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Regular Contributor

Silver Sneakers being droped by AARP recommended insurer

I guess like all who have the "silver sneakers" card will become another worthless trash item.

United Health Care will discontinue your membership starting 1/1/18.

I am glad I went and purchased my own gym since but it is my guess that many others

do not have the money or the room for it like I do.

I had been using mine for treadmill and sauna during the cold times. the rest of the year i was

wlaking locally or golf course walking and swinging.

 

I think AARP might just search out another insurance company....as I might do on my own.....

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Periodic Contributor

But gym memberships should be a preventive measure available to all Medicare Part B participants.  I am 65, and not overweight or obese and do not have additional cardiovascular disease (CVD) risk factors.  I exercise regularly in a gym and eat healthy.  I take these proactive steps to maintain my good health.  Behavioral counseling should also be available to all Medicare Part B participants, as some folks need motivation/help to adopt healthy lifestyles.  Prevention measures are far less expensive than expensive medical procedures and pharmacetical drugs!

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Honored Social Butterfly

@NancyR150749

Our healthcare insurers - including Medicare, Medicaid, CHIP or even the VA Health System does not run by "should be"   a preventive measure available to all Medicare Part B participants.

 

It has to be proven by a scientific method and then the cost of it has to outweigh the cost of not having it and whatever results both ways.  That is what determines best practices for anything.  Healthcare is no different.

 

So then there has to be a change to  MEDICARE - put your fight where it really would count for all beneficiaries - doubt it would make a difference but that is based on the financial problems of Medicare.  I am sure they would love to add it, dental and vision too, if they could afford it - but somebody has to pay - Want your Part B premiums to go up even more than they already do?

 

OR join a Medicare Advantage plan where this sort of extra coverage is part of the overall concept.

 

 

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Regular Contributor

First of all are you an employee of an independent health plan advisory service? If not, you are no more an "expert" on these plans than anyone else on this forum, despite being a "former HR person". I've spoken to several independent health plan advisory services who say if you can afford it, stay on the Medigap plans as the "Advantage" plans that you tout, in the end, have many disadvantages, including cost if you develop a debilitating illness, and not being able to pick your own doctor or hospital among other things. They sound good but are not what they appear to be at first glance. Once you leave Medigap for Advantage you may never be able to return to it if you develop "pre-existing" conditions as you must apply to the Medigap insurer you chose and be found acceptable to them, if you didn't initially sign up with them. The bottom line is we all need to make our own decisions but if Medigap programs can/will offer such benefits as Silver Sneakers we should take advantage of the offer and make our displeasure known if they later chose to remove the benefit. Most people recognize when they are being manipulated for additional profit, which is what this is. We SHOULD make our displeasure and our voices heard. I, for one, have had enough of companies whose only consideration is the bottom line.

Honored Social Butterfly


@goliath wrote:

First of all are you an employee of an independent health plan advisory service? If not, you are no more an "expert" on these plans than anyone else on this forum, despite being a "former HR person".

 

I've spoken to several independent health plan advisory services who say if you can afford it, stay on the Medigap plans as the "Advantage" plans that you tout, in the end, have many disadvantages, including cost if you develop a debilitating illness, and not being able to pick your own doctor or hospital among other things. They sound good but are not what they appear to be at first glance.

 

Once you leave Medigap for Advantage you may never be able to return to it if you develop "pre-existing" conditions as you must apply to the Medigap insurer you chose and be found acceptable to them, if you didn't initially sign up with them. The bottom line is we all need to make our own decisions but if Medigap programs can/will offer such benefits as Silver Sneakers we should take advantage of the offer and make our displeasure known if they later chose to remove the benefit. Most people recognize when they are being manipulated for additional profit, which is what this is. We SHOULD make our displeasure and our voices heard. I, for one, have had enough of companies whose only consideration is the bottom line.


I will respond to your points -

 

If you are speaking to me  - 

I am a senior, yes, retired - my background is in nursing and then as partner in my late husband's business - nothing to do with HR - we did have to buy our health insurance in the individual marketplace and never went without it no matter the cost.

 

The only reason why I am probably slightly more knowledgeable about Medicare is because I help other seniors with it - signing up, picking their way to get their benefits, picking the whatever plan, handling complaints about services, etc.  I explain it to them and they make their decisions - understanding goes a long way in working with the Medicare system.

 

Ok let's compare cost to the beneficiary in traditional Medicare and a Medicare Advantage plan.

