder.  

This seems like a good deal from the NC - BCBS even with underwriting.  Protect themselves but still offer some consumer protections within their client based.  

Good Luck

[TRL1111]

It's a clear financial winner.  High-deductible G is becoming a clear winner for a lot of people.

For me, though, I despise managing medical bills, so I'm going to lean to the side of Plan G over a high-deductible G.  But with numbers like yours, I would be very tempted to put up with dealing with the bills.  In fact, my numbers are approaching yours but for the time being, I can afford my regular Plan G without any disruption to my lifestyle, so I'm going to stick with it, and consider the extra premium I'm paying for my regular Plan G to be an investment in my mental health.  I really hate dealing with medical bills.

And actually, I almost never go to the doctor, so I'm an ideal candidate for a high-deductible plan.  But I've been helping a friend who had a stroke and I've gotten a glimpse at the healthcare industrial complex, and I'll just say that I'm really glad he has a Plan F because I have to deal with only the occasional Medicare denial, and looking out for fraud.  But if Medicare covers something and it looks like it's legit, I don't have to think about it again. 

Plus the Renew Active gym benefit with my AARP/UHC Medigap supplement is working really well for how I want to use gyms, and AARP/UHC doesn't offer a high-deductible supplement in my area, so I'd have to give that up.  I might could find a high-deductible Plan G with a different gym benefit, but Renew Active's network is a little better for me than Silver Sneakers.  That's obviously a highly individual factor.

Further muddying the waters is that I was on an ACA plan prior to Medicare, and what I have now, even paying for the Plan G supplement, costs about half of what my ACA plan premium was, and Medicare is much better insurance.  So coming from that situation, paying for the Plan G Medigap isn't as painful.

Which shows that even when financial consideration are heavily in favor of one course of action, other individual considerations might also exist.  

[jo85336578]

The NC BCBS HD-G plan I'm considering has Silver Sneakers and the "Blue-to-Blue feature that would allow me, once I pass medical underwriting for the HD-G plan to later switch to any other NC BCBS Medigap (or even MA) plan without medical underwriting. (This NC BCBS plan is only available to legal NC residents.) 

[jo85336578]

I just discovered another benefit of the HDG plan I'm considering:  ("But wait, there's more....!)  My NC BCBS HDG plan that I'm considering for 2027 has a "Blue-to-Blue option that allows someone with any NC BCBS Medigap or MA plan to switch to any NC BCBS Medigap plan without medical underwriting,  with an effective exchange date of either January 1 or June 1:

CAUTION: Before you act on this, please confirm it with the issues: NC BCBS. At this hour, I have not confirmed it with the insurer yet.

What is the Blue to Blue Rule?

Understanding the Blue to Blue rule can help you get the best health insurance in NC for your needs. Blue to Blue allows current Blue Cross and Blue Shield of North Carolina (Blue Cross NC) Medicare Supplement members to switch between plans without medical underwriting, making it easier to adjust your coverage as your needs change.

As a member, you can switch plans at specific times throughout the year without having to answer health questions. This means you can find the best Medicare Supplement plan in NC to suit your budget and health needs. Switching is easy, so it's a good idea to review your options to ensure you're completely satisfied with your coverage.

How the Blue to Blue Rule Works

When You Can Switch:

• May 1 - May 31 for a June 1st effective date

• October 15 - December 31 for a January 1st effective date

• Anytime if you have Guaranteed Issue rights (such as losing other coverage)

Available Plans: Blue Cross NC currently offers Medicare Supplement Plans A, G, High Deductible G, K, and N. Members can switch between these plans during the designated periods.

Special Advantages:

• Entry-age members with prescription drug coverage can switch to drugless equivalent plans while retaining their original entry-age rate

• Current members don't need to re-answer tobacco usage questions when making plan changes

• Members move to their current age rating when switching plans (except entry-age members moving to drugless equivalents)

What the Blue to Blue Rule Covers

The Blue to Blue rule applies to these Blue Cross NC products:

• Blue Medicare Supplement

• Blue Medicare Advantage HMO

• Experience Health HMO

• Blue Medicare Advantage PPO

Important: The Blue-to-Blue rule applies only to core Blue Cross NC medical products. It does not apply to partnership plans with Blue Cross NC.

Benefits of Choosing a Blue Cross NC Medicare Supplement Plan

No Medical Underwriting: You have the freedom to change plans during designated periods without answering health questions or going through underwriting.

Twice-Yearly Flexibility: Members can switch supplement plans two times per year at designated periods, so you're not locked into a plan that no longer meets your needs.

