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.  

[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.

[kasyy]

thank you for saying it all - I have said that from the get go - these advantage plans are a scheme between those very groups and Insurance companies (who profit the bounty) to scam the seniors of this country .  And they've done their job well - those advantage plans will be the end of  medicare as we know it eventually.  IF they get their way.  Seniors need to be vigilant - because someday they will completely succeed in taking it away.

[GailL1]

@zooeyhall 

Seems like you have covered it all and am very glad that you have the plan that you want and it is within your price point (for now).

The only thing you didn’t cover was why MA plans exist in the 1st place - Because some beneficiaries cannot afford or do not want a Medigap plan and having Original Medicare without some type of supplemental coverage could create a financially catastrophic condition since OG Medicare does not have a maximum out of pocket cost - not annually and not lifetime.  

For many, having a MA plan is not that much different than the plans they have had under their employers with group coverage - network, copays, deductibles, prior authorizations for medical procedures or drugs, step therapy, quantity limits, - all were used in some way under different plans during their working years.

Then there are the Special Needs Plans that are also MA plans - for the disabled, for those who have many chronic conditions, they give extra benefits to help out these beneficiaries who may lack access to things that can and do help their healthiness - giving benefits like transportation to and from appointments, a card to get OTC needed items, even an allotment to help pay their energy bill and getting access to healthy foods.

Yes, not all states make it easy to switch a Medigap plan to one that is less expensive - but when that is available, premiums rise because it add to the risk of the insurer since it bypasses the underwriting.   So do as you might and switch plans to something more reasonably priced, just having the availability of doing it is making the rates go higher.  

Medicare Advantage plans have a place in Medicare, a purpose.  Just like Medigap plans have a purpose.  

However all MA plans are not the same - an HMO is much more restricted than a PPO plan.  Problem is, people don’t chose with scrutiny - sometimes they just look for “cheap” or extra benefits and forget about the actual purpose of the plans - healthcare.  

CMS now seems to be doing a good job in tightening the rules on MA plans - making it easier to get prior authorizations for medical procedures and drugs.  Setting rules on the risk adjustment criteria that MA plans get if their beneficiary is sicker than most - now they have to have the added conditions in their medical file - and audits are done to validate this.

Beneficiaries should pick what is the best plan for themselves - their health and their pocketbook - MA plans give this option.  

[EvanW205162]

Can anybody report on their experiences after switching to a new Insurance company?  How was the claims process?  Were there any coverage issues or claim denials?  I would think that if one would switch with the same plan letter the coverage should be identical - but it would be interesting to hear any actual experiences of those that did switch.

[CBtoo]

If you are talking about advantage plans that will be different than if you have a supplement (eg medigap).

By law supplements pay if medicare pays. So the only time you'd have a problem is if medicare refused to pay. 

Advantage plans have their own rules. They have to cover everything that medicare A and B covers however each company deals with pre-approvals by their own set of rules. That effects denials.

[EvanW205162]

I am talking about supplimental (same as the UHC policy) not Medicare Advantage.  Yes, by law the coverage would be identical but, as you mention, there may be other ways (such as pre-approvals) that would make other companies difficult to deal with.

Of all of the posts in this thread, all that I remember are comments about the pricing and increase in rates.  I don't remember posts pertaining to any decrease in service (even though that may be off topic).  With regards to coverage and claim payment, my experience with UHC has been positive.  I was just wondering if anybody did switch, did they experience an equivalent level of quality - or not.

[TRL1111]

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@EvanW205162 wrote:

I am talking about supplimental (same as the UHC policy) not Medicare Advantage.  Yes, by law the coverage would be identical but, as you mention, there may be other ways (such as pre-approvals) that would make other companies difficult to deal with.

---

Medigap supplements don't have pre-approvals.  They have no say whatsoever in what they cover.  There's pretty much no opportunity for anyone to be unhappy with their Medigap supplement company..  