1.  Traditional Medicare has NO cap on out of pocket expenses.  A Medicare Advantage plan has an annual limit on out of pocket cost to the beneficiary - that is the reason some people like Medicare Advantage plans.

 

2.  Everybody pays the Part B premium (representing 25% of the cost of the Part B program). So no difference there.

 

3.  Yes, within a MA plan you do have to work within network of providers but since you can change plans every year if need be - it is not too much of a hassle.  However, MA plans are not everywhere - mainly due to the lack of providers within certain geographical areas.  In Traditional Medicare, as long as the doctor or other health provider accepts assignment - then you are assured that Medicare will pay their 80% of the negotiated fee - leaving you to pay the 20% or set amount depending upon the service.

 

4.  So you say, well, I will just buy a Medigap plan to cover my cost of Traditional Medicare.  What is that cost per month?  $100 per month, $200 per month, $300 or more per month - yes, that's right, your premiums will go up,up,up.

 

5.  Compared to a Medicare Advantage plan that may have ZERO monthly premiums or $30 or $40 perhaps even including the Prescription Drug Plan - which a senior has to pay extra for in Traditional Medicare.

 

Medigap coverage is for those WHO CAN AFFORD IT - only about 25% of seniors in Traditional Medicare have a Medigap policy.  Some of the others have Employer Retiree coverage, others who are poor have Medicaid - then others who cannot afford the monthly premium of a Medigap policy have nothing -'they just pay their cost out of pocket and hope some condition does not break them.

Traditional Medicare use to have a fund called "Bad Debt"'which they would use to pay providers for seniors that did not pay their share cof the cost - the deductibles, the 20%, Etc.  Obamacare did away with the "Medicare,Bad Debt" fund.

 

You can go back and forth between Traditional Medicare and a Medicare Advantage plan all you want - there is no rule preventing anyone from moving from one way to get your Medicare benefit to another way of getting it - it is your benefit.

 

You are right, moving back to the Traditinal Medicare program from a Medicare Advantage plan depending upon the timing could prevent you from getting a Medigap plan or at least one that is reasonably priced if they rate you high.

But a Medigap plan isn't always in the financial borders of a beneficiary especially if their income is low but not low enough for Medicaid.

 

Medigap plans are for those seniors who can pay the higher monthly premiums for this beneficial GAP coverage - and that is all that it is - GAP Coverage.

 

When they offer extra programs like Silver Sneakers with no out of pocket cost to the seniors -'where do they get the money to pay the cost of such a program?

Regular Contributor

My apology about formerly being in HR. I read this quote but it was from another member: "I worked in a Fortune 100 HR department for 10 years, from which I retired several years ago.  The execs in that dept were interested in one thing:  cutting insurance costs"  This was not your quote and I do apologize for assigning it to you as you did not say it. I do not wish to knowingly include a falsehood in my posts.

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Hello everyone,

Please remember to post according to the community guidelines, and refrain from insults and inflammatory comments.

Thank you for your cooperation in making the AARP Community a safe and welcoming place for all.
http://community.aarp.org/t5/custom/page/page-id/Guidelines

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GaiL1 - why do you keep accusing people of being discriminatory against those who don't have a Medigap plan? 

 

"If a senior cannot afford the premiums of a Medigap (Medicare Supplemental) plan at all - aren't you being rather discrimatory - this senior gets the benefit because they have a Medigap plan while this other (poorer) cannot afford a plan." 

 

Maybe I missed it, but I don't see anywhere that someone has argued that those without a Medigap plan should not get the Silver Sneakers benefit!  This is simply people who already have the benefit of Silver Sneakers lamenting that they will lose it.  You are creating a false narrative! 

 

While one can certainly explore the whys, wherefores and fairness (or not) of the differences in plans/options/affordability, etc., that is a different issue and belongs on a different topical thread.  It is a worthy debate but you are creating it yourself and I don't see anyone arguing with you about the unfairness of the plan differences.  That's not what this is about despite your attempts to change the subject.

Honored Social Butterfly


@ChristineS148307 wrote:

Maybe I missed it, but I don't see anywhere that someone has argued that those without a Medigap plan should not get the Silver Sneakers benefit!  This is simply people who already have the benefit of Silver Sneakers lamenting that they will lose it.  You are creating a false narrative! 

 

 


That is exactly what you and others are saying when you vie for these extra programs in a Medigap plan.  The place for these extra programs is in a Medicare Advantage Plan - where you can pick and chose the plan that meets your needs and wants - that is the place for these extra benefits.

