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.  

[rr1026788]

United Healthcare had profits of $14.4 billion in 2024 and $12.1 billion in 2025. Profit was reduced due to restructuring. Why do the customers have to pay for restructuring? Are these profits not enough? My plan increased 23% and I do not think this is justified. After all Medicare only raised their premium 9.7%. I believe AARP should have enough clout with United Healthcare to pressure them for a decrease in the members health insurance costs!

[GailL1]

@rr1026788 

United Healthcare Group is a giant company -

• it serves Medicare with its Medicare Advantage plans (Medicare Part C) and as a supplement to Medicare (Medigap) as well as Medicaid and dual eligible plans - also special needs plans. 
• I believe it participate in marketplace plans for those who need individual health plan coverage - subsidized and not.
• It has a huge presence in employer provided health benefits, including some union plans
• It also has Optum, Optum Health, Insight, and Rx divisions
• It also operates some divisions in Canada

It is in some highly regulated health fields - like Medicare and the ACA where it has to play by the rules of coverage and payout a certain % (85%) of premiums for care with the remaining 15% going to administration and profit.

FOR ALL MEDIGAP INSURERS:  Premiums for your Medigap plan aren’t set on a whim - they are based on (1) USAGE (2) RISK (3) INFLATION.  Medigap plans are overseen by STATES not the federal government.  YOUR state approves the premium rate increases for Medigap plans.  

So if, as you say, “ My plan increased 23% and I do not think this is justified.  After all Medicare only raised their premium 9.7%. I believe AARP should have enough clout with United Healthcare to pressure them for a decrease in the members health insurance costs!”   Perhaps you should check with your states Dept of Insurance and get an explanation as to why they approved this amount of an increase.  AARP has nothing to do with UHC and their rates - their relationship is based solely on royalties that AARP gets for the use of their branded name - that is the extent of AARP’s clout in the relationship.

 Medicare raises their Part B premiums every year when there is a need since that is partially how Part B is financed (25% from premiums and 75% from the government (taxpayers) money)  but that is assessed on ALL beneficiaries - those with Original Medicare and those with Medicare Advantage plans.  And in some ways, Part B premiums are constrained by the annual COLA , which we get, because of the Social Security Hold Harmless Clause.  Medical inflation is outpacing regular inflation.  So who knows how next year will go in Part B premium assessment.  

Medigap is not really health insurance - it is financial protection insurance for those on Original Medicare to prevent a catastrophic medical event from hitting those on OG Medicare since OG Medicare has no limit on out of pocket cost.  

We have a huge number of seniors on Medicare and those who have OG Medicare and no other means of covering the part that Medicare does not cover have to have a Medigap plan and they are using their benefits big time.  When they use their benefits, their Medigap plan pays it’s part of the cost according to the plan they have picked.  Plan G is the most popular at the present time.  

Every time a state passes a law that expands their guaranteed issue rules for a Medigap plan, it increases the risk that is put on the insurer and the plan.  Thus you are also paying for this good deed of letting people switch plans WITHOUT underwriting or by expanding the plan choices of those who are less than 65 and are on Medicare because of a disability.  

Of course, you can always switch plans or insurers in some cases, by underwriting or by using your state rules on this, if you have that in your state.  

Also UHC is NOT the only Medigap insurer that are raising rates this year. It is pretty much all of them, at least the ones that are the big(er) players.

I suggest you at least try to understand how premium increases happen in the Medigap realm because calling on AARP to do something about it is an act of futility. 

Ask yourself, is my Medigap plan still a good value at the premium rate I am paying?  

Of course, it is, unless you have the money to pay out of pocket - it is not mandated to have a Medigap plan but it sure helps the ole pocketbook if there is a need for healthcare since OG Medicare does not have a maximum out of pocket and your share of the whole COULD go sky high.  The optimum word here is COULD - risk vs reality.

Ask yourself, could I take on part of the risk and pay at least something for my OG Medicare healthcare and perhaps pick another Medigap plan with lower premiums.

Of course, you can, but that decision is up to you, your healthcare needs and your pocketbook.

