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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 541 of 590

It is true that you may not be a guarantee issue after 6 months after applying for Medicare Part B but I believe that underwriting standards are more lenient than you may think. Apply early so that you can have a firm commitment for the other carrier you may select and in this way you won't be without coverage. Most insurers I believe will either accept you or decline you but do not upcharge you for preexixting conditions. Call the other carriers to confirm this.

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 542 of 590

While I will remain with my current program, going to the gym is now out. I will find other ways to try and stay healthy. This move by United Healthcare is not beneficial, in my opinion.

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 543 of 590

If United healthcare drops my Silver Sneakers benefit then I will drop United Healthcare!  

 

Seniors travel.  A gym membership reduction is NOT adequate.

 

My gym activity completely reversed the on set of arthritis in my fingers and shoulders!

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 544 of 590
I totally agree! I use my silver sneakers for a water aerobics class as well as 24 Hour Fitness and it improved my health immensely. I was able to gain strength , ose weight, and in general enjoy life more. I'm really upset they're taking this away from us.
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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 545 of 590

@lh49631149 wrote:

 

UHC Medicare Supplement members who use Silver Sneakers are the ones who take health the most seriously and understand the importance of physical activity for preventative care.  With this abandonment of Silver Sneakers, UHC was hypocritical about how important Silver Sneakers was in the past.  UHC rationale for dropping coverage can only be because it puts more $$ in their pockets. Like many of the worst companies, UHC will only do the minimum required, in this case, only what the government says they have to do (your words in the next to last paragraph)..

UHC will lose their best clients, i.e., those who use Silver Sneakers and likely have fewer health problems and ultimately fewer claims with Medicare and UHC.  Put those numbers in your financial analysis.


A Medicare Supplemental (Medigap) plan is different than a Medicare Advantage plan - although both are offered by private insurance companies. 

 

A Medicare Advantage plan is an option for getting your actual Medicare benefits.  A beneficiary has the choice of getting their Medicare benefits through the traditional (original) program OR through a Medicare Advantage plan.  A Medicare Advantage plan covers everything that traditional (original) Medicare covers just in a different way.  It may also offer extra benefits - these would be the option of the private insurer since these extra benefits aren't legislated to be covered. 

 

A Medicare Supplemental Plan or Medigap policy (they are the same thing) is private health insurance that helps supplement Original Medicare. This means it helps pay some of the health care costs that Original Medicare doesn't cover (like copayments, coinsurance, and deductibles). These are “gaps” in Medicare coverage. ... Then your Medigap policy pays its share.

 

That is pretty much all  a Medigap or Medicare Suuplemental policy is - GAP or Supplemental coverage insurance.  This type of policy ONLY picks up what original Medicare does not pay.

I have no doubt that seniors staying active physically helps their overall health but in this case, it may be helping out original Medicare and the claims paid by both original Medicare and Medigap.  

 

But since this type of activity (Silver Sneakers) is NOT covered by original Medicare as being medically necessary, then this is an extra benefit by a private insurer and they do have the right to design it or re-design it.  And yes, make money off of it if that is the case. 

 

Silver Sneakers is a program by Tivity Health - it is offered to Medicare plans, to employer plans, other group plans - no insurer has to use it specifically.  AARP it seems has joined with Tivity Health to create that flip50 program for people in their age membership (over 50 - which covers more than just Medicare beneficiaries).  UHC has estabilised Optum Fitness, I think it is called.  Other private Medicare insurers which use Silver Sneakers will have their contract with Tivity Health coming up for renewal in the years to come so there may be more decisions to be maide by other seniors then depending upon what the private Medicare insurer decides.   The Humana and Tivity Health contract, I believe, comes up in 2020.

 

Here is the 2017 Guide from The Center for Medicare and Medicaid Services which explains many of the nuances associated with a Medigap or Medicare Supplemental plans - all the rules are listed here as to what is guaranteed issue, when guaranteed issue is in play and when it is not. 

CMS - 2017 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare

 

I think people who are considering changing their Medicare Supplemental or Medigap Plan should become familiar with it and understand what could happen if they change plans without a guaranteed issue specification.