 

Traditional Medicare provides coverage for a wide array of medical and (Part B) drug benefits, but, with its deductibles, cost-sharing requirements, and lack of an annual out-of-pocket spending limit, many people on Medicare purchase Medigap supplemental insurance to help cover their out-of-pocket costs - That's it - the purpose of this GAP insurance..  When these extra programs are mixed within a Medigap plan, which have very specific plan coverage for the gap, the cost for all seniors having them is escalated under that insurer.  You don't really believe that you get something for nothing, do you?  From a private insurer???

 

Medigap plays a major role in providing supplemental coverage for people in traditional Medicare, particularly among those who do not have an employer-sponsored retiree plan or do not qualify for cost-sharing assistance under Medicaid. Medigap helps beneficiaries budget for out-of-pocket expenses under traditional Medicare. Medigap also limits the financial exposure that beneficiaries would otherwise face due to the absence of an out-of-pocket limit under traditional Medicare.

 

Traditional Medicare should be a place where everybody has the same coverage, paid in the same way, with the same rules about what is covered and what is not - it is a government ran healthcare system - there is no choices within it - it is dictated.  I don't care if people buy a Medigap to cover their own GAP in coverage if they can afford one.  It is these extra benefits being included within the Medigap coverage that I have a problem with - especially when it is billed as "free" - and for which all of you seem to have taken up arms.

 

Some are saying that it is preventive care - well it is not sanctioned preventive care by Medicare.

Some say UHC had no right to cancel it - well on all the paperwork I have seen it plainly states that these benefits can be cancelled at any time - fitness, dental, vision.

 

Federal law requires Medigap plans to be standardized to make it easier for consumers to compare benefits and premiums across plans. Adding these extra programs to some Medigap plans takes away this standardization.

 

Medigap is not subject to the same federal guaranteed issue protections that apply to Medicare Advantage and Part D plans, with an annual open enrollment period. As a result, in most states, medical underwriting is permitted which means that beneficiaries with pre-existing conditions may be denied a Medigap policy due to their health status, except under limited circumstances.

Evidently this isn't happening since so many of those commenting here don't seem to have a problem changing plans without a guaranteed issue circumstance.

 

If you want extra programs within your Medicare benefit - then pick the type that can offter the extra programs - GAP insurance is not the place for extra programs OR change Medicare rules so that it is medically necessary and then EVERY beneficiary can get the same shot at it improving their health with the comraderie that goes along with it.  Then the Medigap insurers would pick up all beneficiaries out of pocket for such a service.

 

 

Newbie

Very upset. Had ins agent in home to change to health ins company that still offers SS. Seems because I'm a cancer survivor (precondition) disqualifies me from changing health insurance or else paying as much as if I built my own pool. Be carefull was shocked to find out I could be refused or forced to pay mega bucks to change. The W wants $40.00 a month is that $480.00 a year? Some gyms @$29.99 a month plus enrollment fees app $100.00 is that 400.00 a year. Thankyou AARP very very much.  Our AARP membership expires in 2024 won't be renewed, our multi vehicles and homes insurance willnot be renewed with The Hartford. Your loyalty to us deserves the same in return.

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I am very sorry to hear of your situation. Our local Recreation Center that now offers Silver Sneaker classes five days a week, is looking at various options to make the classes available to everyone regardless of insurance coverage.  One idea is a low fee per month without having to pay membership fees.  Perhaps a facility in your area will also agree to work with you and others in the same situation on an affordable alternative.

 

Otherwise, have you looked into your local Senior Center?  Our Senior Center membership per year is reasonable ($33 per year) and offers an exercise class once a week.  In addition there is an exercise class with a nurse once a month. They also have many social activities to keep you busy.

 

Our local hospital has free classes for cancer patients and survivors, generally Yoga classes.  Perhaps your hospital has the same.  

 

It is unfortunate that AARP does not seem to be our Advocate in this matter with UHC.  Silence is all we have heard.

Periodic Contributor

I am furious about this. This is a benefit reduction while paying the same price and then more to go to a center. In fact we will have to pay more.  Someone needs to get back to the bargaining table. The letter from uhc was insulting — telling us how much we are valued and we will have......what. Someone on a phone line. A coach.  And some events where we will meet people and be happy.  Really........?

 

Furious Kathy

 

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Periodic Contributor

For anyone furious about this, I strongly recommend that you contact UHC, not AARP. The 'official' reason that UHC dropped SS is that "not enough people used the benefit". In Arizona I know this is untrue as over a half of my gyms members are using SS. 