[CBtoo]

Supplements are not allowed to require pre-approvals regardless of the company that sells them. By law if medicare pays their part (and medicare would control any pre-approvals and take care of that) the supplement has to pay theirs (now whether or not they paid $0 depends on whether or not you have met your deductible with the supplement but your EOB wouldn't say it was denied, rather they paid $0 due to the deductible not being met yet). As a result you don't have to worry about pre-approvals by the supplements. If medicare pays, it is automatically approved to be paid. 

Usually the medical practice first sends your bill to medicare A or B depending on what one was relevant along with including the information about whatever supplement you have.

Then once medicare pays there is an automatic electronic communication/transfer between medicare and the supplement you have. Then the supplement automatically processes your claim for them to pay with no human intervention.

As a result some of the wait for the supplement to pay depends on medicare's processing time and some depends on your health care facility's billing department (and since they want their money likely they won't delay much). 

Decrease in benefits: Supplements might offer extras (eg above and beyond what the law requires) and those extras may decrease or change but the required coverage for the particular alphabet letter assigned to the supplement can't change unless that changes for every supplement offered with that alphabet letter. 

For example UHC offered, at one point in time, silver sneakers. Then they changed from that program to a gym membership of their own making. But the gym offering on that supplement was an "extra" so they could change that or even get rid of it if they wanted to. The law doesn't require gym membership to be offered. 

[BruceW844572]

Look up what the CEO makes per year, then tell me why they need to increase our premiums, while AARP is asking for donations to help seniors.  

[blazingsword]

Mine went up by $50.00 per month starting June 2026; and my total will be $468.00 per month as of that time. Highway robbery if you ask me.

[GailL1]

@blazingsword 

Then change to another insurer or change plans - ALL Medigap policies cover the same things in the same way - insurers just have different beneficiaries enrolled in these plans so their pricing is gonna be different since pricing of Medigap plans is based on

• the initial rating method - All AARP/UHC Medigap plans are community rated
• Usage
• Risk
• Inflation

so just switch to another insurer or another plan that AARP/UHC offers where you live if you can find one that is cheaper and suits your needs.  ALL of them are increasing this year no matter the insurer.  

Why do you think this is highway robbery? Insurance is a shared cost - especially health insurance - I pay for you and you pay for me- so if your state is passing laws to increase the risk on the insurers, they will be passing this along this cost.  Maybe your plan has a lot of really sick people in it - maybe they are all needing a hip or knee replacement or they all came down with some type of cancer and need expensive treatment.  

Exactly how do your think insurance works - especially Medigap plans?  

You pay for me and I pay for you -

Medigap insurers also have to keep a reserve fund just in case they are hit with a lot of claims all at once - states tell them how much and make sure that it is funded.

Your state also approves all the rate increases by insurers of all types - health, auto, homeowners, life, long term care -

Yes, it is true that Medigap insurance is more profitable for the insurers than other types of coverage like a Medicare Advantage plan or even employer or individual health plans.  But that is because it really is not health insurance.  Medicare Supplemental plans are GAP insurance that protects you financially in case you have a catastrophic health event while insured by Original Medicare since Original Medicare has NO limit on your part of the cost.  So with this in mind, Medigap insurers have limited administrative cost since they make no health care decision, they don’t have to construct and manage networks of providers, they don’t ever have to set the prices for care - Original Medicare does ALL of that - the only thing a GAP insurer has to do is pay what Medicare does not pay based on the plan that you have chosen.

They all work the same way based on the plan you pick - so if you don’t like the one you have now because you think it is robbing you  blind - pick another one and switch.  Depending on your state, the switch could be easy or you may have to go thru underwriting to switch but you could at least explore your options for a better deal if that is what you are looking for -

[MargaretS512549]

Some people cannot simply change carriers because they have preexisting conditions. Why should you be locked in and then just have to swallow 30-40% rate increases? We should all be allowed to shop around.