Rate Stability: Blue Cross NC Medicare Supplement plans use standardized rates with annual rate changes on June 1st each year, providing predictable premium adjustments.

Coverage Continuity: Switch between plans without any break in coverage, ensuring you're always protected.

Special Protections: If you need to move from a plan with prescription drug coverage, you can switch to the drugless equivalent while maintaining favorable rates.

Important Considerations

Plan Movements Requiring Underwriting: While most Blue to Blue switches don't require underwriting, moving from pre-2019 plans to 2019 plans does require medical underwriting and answering health questions.

[GailL1]

@jo85336578 

I have heard that this was a possibility in some other states also but I thought it was a kind of special deal at certain times because they also allowed those with coverage under another insurer to come into the BCBS Medigap plan fold without underwriting.  The plan choices were limited to what they could pick as a plan - it was limited to certain plans just like this one.  I never knew that it was an ongoing process in certain states.

Sounds good if it works out - 

BCBS seems to offers some special conditions of Medigap coverage in other states as well - like in Illinois, you can even get a Medigap outside of the IE with BCBS - without underwriting.  

Illinois Dept of Aging - 2026 MEDICARE MEDICARE CHOICES  

from the link page 12

Guaranteed Issue Policies from a Guaranteed Issue Company

For persons aged 65 or older and NOT in their Open Enrollment Period or any Specialb Enrollment Periods there is still an option to get a Supplemental plan. In Illinois, we have one

Medicare Supplement insurer that offers policies to anyone over the age of 65 in ANY health condition, throughout the year at the same premium rate as anyone in the same policy class.

That company is Blue Cross Blue Shield of Illinois (a Guarantee Issue Company in 2026).

NOTE: BC/BS also has some plans with underwriting.

•

If you are under 65 and receive notification of your Medicare Part B eligibility retroactively, your six (6) month Open Enrollment Period starts on the date you receive that notification.

Please note if you are under 65, disabled and on Medicare and did not purchase a Medigap policy during your initial six (6) month open enrollment period, you will be able to purchase

a Medigap policy from Blue Cross/Blue Shield from October 15 to December 7.

end copy paste from the IL booklet link

Sounds like a good consumer oriented company - BSBS - they certainly were when me and my husband had individual plans thru them when we were self employed and he was diagnosed with a terminal disease - could not have asked for a better insurer to be there for us during this time - went over and above what I thought we would be getting.

Let us know what you decide to do - good researching.

[jo85336578]

And to be clear, I would have to pass medical underwriting to get into the NC BCBS HD-G plan. The "Blue-to-Blue" feature would come into play only after I become a NC BCBS insured if I want to switch back to regular plan G and can't pass medical underwriting. Everyone needs a safety net.

You add a lot to this discussion board. Thank you.

[jo85336578]

I just learned that the NC BCBS "Blue-to-Blue" exchange (without medical underwriting) can only happen on two specific starting dates each year, and I believe those dates are June 1 and December 1. An agent went through the medical underwriting questions yesterday and I passed. I did not actually officially apply yet because my G rate is still "just" $200 until 2027. Hopefully, I will still be able to pass med underwriting prior to my start date.

[jo85336578]

TRL1111,

Your point of managing medical bills is well-taken. But having been a CPA before I retired and currently being in excellent health, I will accept that risk. 

But on your point of Silver Sneakers, I failed to mention that my current AARP/UHC G plan does not have Silver Sneakers while (drum roll, please).... My HD-G plan WOULD have Silver Sneakers. 

I appreciate your comment as well as Gail's. Good Health to everyone.

[TRL1111]

---

@jo85336578 wrote:

But on your point of Silver Sneakers, I failed to mention that my current AARP/UHC G plan does not have Silver Sneakers while (drum roll, please).... My HD-G plan WOULD have Silver Sneakers. 

---

Score! 

But actually, AARP/UHC plans don't have Silver Sneakers--they have their own program called Renew Active.  It's kind of holding me hostage because Renew Active has some places I like to go that Silver Sneakers doesn't have.  A big one is Lifetime Fitness, where memberships are hundreds of dollars, and my membership gets me into any of them in the country.  Another is a pilates studio that has reformer classes, which are $31 each, but Renew Active gets me four per month.  Neither of them takes Silver Sneakers.  Then again, I make heavy used of places that are on both Silver Sneakers and Renew Active, like YMCAs and community recreation centers.  So far, it's worth it to me to keep my plan that includes Renew Active, but it's not painless.  Now, that $114 check?  That's causing pain because I like things to be right.  😀

[CBtoo]

Of course the Renew plan isn't free. For me there is about a $90 difference between the AARP/UHC plan G with the Renew, etc, stuff and their G that does not have that. Your premium likely would have been even lower without the Renew and other stuff. 