 

When I spoke to a UHC customer representative, they indicated that they are reporting the complaints to management and are encouraging everyone do so. Whereas I doubt the outcome will change anything, it's the best shot!    

 

 

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Honored Social Butterfly

@kk9436

 

Why don't you complain to MEDICARE

Medicare.gov - Complaint Form

 

Maybe it will affect the insurers "Star Rating" - meaning it will affect their pocketbook.

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Periodic Contributor

SS is not a requirement of Medicare medigap plans. It's just a perk the various insurance companies use to distinguish themselves and lure customers to buy their medigap plan..  I don't think complaining to Medicare will do anything.  If insurers like UTC lose customers because they take away a benefit, then they listen.  

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@NancyR150749 wrote:

SS is not a requirement of Medicare medigap plans. It's just a perk the various insurance companies use to distinguish themselves and lure customers to buy their medigap plan..  I don't think complaining to Medicare will do anything.  If insurers like UTC lose customers because they take away a benefit, then they listen.  


True, the "Star Rating"'system does ONLY affect Medicare Advantage plans but people here are also complaining about the SilverSneakers program being removed from those UHC /AARP plans as well - even though it seems to being replaced by one that is designed by UHC.

 

Medigap or Medicare Supplemental plans are not really Medicare insurance - they are ONLY GAP coverage with specific gap coverage based on what traditional Medicare pays -

 

Any insurance company that is offering any special benefit outside of the traditional Medicare coverage requirements are only offering it as a marketing enticement to get enrollment in their GAP plan and it can go away at anytime.

 

If Silver Sneakers or any of these special things is important to a beneficiary, then all they have to do is switch from traditional Medicare to a Medicare Advantage plan and then EVERY year during open enrollment they can switch to whatever Medicare Advantage plan they want to keep whatever benefits they deem necessary for themselves.

 

Premiums for Medigap (Medicare Supplemental) plans can increase every year based on several things - all under the scrutiny of any particular state.  The way these types of policies are rated as set down by not only traditional Medicare rules but also state specific rules - community-rated, Issue-age rated, Attained age rated.

 

You have the "birthday rule" in CA - other states don't have that rule.  

In fact many seniors in the traditional Medicare program do not have ANY Medigap coverage.  Their income is too much for Medicare / Medicaid or Extra Help but their income is too low for paying a monthly Medigap plan.  

 

Many disabled people on SSDI who have done their 24 month time and are time on Medicare and choose the traditional program do not have access to any Medigap policy until they reach 65 years old.  

 

I just don't understand all the complaints here about a Medigsp policy that is dropping some special option when there was no assurance that it would stay a special offering.  Especially when a senior has other choices - that's what people (anybody) are suppose to do with health insurance - pick the plan that is best for them.  

 

If traditional Medicare is not the best choice for a person's needs - look to a plan that is - in this case, go to a Medicare Advantage plan where it can be changed every year during open enrollment.

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Periodic Contributor

We picked AARP because it included Silver Sneakers which in our community saved us almost $1000 per year in gym memberships. The difficulty now is being unable to change carriers due to preexisting conditions. The selection you make at 65 is important because medical underwriting may make a change difficult to impossible. We have avoided ‘mother may I Medicare’ because we want the choice to pick the best provider not necessarily the one in your Advantage plan.

Regular Contributor

Don't get to bogged down because of pre existing condiitons. The underwriting is much more leniant unless you have had a heart attack, diabetes or cancer to name a few. Go and apply. You may be pleasantly surprised. Good luck!

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Periodic Contributor

We have all of the above for preexisting.

lobbying is a good idea but I doubt any expansion under the current administration. 

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Regular Contributor

Please note that changes can be made to the Advantage plans at any time by the insurance carrier. Silver Sneakers can be withdrawn from Advantage plans in the future just like they currently withdrew it from the Medigap plans. The GREAT disadvantage that I see in the Advantage plans is that they can dictate your network of available physicians and or hospitals and they will in the future after they have converted most people to the Advantage plans. Right now the Advantage plans are offering many benefits that they can change at any time at there discreation.

Regular Contributor

You are missing the point.  First of all, we are not talking about Advantage and Complete plans.  Those plans DO include Silver Sneakers or an accepted version of it.  Silver Sneakers being dropped affects those with Medigap policies.  Everyone does make a choice and I made the choice to pay a monthly premium for AARP UHC Supplemental because it fit my personal needs AND included Silver Sneakers.  I believed the sales pitch that SS was an added value at no extra charge because Senior Health is very important to them. Obviously, the only thing important to them is their bottom line and enormous bonuses.  Kickbacks from Medicare and others to the insurance companies is more for Advantage and Complete plans than for Medigap plans and this is not right.  