It isn’t on AARP, it is up to you to decide what is right for you.  Premiums for Medigap plans is not gonna go down.  Medical science is marching on - new treatments, expensive treatments are being approved and added everyday - treatments and monitoring of Alzheimers patients, chemotherapy for cancer victims, to name but just a couple - all these things drive up medical cost -  and when OG Medicare pays, your Medigap plan pays based on the plan you chose.   And that is what insurance is - a plan for your to pay for me and me pay for you.  Everytime I use it, you pay and vice versa.  

[TRL1111]

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@rr1026788 wrote:

My plan increased 23% and I do not think this is justified. 

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Premiums are based on the amount of claims that the plan has to cover.  How much did claims go up for your plan last year?

[jo85336578]

After learning that my 2027 premium on my AARP United Healthcare Plan G will rise 35% in January 2027, I am asking how do I make an informed / intelligent decision of which insurance company to move to?? (I know I can consult Medicare dot gov but that site only shows current (2026) premium rates and nothing about historical rates of increase, etc. I'm ready to move away from AARP / UHC!!

[GailL1]

@jo85336578 

1st are you on Medicare because of your age (over 65) or a disability (under 65)?  That makes a difference in what you can and cannot do in some states.

Next:  what state are you within ?  That is the place to start to find out what the rules for switching plans are in your home state.  Are you going to have to go thru underwriting or is there a “birthday rule” or in a few states continuous enrollment.

You can talk to a SHIP agent in your state - (State Health Insurance Programs Assistance)  Here is the locator for your state.

SHIPHelp,org  

OR you can talk to a long time, respected, independent Medicare Insurance broker in your area and sit down with them and let them do the info gathering for you - it cost you nothing.  They only get paid if you select a plan with their representation.  Ask friend and relatives who they might use.  OR as the agent that you buy your other insurance products from like homeowners or auto - they too may have a recommendation of a local, independent Medicare Plan in your area,  

It is sometimes difficult to to compare rating history of a particular insurer unless your state legislates that they all do it the same way - either community rated, issue age related or attained age related.  You would need to know this for any new insurer that you are considering - I believe ALL AARP/UHC Medicare Supplemental plans are community rated and are considered a group plan but maybe more than one specific group depending on which subsidiary might have done the underwriting of your policy.

I have always found that this publication from Medicare is a good overall description of Medigap plans even though at the national level the only thing they do is establish the individual plan descriptions on which plans stay open and which ones they are restricting from any further sales like in 2020 when they stopped the sale of Plan F and Plan C to stop first dollar coverage.  In 2010, they stopped any more sales of Plan H, I, J and I think E for the reason that they no longer were applicable with the changes to Medicare in early 2000’s with the advent of Medicare Part D. 

It is just a general knowledge publication but it helps to understand the actual coverage of a Medigap plan.  A Medigap plan is NOT part of the program of Medicare.  It is private insurance that is purchased in combination with Original Medicare - it is medical financial protection insurance to help a beneficiary out if they are struck with some cost catastrophic medical event since OG Medicare does not have a limit on out of pocket cost.  

Whoops forgot the link - here it is:

Medicare.gov - Medicare Supplemental Insurance 

 I will be happy to look up any state info for you on Medigap laws - if you need any help - it is usually found on your state’s dept of insurance website or related government agency site - like some times it is the dept of finance. Just let me know here if I can assist you in at least getting you started with your options.

[cherylrose103]

I don't believe he is talking about leaving Plan G, but looking at other companies with the same Plan G, but with lower premiums.

[jo85336578]

Cheryl,

Yes, initially I was looking at other companies' regular G plan but only one other company had announced the 2027 rates at that point. But I remembered hearing a little about HD-G plans and was now motivated to really become intimately knowledgeable about the plans. I decided that many people can't think beyond "that's such a huge deductible" instead of comparing "Best case" vs. "worst case" annual outcomes. To me, the choice of a HD-G plan became clearer once the difference In monthly premiums (G vs. HD-G) approached $250. That's what one should focus on and not just the deductible, IMO.

[GailL1]

@cherylrose103 

I believe he answered that in his next post to me - Plus it doesn’t matter in most states - same underwriting would be required if just switching plans or just switching insurers.

@jphorenci seems to be considering a Plan HD-G in comparison to the Plan G.  (see his next post to me) That would be a large savings especially in the years where there is no major medical expenses.  Even then it is still a savings over the lifetime.