[TRL1111]

---

@CBtoo wrote:

Of course the Renew plan isn't free. For me there is about a $90 difference between the AARP/UHC plan G with the Renew, etc, stuff and their G that does not have that. Your premium likely would have been even lower without the Renew and other stuff. 

---

I've never said it was free.  And I can't compare the premiums any more because they stopped offering the version that doesn't have the wellness benefits.  But when I signed up a few years ago, they did offer both and the one with wellness extras was like $10 or $15 more than the one without. 

And now the one without wellness extras is a closed book, which most people predict leads to skyrocketing premiums, so people saving that $10 or $15 might end up getting screwed as time goes on, if they can't switch to another Medigap supplement (Texas allows underwriting).

Renew Active paid over $9,000 on my behalf over the course of 2-1/2 years for my pilates classes alone, plus all the other gyms I go to (that have much lower reimbursement rates).  They understandably stopped including those pilates classes, so the amount they're shelling out on my behalf is much lower these days, but I'm still getting a lot more out of it than the "extra" I'm paying for it.

Then again, if I were willing to forgo Renew Active, I could get a cheaper Plan G supplement because AARP/UHC's premium is definitely not among the lowest available to me.  Right now the cheapest Plan G available to me is $70 cheaper than my AARP/UHC Plan G, and I could easily pass underwriting to get it.  But even at $70 a month it's still cheaper than paying for memberships or day passes at the gyms I like to go to.

It's all just part of the decision matrix (leaving aside that I don't think making old people have decision matrices when it comes to getting health insurance is a great idea).

[CBtoo]

Where I lived it was initially $70 when it was introduced in this state a couple of years ago. Now for me it is around $90 (rounded).

[TRL1111]

---

@jo85336578 wrote:

Your point of managing medical bills is well-taken. But having been a CPA before I retired and currently being in excellent health, I will accept that risk. 

---

Heh.  The problem isn't the numbers adding up, but why the numbers are what they are.  I'm a lawyer, for heaven's sake.  I should be able to understand the explanations.

Medicare sent me a check for $114.22, and the accompanying MSN had a footnote that said, "Of the total $114.22 paid on this claim, we are paying you $114.22 because you paid your provider more than your 20 percent coinsurance on Medicare approved services. The remaining $ .00 was paid to the provider."

But I didn't pay my provider ANY coinsurance.  At the first visit, I paid about $200, which went toward my $257 Part B deductible.  Then I paid some money to a lab place, which completed my deductible.  I never paid another penny after that, to anybody.  Why am I getting money back?  Why am I paying less than the Part B deductible, and why is my Medigap supplement paying later claims on my behalf if I haven't paid the full amount of the Part B deductible?

Plus then we have the fact that the Medicare-approved amount was $143.10 but the amount Medicare paid was $114.22.  That has two footnotes:  (1) After your deductible and coinsurance were applied, the amount Medicare paid was reduced due to Federal, State and local rules, and (2) This claim shows a quality reporting program adjustment.

I have no idea what that means.  But I can do arithmetic, and maybe it's a coincidence, but that $114.22 is 80% of the Medicare-approved amount, so it sounds like that's what Medicare is supposed to be paying.  Or, actually, it's 79.8183%.  These are the numbers on the MSN.  On my Medigap EOB, the Medicare-approved amount is $143.10 (same as MSN), but the amount Medicare paid is $114.48, which IS exactly 80%, but doesn't match the MSN's $114.22. 

The Medigap EOB has this at the bottom:  "Comments about your claim.  The Medicare Paid Amount may be different than the Medicare Paid Amount shown on your Medicare Statement.  This was done simply to process your claim."  So it's apparently not unusual for those amounts not to match, but...huh?

This is the sort of thing that drives me insane.  

[GailL1]

@TRL1111 

I cannot answer your question about the $ 114 specifically but what it might be is that you paid the provider BEFORE your Medicare cost were calculated.

NOT all Part B services are paid at the 80% Medicare negotiated rate.  For some services they pay less because they are calculated based on another method of negotiations - 

The CMS.gov - Prospective Payment System is one of them but there are others too.

They are trying to get away from as much Fee for Service as they can especially on some services and other payment models

like this one serves that purpose.  

Also if you are in an Accountable Care Organization - payments to providers are much different.  

The same Part B deductible amount but it is applied to a different (lower) pay model.

