Silver Sneakers being droped by AARP recommended insurer

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 451 of 693

@John85259

 

I really do wish you would read your "Medicare and You" handbook.

 

ALL Medicare Supplemental (Medigap) plans cover the SAME things-

Plan F by insurer A is exactly the same as Plan F by insurer B and the same for all the other insurers.  Same thing with Plan G - it is all the same regardless of the insurer.  The only thing different between them is the premiums each is charging you.

 

A Medigap policy ONLY works with traditional Medicare because it is GAP insurance.

 

If any doctor, or other provider - hospital, clinic, etc. in the WHOLE country takes Medicare assignment and you have a Medigap Plan F - you can see anybody you want as long as they take Medicare assignment - Medicare will pay and your Medigap insurer will pay.

 

In fact, let's say when you turned 65, Medicare age, you were living in Florida - you signed up for Medicare in Florida - you picked your Medigap insurer and Plan F or any of the others.

 

Then you moved to Arizona - you do not have to change anything based on the move except your address for premiums and mail from Medicare.  You can still use traditional Medicare and the Plan F from Florida and it will cover you in Arizona AS LONG AS THE DOCTORS YOU SEE IN ARIZONA ACCEPT MEDICARE ASSIGNMENT - you are good to go, without missing a beat.

 

Traditional Medicare is a national program and your Plan F is your Medicare Supplemental plan - it is your GAP insurance.

 

You can look up any medical provider on the Medicare.gov website and it will tell you if they accept Medicare assignment or you can confirm with the provider.

See anybody that accepts assignment - They could be clear across the country and you would be fine with coverage.

 

This is directly opposite to Medicare Advantage plans.  MA plans are a different way of getting your Medicare benefits - They are more locally oriented in their list of providers who accept their specific plan.  They are sold on a state or even local manner - they are not national because they use networks of providers.

 

i hope I have explained this a bit for you.  Read your Medicare and You booklet.

 

 


* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 452 of 693

Here's some more info for people from Arizona.  I called Blue Cross - Blue Shield and their MediGap coverage includes a fitness plan similar to SilverSneakers that is called "Silver and Fit".  I checked the Silver and Fit website and the health clubs they list for my area are virtually identical to what is offered by SilverSneakers.  Their Plan F prices are pretty much the same or a little less than AARP-United Healthcare.  They have a downloadable PDF file on the BC-BS website that has 2018 prices, but they don't list 2019 prices on their website.  You have to call the phone number on their webpage and talk to a insurance broker to see what they'll be charging in 2019.  The guy I talked to was helpful and gave me the prices I was looking for that cover 2018 and 2019.  Since I'm less than 4 months from my 65th birthday I can change from AARP-United Healthcare to Blue Cross - Blue Shield immediately and not wait until 2019.

 

Since I want to have my healthcare needs addressed by the nearby Mayo Clinic I asked if their Plan F would cover it completely just like my AARP-United Healthcare Plan F does.  I was told that BC-BS Plan F will cover everything.

 

They have 3 prescription drug plans that are probably comperable to what AARP-United Healthcare offers but I can't confirm it 100% without digging through their publication of which drugs they cover and that sort of thing.  I'll look into this a bit more and see if there are any substantial differences.

 

This confirms what was mentioned by someone else earlier in this discussion, that BC-BS offers coverage that is essentially the same (both policy and price) as AARP-United Healthcare with a fitness club plan that is similar or identical to SilverSneakers.

 

It's doubful that the corporate bureaucrats at AARP-United Healthcare were expecting their decision to replace SilverSneakers with something less beneficial to their customers would result in their customers finding something better elsewhere, but that's what's happened.  You don't have to be a genius to know that taking a benefit away from your customers is not a good way to keep those customers coming back in the future.  What were they thinking?  Whoever signed off on this nonsense should be updating his/her resume and looking for a new job because at a competently run company they'd be fired.

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 453 of 693

This explains a lot. They cut out Tivity Silver Sneakers and replaced with their own program.  Thanks. 

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 454 of 693

@MaryL1957

 

You can read the details about the facilities sign up here

https://fitnessadvantage.optum.com/gym-partner

 

Here is their initial marketing brochure to the fitness centers - talks like there is no charge to MA members.


* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 455 of 693

@ls63763447 wrote:

Since you seem to have all the answers, can you tell us how the gyms or fitness centers are reimbursed and by whom?


I will have to give an educated guess here with my reasoning, of course.

 

UHC and other Medicare plan insurers most like have or had a contract with Tivity Health (parent company of Siver Sneakers) for a set dollar amount roughly based on the number of plans where they offered the Silver Sneakers benefit.  Most likely that was by state.

 

Tivity Health came up with the Silver Sneakers program, got the facilities lined up and offered certification for the program.  