 

If this subject annoys you, so be it. 

Periodic Contributor

Well stated - let's hope this puts an end to the endless comments about this subject. Everyone has a choice - make the best one for you and your family.
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Regular Contributor

If you're annoyed by the discussion stop reading it. I have found a lot of useful information in the comments!

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Regular Contributor

Perhaps there are endless comments because a very large number of people feel misled.  I would think the purpose of this forum would be for members to exchange information and opinions.  That is what is happening here.  Many people signed up for the AARP promoted UHC program specifically for the SS benefit.  No one is forcing you to read this, unless you work for one of the organizations and are trying to intimidate the people expressing their thoughts and opinions.  If you are tired of the posts, quit reading them.  Let the people who want to express their views do so.

Periodic Contributor

I just called UHC 800-523-5800 and spoke to a Medicare customer service representative to file a complaint for dropping SS in California.  I encourage others to do the same!

 

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My husband and I will be in our orginal Medicare enrollment  in Jan 2019.  We initially thought we'd go with AARP supplemental Plan G.  But now that we realize it will not include Silver Sneakers, we will investigate Blue Shield of California Plan G instead. I was told by the AARP agent that people in my state, California, were not using Silver Sneakers.  I find that very hard to believe.  All medigap plans should be promoting good health by supporting free gym memberships, not dropping the benefit! 

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Periodic Contributor

Nancy, not sure what you mean when you say Californians are not using Silver Sneakers. Do you think they mean that people aren't utlilizing the benefit and that is why they why they are not continuing to offer it in CA.
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Periodic Contributor

Yes, I was told by the AARP medigap insurance agent that SS was being discontinued in California because UHC determined it wasn't being used by the participants.  Instead, UHC would be offering the participants health counseling.  It doesn't make sense.  It looks like a a good benefit is just being dropped.

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Periodic Contributor

Wow, this is more new information for 2019. There are going to be alot of unhappy people here in California. I thought it was just UHC that was withdrawing from SS. At some point, I hope Silver Sneakers makes a public statement - wonders will never cease!
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Regular Contributor

QUESTION TO THE COMMUNITY: I am definitely dropping my UHC Medigap and not just because of Silver Sneakers (though it's loss started me down this path) but because Anthem has offered my health plan advisory service a guaranteed certificate for it's members who want to switch their 2019 medigap insurance. My HPA has recommended I do so because their plans are considerably cheaper. Anthem is well known in this area and competes with UHC for business. According to my HPA they initially recommended UHC to me because at the time Anthem was more expensive, but apparently Anthem has been revising it's rates over the last few years to be competitive while UHC has been raising theirs. This is an opportunity to change my Medigap provider which rarely, if ever, happens AND they offer Silver Sneakers. 

 

This is also an opportunity to change "letter plans". I am currently on Plan N which is starting to nickel and dime me to death due to now seeing more than just my family doctor. So my question is what plan to pick. My friend, who goes to doctors a lot due to a cancer diagnosis, is on Plan F which is considerably more expensive ($175/mo) but pays for everything including the Part B deductable which is $185 next year. (Apparently the feds have made it illegal for Plans to pay the Part B deductable after 2019 but the people on it will be able to grandfather in.) My HPA recommends Plan G. It's pays everything but the $185. (It's $135/mo.) Then there is Plan N- which I'm on- for $123/mo.and I have $20 co-pays for each doctor visit I make. At age 81 Plan F is $275/mo, Plan G is Close to $208 and Plan N is close to $189/mo. While I can do the basic math, I'm wondering about what folks have found are the pluses and minuses to their Plan over time as their health changes.  For example, at 65 I only paid an additional $40/year in doctor visits, plus the deductible, but this year that same Plan has cost me $360 plus the $183 deductible. While I know I can't predict the future, I will probably not get an opportunity to change plans again, so this is an important choice! What Plans are folks on, would you change to something else if you could and why?

Thanks in advance for your replies!

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Periodic Contributor

After AARP was not able to get an agreement with UHC to continue Silver Sneakers. I looked at other insurance options and decided to enroll with Kaiser. 

It may have been some 25 year old just out of business school who won’t be on Medicare for years that made the suggestion to drop Silver Sneakers. Just showed me that AARP is just looking out at their bottom line. 

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