[TRL1111]

---

@GailL1 wrote:

I cannot answer your question about the $ 114 specifically but what it might be is that you paid the provider BEFORE your Medicare cost were calculated.

---

I never did that.

I got about 3/4 of the way through showing all the numbers, but deleted it because in trying to match the $114.22 check to claims, I ran into where the MSN and the EOB are different.  $114.22 is the "Amount Medicare Paid" on an MSN, but the EOB from my Medigap plan says the amount Medicare paid was $114.48.  Remember, I cited the comment on the EOB in my previous post:  "The Medicare Paid Amount may be different than the Medicare Paid Amount shown on your Medicare Statement.  This was done simply to process your claims."  Sooooooo......which numbers am I supposed to be using to reconcile the billing???

Yes, it's 26 cents.  But the amount doesn't matter.  The fact that's it's wrong, or at least different for a reason I don't understand, is what matters.  It's arithmetic, FFS!

Which made me mad all over again, which just reinforces my decision that I'm willing to drive myself into poverty if it means I don't have to deal with this nonsense.

Without going into the specific numbers, the bottom line is that people on Plan G start having their 20% coinsurance paid in full by their supplement once they meet their Part B deductible.  In 2025, that was $257.  The MSN shows when I met the $257 deductible, and my Medigap paid all my coinsurance after that, like they're supposed to.

But when Medicare sent me the $114, that meant I paid only $143 for the entire year, and not $257.  That's obviously wrong.

[CBtoo]

Yes the things that make no sense without a clear explanation doesn't help. The other thing that is nuts is that medicare only shows billing codes and not diagnosis codes that led to the billing codes. You have to get that from your provider even though medicare actually has that information in their system. They just refuse to tell you for whatever stupid rule reason. 

I am trying to clean up my medical records  (full of stupidity mistakes) so that I pass medical underwriting and discovered this the hard way. I had to call medical underwriting at AARP/UHC 5 or 6 times to get them to tell me ALL of the visits that were involved, which medical diagnosis code and date of visit so I could get corrected each an every one of them, get the bill from the provider then resubmitted to medicare to get the situation fixe. Then just when I though I had fixed them all another provider screwed up copy/pasting old records, someone then copy/pasted theirs and now I have two more to "refix". 

While having electric records has their advantages, keeping one's medical record accurate is not one of them, Neither is finding out what to fix so you can pass medical underwriting. 

[SereneSeagull]

I can vouch for that, after dealing with parent’s records over the years.  Being proactive on keeping it correct is absolutely exhausting and shouldn’t have to be.  

[GailL1]

@TRL1111 

Yes, Medicare should probably elaborate on the cost of specific things - Medicare does NOT pay 80% of their approved amount on all claim items.  Many of the procedures, treatments have been negotiated further using a method they call their Prospective Payment Systems (PPS).

Then there are their bundled payments which includes like items together instead of paying for each separately.

And there are even other payment methodologies which the beneficiary only gets a footnote of how a service is being paid - 

It did use to be only Part A type things but now it is Part B coverage too - especially Part B medications but not exclusively.

Just figure they know what they are doing and paying - maybe / maybe not.  

[jo85336578]

Roseanne Roseannadanna,

Thank you! Yes, I'm well over 65. I'm 81 and 16 months ago, switched from a large group state retirement MA PPO plan to an "AARP UHC of America" Medigap Plan, initially to plan N and later to plan G (passing medical underwriting for initial enrollment as well as changing to plan G. No, I don't live in a state that offers any special opportunities for plan changes. I've spoken to SHIIP as well as my state's Insurance Commissioner's staff who described the 35% increase in premium as "not unusual." I've spoken to an independent insurance broker but am waiting until more insurers announce their 2027 rates. Yes, I do realize that Medigap plans are not Medicare programs and are only offered by insurance companies that have to show loss ratios from the previous year when applying for rate increases to state insurance Commissioners. I have found that the most knowledgeable SHIIP folks are employees of the state insurance commission, and their most recent advice was "Why don't you take advantage of your State retirement benefit of your State group MA plan?" He agreed that it's a "Cadillac plan" (my words). But I simply don't trust them not to downsize the current passive PPO plan to a HMO narrow network plan if push turns to shove in our state legislature by which time I may not be healthy enough to pass medical underwriting. And by the way, I believe that my current AARP UHC of America" is the one described as closed or whatever, making it more likely to have rising premiums than their other Plan G offered by AARP UHC (without the suffix "of America") that has gym and other "health" benefits that currently costs around $40 more than my G plan but not expected to rise so much in 2027. There are so many nuances in this game that it's hard for someone to figure it out! (And last observation: I've learned that probably 75% of folks on "some Medicare plan" have no clue about whether they're on a Medigap plan or a MA plan. Hopefully they have one or the other!