[GailL1]

@MargaretS512549 

I tried to explain this to you in my reply to your other post on this same thread - 

Why not try underwriting if that is what you have to do in your state to change Medigap plans or Medigap insurer.  You might be surprised that your preexisting isn’t something that would preclude you from doing the change - that is up to the insurer to determine how much risk they will accept in the plan you are want to switch to - but they may charge you more than what others who picked the plan initially are paying.  

Talk to a local Medicare plan broker - if they have been in business for a long time, they know their insurers and they can give a pretty good guess based on your medical history as to your chances of passing underwriting.

But if you are still contemplating a switch of plans - you may be facing the exact same thing in a couple of years with Plan N - cause that is where many who are switching from Plan G are going >>> to Plan N.  So premiums are gonna rise.

It would make much more sense to go to the High Deductible Plan G cause once you meet the deductible (2026 = $ 2950) it works exactly like a regular Plan G for the rest of the year.  Course many people never meet the deductible cause what goes into it just doesn’t add up based on their current medical issues - 

The deductible for PLan HD-G is the 20% you pay for your out of pocket Part B claims, the Part B deductible ($283 = 2026) - any Part A cost which you end up paying -   

The premiums for the Plan HD-G are very low - in most states less than $100 a month and actually closer to $ 50 - $75 a month.  The deductible for Plan HD-G rises when there is a COLA increase and by the same %.  

Medigap plan premiums are gonna keep rising until medical inflation is brought under control - I don’t see that happening anytime soon.  Everybody wants to make a good salary and have good benefits from health aides to surgeons.  We are gonna continue to have medical advancements and these are expensive in the beginning and may stay expensive depending on what it is - so I do not see medical cost ever moderating.  That is just my own opinion but an opinion that has a lot of years behind it.  

[CBtoo]

To add to your answer - one of the problems people are having now is how errors in Electronic Records spread like wildfire across doctors and are incredible time consuming to fix. 

To give you an example: I had kidney stones where things got blocked on one side and urine started backing up. As a result a kidney function test showed acute kidney injury (which is usually temporary, which it was in my case was). But, because the doctor who admitted me to the hospital had listed that particular kidney function and no one wrote in the medical record that it converted to normal after the stones passed I am STILL having to get that removed from doctor notes.

Copy/paste is a bad thing (well and it got put into the list of medical conditions behind a fire all we can't see in EPIC/mychart). I thought I had finally gotten that cleaned up and then my last doctor visit for something else it was back. And listed in a way it got coded for in that doctor's visit. Sigh.

It's like playing wack-a-mole. I can't pass medical underwriting until that is fixed. I'd be stuck in tier two prices which defeats the purpose of switching from the G with the extras (that they call free) to the G without them. Since the G without them is far cheaper these benefits are not free. (this is the AARP/UHC supplement). 

By the way - it is not enough just to get your medical records changed. You have to get the facility to resubmit the bill explaining it was an error. If they don't do that the information the insurance companies have access to will still show the error.

the "look back" is 2-5 years depending on the condition depending on the company and state. Many cancers are 3-5 years, with blood cancers being 5 years. And there are some things where you will fail (which includes taking some meds). Also you won't pass if you have certain tests or surgeries scheduled you have done yet. You have to wait until after the tests until the results are known or being hospitalized in the last 90 days...  And of course there are conditions where you automatically fail - like being on dialysis, being in active cancer treatment...

The list is pretty long and company criteria varies. It takes major work to get the companies to admit to everything on the list and most of the time that list is hidden behind insurance agent fire walls. Also if you fail it may take multiple calls (the agent can't do this for you although if you were on a call and on speaker phone then they can listen in and with your permission comment) to even get told why you failed, which visit dates have the problematic information, It took me 5 calls, each time getting fixed what they told me only to fail because they didn't tell me everything. I finally decided to wait out the 2 years for one thing for it to age out, only to discover there was a new mistake in there (the kidney stone issue mentioned above).