Problem is when people have to outlay money for healthcare, they forget about the savings that they had accrued by going to he HD-G plan in the 1st place - so maybe a good thing to do is set aside the savings in an account for the 1st year anyway so it will remind one of the savings.  

If one is gonna switch plans whether by underwriting or just because you have the ability to do it every year, (heed your state laws) then if at all possible, maximize the savings don’t just piddle with it cause you will just be constantly chasing the “pie in the sky” IMO.

[jo85336578]

Gail,

For 2027, my current G plan's monthly premiums would be $270 ($3,240 per year) and an annual deductible of $283.

For 2027, I can get a BCBS HD-G plan for $41.25 per month ($495 per year) with an annual deductible of $2,950.

For either one, I would have to pay my Part B monthly premiums.

Therefore it appears that my best case outcome would be $3240 for G and $495 HD- G.

And worst case would be $3523 for G and $3445 for HD-G.

This leaves out the monthly Part B premiums due regardless of which plan I choose.

Summary:  A no-brainer with HD-G the clear winner in both best and worse cases.

Is my analysis correct?

[GailL1]

@jo85336578 - corrected to the proper addressee

Your figures are correct.  Your analysis is correct.

 I have a different view from @TRL1111 - I have never had a problem keeping up with insurance claims - I know how they are paid and just follow them on an Excel spreadsheet.

I also like to save money - And I feel that paying something for my medical care (more than the Part B deductible) is perfectly fine with me.   I am grateful that I can.

I think you will also find that the HD-G will have much lower increases also - most likely a healthier group, and ones that will most likely not head to the doc for every little thing.  That’s IMO, of course.

Pick the plan that is best for you, your health and your pocketbook.

[jo85336578]

Gail,

If I move from my current AARP/UHC "G" plan to a NC BCBS HD-G plan starting info January 2027,  my HD-G for 2027 would cost less than my G plan regardless of my health events.  Regardless of plan choice, the insureds should be sure they will have the liquidity to pay bills regularly.  If the numbers work as they did for me, HD-G will cost less than Plan G no matter what my health is in 2027. And I believe that the support my numbers show for HD-G will only increase over my remaining lifetime because premium increases for G will surpass HD-G. Here's more information about my plans:

Is the wealth / cash flow problem in America forcing seniors to pick Medigap Plan G over HD-G?

Once a senior sees that the total annual cost of Plan HD-G premiums  (around $495) plus the annual deductible (this year $2950) in my case exceeds the annual cost of Plan G's premiums (my actual announced $3270) plus the $283 annual Part B deductible and sees that in either the best case or worst case scenario, the HD-G plan would save the senior money, the only reason I can imagine for not choosing the HD-G plan is the seniior's lack of wealth or cash flow to support the irregular cash flows (but lower expense) of the HD-G plan.

Some have said that they fear being on HD-G in a future that they ima gine will bring higher medical expenses. That is simply illogical because the HD-G pays the same as G once the annual deductible is met. (And the deductibles actually paid are already included in the worst (or best) case scenarios described above.

Some have mentioned perceived fear of not meeting medical underwriting to get back to either G or N. To that I ask, "Why you ever want to return to G or N" after enrolling in HD-G?  In coming years and for the rest of your life, the monthly premiums of either G or N are expected to ilancrease much more than HD-G. 

So it must be a worry that you cannot afford to possible irregular cash flows associated with HD-G. May I suggest that before signing up for HD-G, you establish a separate FDIC-insured savings account to pay for your HD-G monthly premiums ($41 in my case) plus any deductibles that you might have. And if I were to establish a separate savings account to pay for a Plan G (for its monthly premiums of $3270 plus the Part B deductible), I would have to deposit a greater amount. So while the cash flows would be irregular, the cost of Plan G would , in my case for 2027, would be greater than the cost of HD-G.

The figures above the 2027 premiums of a HD-G plan I have found from N.C. BCBS (for NC residents only) and the announced 2027 premiums of $270 for an AARP/UHC Plan G with spousal and new member discounts. I would bet with a high level of certainty that future G premiums will rise faster and more than HD-G premiums. 

[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]

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@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. 

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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]

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@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. 

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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]

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@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. 

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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.  

[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.