[GailL1]

@jo85336578 

👍

Sounds like you are on top of the problem or perhaps I should say - “muddled down in it”.

Good Luck - 

[Wagz2023]

 How do we see the other comments on these posts?  I'm interested in what other option there is to AARP United Healthcare.  This increase is insane!

[CBtoo]

If you want to see what is available in your area then go to medicare.gov 

You don't even need to sign in, You fill in the information and it will tell you what plans are in your area. If you are looking at advantage plans add your meds. 

You then should call each company to confirm that the price given on the website is correct. DO NOT when you call give them your social security number. You tell them your age and zip code. Using that they should be able to tell you the price. You will need to tell them if you smoke (look at the questions asked on the medicare site. That is all you need to give them to get an accurate price.

If you give them your social security number some people will sign you up whether or not you want them to. They can't do that without your social.

[GailL1]

@Wagz2023 

What state do you live in because it is your state that governs the rules of when a person can switch plans or insurers or how those under 65 (SSDI) are covered.

It is also YOUR state that approves of the rate increase that Medigap insurers compute that they need based on their Medical Loss Ratio.

[zooeyhall]

I am 71 and have had traditional Medicare with a medigap policy from the beginning.  Back in 2020 (when I turned 65), "Medicare advantage" was all the rage.  Joe Namath and William Shatner constant ads for Advantage plans on MeTV.  Low to no premiums!  Dental, hearing, and visual benefits!  Health club plans!  What could go wrong?  Why would Captain James T. Kirk not be upfront to us?

The main reason I stuck to "traditional" Medicare, was because out here in rural areas, after checking around I found that many doctors and even the local hospital did NOT accept Medicare Advantage.  Plus I discovered that with Advantage plans, you had to be "in-network".  Again---a serious restriction in areas where you don't have a lot of provider choices.

Another red flag was the stories that started popping-up about denials from Advantage providers.  Just like was already well-known from the HMO's that these companies also managed.  

Also I heard from others about how difficult it was to switch back to "traditional" medicare/medigap, once you had an Advantage plan.  Especially if you had health issues.  And if you were outside of the initial one-time only 6 month enrollment period when you turned 65.

So all this made me stick with traditional Medicare and a standard medigap policy.  When I started in 2025, I had a Lumico medigap that cost me $130/month.  It gradually went up, until last year I was paying $250/month.

I spoke to my insurance agent, and he got me on a different provider for $135/month, (Plan G) which I am on now.  I did have to answer questions about any major health issues (like diabetes, etc.).  But since I'm in good health (no pre-existing), it was no problem 

I live in Nebraska, so not sure how all this is affected by Nebraska laws.  But reading things here, I'm glad I stuck with "traditional" Medicare from the beginning.

[jo85336578]

zooeyhall,

Thanks again for giving me the name of American Benefit. What's interesting is that for me (or apparently any male at 81 in my zip code would have a premium of $257 for American Benefit which is actually more than my current 2026 premium of $200. While I'm distressed at my 35% increase for 2027, taking me to $270, I expect American Benefit's premium would be well above AARP UHC's announced 2027 rate of $270. Until we know other insurance companies' 2027 rates will be, it's hard to make a decision to stay or go. I can afford higher rates to stay in the Medigap world but I just hate to be taken advantage of.

[jo85336578]

zooeyhall,

My wife and I are in the same boat. Just got notice of a 35% increase in our AARP/UHC Medigap  Plan G. Please share the name of your new Medigap company. I don't want to go back to Medicare Advantage. Thanks in advance.

[zooeyhall]

It is American Benefit Life Insurance Co.

I was suspicious of the whole idea of "Medicare Advantage" plans from the get-go.  What raised the "red flags" for me. was that it was being promoted by such groups as The Heritage Foundation, The Cato Institute and the U.S. Chamber of Commerce.  If you know anything about conservative think tanks like these, then you know that anything they advocate for is NOT in the interest of seniors.  These groups have long wanted the "privatization" of Medicare (and Social Security if they can).  And hate the very idea of Social Security and Medicare.  They saw Medicare Advantage plans as the perfect opportunity to do a slow "back-door" privatization of Medicare.  Another organization that lobbied heavily for shifting seniors from traditional Medicare to Medicare Advantage was the "Beter Medicare Alliance".  Whose members included some of the biggest private insurance companies (such as UHC and Humana).  According to OpenSecrets.org, the above named groups and organizations spent millions lobbying Congress to implement Medcare Advantage.