 

I 'm not really even sure if the insurers knew how many people used the program or how often because they were just paying Tivity Health to run it and payment was just made on how many plans they had which covered Silver Sneakers.  So the insurers paid Tivity Health.

 

In Nov.2017, when UHC press released their plans to create their own senior health and fitness program and to pull out of the Silver Sneakers program in 11 states, Tivity Health's stock took a dive in the market.  Now I Do not know if this number of states is all the ones where UHC offered the Silver Sneakers program or if that list has now been expanded to include more.

 

Tivity Health has been working hard to get back market share in this area - they announced in August 2018 that they were working with AARP on a program called Flip50 which would be offered to all AARP members.  Since the AARP membership covers 50 and over, it is a little different than only covering the Medicare crowd of 65 and over.  I have not seen anything from AARP on this specific program, by name, yet.  

 

I guess all of you read the health and fitness articles, suggestions which AARP publishes and can see any benefits listed on the benefits page.  I read them but personally, I am not a member of AARP - there are few benefits of membership which I see that I would use at my current life stage - maybe later.  I am a senior of Medicare age, I am in the traditional program but do not use a MediGap policy.

 

I just try to keep up on anything Medicare or Social Security related and also anything in health care administratively or treatment wise.  I have background from there but now it is just more about interest - fascination mostly about how government can get so complicated when administering it yet the beneficiaries stay in the dark with the details.  Details of such that can trip you up with consequences.  

 

 

 


* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 456 of 693
Gail, they certainly do know which ones because Optum went to all the rec centers in my area...some said yes, some said no to them. So now they want me to go an try to get them to get into the plan. I am retired and not going to do that.

And certainly Optum knows all the ones that had Silver Sneakers. Yes it is about choices and I am choosing to look at other coverage this year. If it is better premiums, has silver sneakers and has my doctors and meds then I will choose to change. Looks like many others are planning on reviewing their choices.

And yes these Fitness plans can be gone at anytime but right now they are not so I am going to select the plan that meets my needs.
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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 457 of 693

Since you seem to have all the answers, can you tell us how the gyms or fitness centers are reimbursed and by whom?

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 458 of 693

@MaryL1957

UHC doesn't know what fitness centers people use - that is the only reason they want you to give them the name of it or ask them to participate.

 

I don't know if it will even make it - Optum Fitness Advantage or Renew whatever they want to call it.  Either it is gonna make it or it won't.  AARP doesn't really have much to do with it.  They just get money for the brand.

 

The major thing comes down to this

- if you get your Medicare benefits via a Medicare Advantage plan -'change it to the one you want/need EVERY YEAR during annual open enrollment.

 

- if you get your Medicare benefits via the traditional Medicare program and you opt for a Medicare Supplemental (MediGAP) plan, any health and fitness program or any other extra benefits are only marketing schemes and can be gone at anytime.  MediGAP coverage is NOT insurance - it is GAP coverage.

 

MediGAP coverage is a personal option - without it you still get the same Medicare benefit as anybody else in the traditional program.

 

Others like Medicare Advantage because they know what they have to pay and there is an out of pocket maximum per year which is not the case in traditional Medicare.

 

it is ALL about choices.

 


* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 459 of 693

@John85259

I don't know why this is so hard to understand -

 

It has nothing to do with being fair - it has to do with what you are buying

 

Medigap is ONLY GAP insurance - it is only available to those in traditional Medicare and By law, rules and regs ONLY covers what Medicare does not pay based on the Medigap plan which a beneficiary chooses.

IT IS NOT A SENIOR HEALTH INSURANCE PROGRAM - it is PRIVATE Senior GAP Insurance.  

 

Not every beneficiary in traditional Medicare even buys one.  It is the beneficiary's choice to buy one.

 

If you want a senior health and fitness program  to be something more than just a marketing gimmick for Medigap insurers, then start by getting Medicare to cover it as medically necessary - good luck with that.

 

Medicare Advantage plans are just another way to get your WHOLE Medicare benefit.  Medicare Advantage plans can include extra coverage because they are on the hook for their clients.  They have a business model that help them if they can get and keep you healthier since CMS is only paying them so much per person + a bit more if they are sicker.

 

in 2019, CMS opened up the door for them to use other health benefits to keep these beneficiaries healthier.  Have you not seen my numerous post  and related links on this.  

 

There is a HUGE difference in a Medicare Supplemental (MediGAP) plan

and a Medicare Advantage plan - different as night and day.

 

 


* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 460 of 693

Keep supporting your company’s position to drop the plan. We still do not have to like it or keep uhc. Blue cross anthem offers lower premiums AND silver sneakers.  I am switching so good bye aarp AND uhc

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