The entire thing is a giant PITA and how electronic medical records can be dangerous with wrong information in there that is so hard to get out of there permanently. For example, I am using one drug off label and people make an assumption that is wrong and without even asking me. Then they put in my records that I have that condition. Now I know to bring it up each and every time) 

In states you have to pass medical underwriting to change from an advantage plan into a supplement (Yes I know this goes beyond what was asked) keeps expensive patients from switching in once they need more medical care as that drives up the costs up since there are a higher percentage of expensive patients in supplements.

Being allowed to switch from one supplement to another one within the same company is a different situation. Most people want to switch "up" (eg lower deductible when they are sick as usually that saves money) and so again you have a higher concentration of more expensive people in some plans which drives those costs up, thus the premium. Then the people who can pass medical underwriting bail to switch to a company that has cheaper premiums, which increases the percent of expensive patients in that plan, rinse and repeat. As a result most companies just have an across the board rule about medical underwriting, 

There is way more to this than what I am posting here and I am not an agent. I had to pry this information out of AARP/UHC over multiple phone calls. And I taught business prior to being retired so I understand finance, etc, and how this kind of stuff works on the financial side of things.

[GailL1]

@CBtoo 

I noticed you said “usually” when you said “As a result a kidney function test showed acute kidney injury (which is usually temporary, which it was in my case was)”  

Time cures any medical records misdiagnosis - they aren’t thinking that this person may want to switch their Medigap plan - that’s not health care.  Your medical records should show everything, for the next provider that may look at it for any added problems.  

Plus insurers have the MIB to check with your permission.  You can always add a statement to it, I believe - but it is kind of like your permanent record - who reads it all?  

CFPB.gov - MIB, Inc. 

Ever looked at your Lexus Nexus report?  Basically the same thing but it shows your driving record and other personal auto info like who else can drive your car in your household or outside of it.

[CBtoo]

Time does not age out things that are wrong that are repeated each year and billed that way each year. You have to take active steps to remove that information. 

For example. I have an incurable but indolent blood cancer. Until I corrected it, even though I was in remission they'd code it as active disease as that mistake kept being carried over. I had to take active steps to correct that so that that wrong billing code from the wrong diagnosis code wasn't included every year. No amount of passing years would have fixed that.

At least with UHC if you challenge what they determined, even if you can prove that is wrong they still want 5 years of your entire medical record at your expense and you can not give them the visit notes you have access to, They need to be the notes that appear in the side of, in this case epic/mychart that patients can't access. Not only that this includes all notes from all doctors you have seen in that 5 year period, all tests, etc. EVERYTHING. This can cost hundreds and hundreds of dollars. 

[GailL1]

@CBtoo 

Not necessarily - your medical record is updated every year.  So if something is not occuring or reoccuring as a result of your health, it is not given much power on the MIB.

Yes, if something like a cancer has the ability to reoccur then it never goes away because of that recurrence propensity.

Challenge all you want but they do have the final word regardless of what you argue.  - Cause they make the rules and get no federal money for this Medigap coverage.

[CBtoo]

And if they update it with mistakes that aren't fixed then the mistakes are still there.There are tons of mistakes in electronic medical records that get carried over from year to year. So if it is a mistake it can carry over each year with updated records until you are dead of old age. And it is a real pain in the butt to get that kind of stuff fixed.

With supplements they are required to pay if medicare pays so challenging UHC is irrelevant. Your wrong medical records are only relevant to the extent you need to pass medical underwriting to get something like long term care insurance, change supplements, whatever.

Mistakes in your medical records are only relevant with advantage plans (which I don't have one of those). And in many cases you can win if you are denied as they often cave when they are challenged. Over half the time people win challenges with advantage plans.Sometimes they have lost in court over certain things they had denied, 

[GailL1]

@CBtoo 

You miss the point - if you do not have any mention of a health conditions that may have been cured (that can be cured) or wrong as the case may be then 5 - 7 - 10 years from now, that condition is not gonna get much power in medical underwriting - it is always what you have been diagnosed with or if it is a possible recurrent disease that it is given power to get you turnded down - but that still does not mean that they cannot uprate your premiums.  