 

Changing a Medicare Advantage plan from one to another is no big deal and can be done annually during the open enrollment period starting in mid-October of each year.  However a beneficiary will have to make sure that other prerequisite are met like doctors and other providers being in network or if it includes a Prescription Drug Plan (MA-PD) that medicines needed are on the coverage  formulary, among other things.

 

This is just information - nothing else.

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MY SIGNATURE: "It’s Always something" - Roseanne Rosannadanna
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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 546 of 590

@lh49631149 wrote:

This comment appears to be from an AARP ./ UHC spokesperson reciting the same information we got in the letter.  Identify yourself if that is the case.



@lh49631149

Don't know who you are referring to but if it is me - then I am just a senior - Medicare age - but I do know my Medicare, including the differences in Medigap and Medicare Advantage plans, and all the various peculiarities.

 

Not telling anybody what they should do - only giving information; the decision has to be made by the beneficiary, taking into consideration all the consequences of changing plans and then making the  decision in their best interest.

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MY SIGNATURE: "It’s Always something" - Roseanne Rosannadanna
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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 547 of 590

That is the reason for the change.  UHC is run by MBA's.  There is no analysis for expenses not incurred; claims not made.  This change will affect their client population. Be careful of making a change in your plan.  Many rules on preexisting issues.  You could end up worse off.  

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 548 of 590

UHC will lose their best clients, i.e., those who use Silver Sneakers and likely have fewer health problems and ultimately fewer claims with Medicare and UHC.  Put those numbers in your financial analysis.

GREAT COMMENT!

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 549 of 590

This comment appears to be from an AARP ./ UHC spokesperson reciting the same information we got in the letter.  Identify yourself if that is the case.

UHC Medicare Supplement members who use Silver Sneakers are the ones who take health the most seriously and understand the importance of physical activity for preventative care.  With this abandonment of Silver Sneakers, UHC was hypocritical about how important Silver Sneakers was in the past.  UHC rationale for dropping coverage can only be because it puts more $$ in their pockets. Like many of the worst companies, UHC will only do the minimum required, in this case, only what the government says they have to do (your words in the next to last paragraph)..

UHC will lose their best clients, i.e., those who use Silver Sneakers and likely have fewer health problems and ultimately fewer claims with Medicare and UHC.  Put those numbers in your financial analysis.

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 550 of 590

@johnamymc wrote:

Seniors: 

So Silver Sneakers is being eliminated- wow! Subtle change to Medigap plans. Hope you see it as it is- somewhere government funding has been cut. Sooooo logical place to cut- programs that only some Seniors use. Please vote in November- #Sneaky Paul Ryan!


Medicare, Medigap nor the government has anything to do with Silver Sneakers.

It was an EXTRA benefit added on by UHC to entice beneficiaries to pick their plan.

 

They still have a health and wellness plan - not Silver Sneakers and it comes with only a discount to participating gyms.

 

Same thing with AARP - they are developing a plan called Flip50 with Trivity Health, the parent company of Silver Sneakers.  Again. It is not free but a discount off the normal rate of $44 a month.  It covers the demographics of AARP - meaning the over 50 crowd.  It also covers more - health, wellness, nutrition - I made a separate thread about it if you want to check out the links which I provided.

 

Again, I am cautioning those talking about changing Medigap (Medicare supplemental ) plans to just make sure that you don't get involved in medical underwriting or pre-existing condition time limit exclusions or much higher premiums depending upon how the Medigap insurer determines their premiums.

 

Just don't cancel your current Medigap (Medicare supplemental) plan until you know you have a new one at the terms that are acceptable to you. 

 

A couple of good links on canceling or switching Medigap (supplemental) plans

 

https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap/guaranteed-issue-rights

 

https://www.aarp.org/health/medicare-qa-tool/cancel-medigap-can-i-reenroll-at-open-enrollment/

 

 

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MY SIGNATURE: "It’s Always something" - Roseanne Rosannadanna
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