I commend you for trying to get your med records right - I do that every time I go to the doc - I just look over what he put on the treatment sheet and the diagnosis that were listed.  I know what they are - unless a new one pops up - then we have to have all the test results to validate the new diagnosis.  

Medical history is only important when picking a MAPD every year to see if you are one of the beneficiaries that will need extra care and thus you are labeled as higher risk - CMS now says that this has to be documented in the providers files and they are auditing MAPD plans to make sure that they have this documentation for these higher risk beneficiaries. 

[CBtoo]

You are missing the point.

As long as that condition isn't IN your medical record as a current condition it won't be a problem (as you say) BUT WHAT I AM SAYING - and this has personally happened to me when trying to pass medical underwriting WHEN WHAT IS IN YOUR CURRENT RECORD OR IN BILLING CODES FOR CONDITIONS IS WRONG (as there are various databases they check) THEN YOU HAVE A PROBLEM that needs fixed to pass medical underwriting. It doesn't matter what your PCP says if the billing codes for medical conditions are listed by any doctor - not just your PCP is wrong,.

[CBtoo]

And that is how it works in some states. Unfortunately premiums for suppliments is then usually higher a sicker patients switch to them so they don't have network issues and their total cost (premiums and out of pocket) then generally ends up cheaper than being on an advantage plan due to how sky high the maximum out of pocket is on advantage plans.

[TRL1111]

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@CBtoo wrote:

Unfortunately premiums for suppliments is then usually higher a sicker patients switch to them so they don't have network issues and their total cost (premiums and out of pocket) then generally ends up cheaper than being on an advantage plan due to how sky high the maximum out of pocket is on advantage plans.

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If you're responding to @MargaretS512549 , she's not talking about people moving from Advantage to Original Medicare plus a Medigap supplement.  She's talking about switching from one supplement to another, specifically from Plan G to Plan N.  It's unlikely that even in that scenario, sicker people are going to want to do that because of the copays they incur under Plan N.

[MargaretS512549]

"She's talking about switching from one supplement to another, specifically from Plan G to Plan N. It's unlikely that even in that scenario, sicker people are going to want to do that because of the copays they incur under Plan N."                       Which is exactly why i don't understand why a person would have to go through underwriting to switch from Plan G to Plan N with the same insurer. It's not logical.

[GailL1]

@MargaretS512549  @TRL1111 

Of course they would entertain this type of change especially if there is a big enough spread between the premiums since all they are looking at is $ 20 office visit copays and a $ 50 ER visit (if they are not admitted - it is waived if admitted to hospital).  The excess charges are rare, in fact in some states they have even outlawed them by providers.  But even otherwise, people can check to see if the doc accepts assignment because it is only the “non-participating” docs that even charge them.  Beneficiaries can look up the status of the docs they see on the Medicare site to see if they accept assignment.  But even at that the excess charges are only 15% of the Medicare rate - 

So it all goes back to how much they are saving in premium cost - that is where the biggest difference will be - and that is a month.

So say their Plan G new premiums is $378 a month but the Plan N is only $ 208 a month - that’s a savings of $ 170 A MONTH or $ 2040 a year - that’s a pretty good savings even considering the copays and perhaps even a few excess charges. 

A better value for people that can is the HD-G plan - even with the added $ 2950 deductible - it just depends on the premium spread between what they have now and what it will be changing to on the new plan.  

A same [exampled] Plan G that is $ 378 a month could have a much bigger savings with a Plan HD-G 

$ 378 X 12 = $ 4536 a year + $ 283 Part B deductible = $ 4819

Plan HD-G premiums of $ 70 a month X 12 = $ 840 a year and you don’t have to add in the Part B deductible cause that is covered within the high deductible of $ 2950 in 2026.

So $840  + $ 2950 = $ 3790 less $ 4819 = a savings of $ 1029 going from a Plan G to a HD-G.

Plus since many on HD-G are healthier any premium increases are going to be on the low side since many of the beneficiaries are lower risk - so if even if you have higher risk, you still get the benefits of being in a group with healthier folks.