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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

Outstanding!  I totally agree and I am changing to Humana, which for me, has the lowest rate in my area.  I don't understand why UHC is dropping a benefit, that in the long run, should reduce their expenses in providing us with medical insurance. I guress short term greed is more important than the health and welfare of their customers.

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In Silicon Valley area Blue Shield's Plan F "Plus" costs less than their Plan F, has added benefits ($100 of free contact lenses or a cost-break on spectacles; hearing aid benefit; etc.), and unlike UHC/AARP's 2019 offerings includes Silver Sneakers.  Blue Shield's eligibility questions inquire about health for past 3 years and so are slightly tougher than UHC's, which only inquire past 6 months, but if you're reasonably healthy you will likely qualify.  My BS "F-plus" 2019 premium will be around $17 higher than UHC's Plan F but my gym (24 hour SuperSport -- pool, towels, nice showers, great trainers) costs over $50 per month so even without the added "plus" benefits it would be worth it.  If your Rx's are mostly cheap generics, I recommend Aetna Medicare Rx Select (PDP) S5810-295; the monthly premium is under $20, and most common generics (blood pressure, lipids, HRT, 1st-&-2nd-generation antibiotics, etc.) have either a $0 (zero) or $3 copay.

So, for under $200 per month you get great Plan F-Plus coverage and a good Rx plan!  Note that Kaiser Senior Advantage, whose base premium (includes Part D) is $105 if you opt for their "Plus" (which includes Silver-and-Fit, pretty much same as Silver Sneakers, plus dental, hearing, and eye benefits), but you have $30 copay for each visit to clinician, lab, etc., and they slap on another $250 if you need an outpatient procedure (e.g., cataracts, etc.); plus their pharmacy copays for Tier 1 and 2 will be $5 and $10, and almost nothing is on Tier 1.  So in the end, unless you haven't yet gotten your Shingrix, it's pretty much a wash financially and of course with Kaiser you have to use their doctors -- and if you need Physical Therapy then all I can say is "good luck!"

If you haven't gotten your Shingrix, and you don't mind being in Kaiser for a year, and you're willilng to risk getting a medical problem in the next year that would disqualify you from a Part-B secondary, then you'll be delighted to know that at Kaiser ALL immunizations are FREE -- including Shingrix!

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Regular Contributor

This is all great if you don't have any pre-existing conditions, which I do.  In California, according to the Birthday rule, I can switch plans with no underwriting for 30 days after my birthday.  When my last birthday came along (in August) I got happy birthday wishes from AARP/UHC telling me what a great insurance plan I had but never did they say anything about dropping Silver Sneakers.  So I let that time period go away as I'm happy with my coverage otherwise.  Then, not 1 1/2 month later, I get the notice that they are dropping Silver Sneakers and my premium is going up.  Honestly, I would not drop my insurance coverage for only that reason, but I'm not feeling warm and fuzzy about their lack of transparency with me.  I cannot image that they did not know in August that they were going to drop SS.  Next year, I will definately look at other policies during my birthday month and will do so from now on.  I may not find anything better to suit my particular situation, but "buyer beware".

Honored Social Butterfly

@ChristineS148307

I have a friend who is a Medicare insurance agent in one of the (11) states which were dropped in this last round - his email from them was dated 09/06/2018.  Mind you, UHC has been dropping the Silver Sneakers (Tivity Health) program in Medigap plans by state for several years.  This change (dropping) was just a multi-state change. 

 

For Medicare Advantage plans, they have replaced this benefit with one of their own design.

 

Their exposure, or any other insurer that write Medigap plans, is limited since it is GAP insurance - they don't write the rules - Medicare (CMS) does.  They don't pick any providers - Medicare (CMS) does that in the Traditional program.  Insurers actually have little say at all in Medigap plans - if Medicare approves the charge - they have to pay their part - that is pretty much it.

 

UHC has been called out on many of their routines in Medicare Advantage plans - dropping providers from their networks in the middle of the year.  CMS is also investigating their use of the risk assessment - Medicare pays more to MA insurers who have beneficiaries that are sicker.

 

I am sure that you have read on this forum several complaints about  the calls from UHC wanting to do home visits to check on their beneficiaries - yea, right - they just want to see if they can rate them a little sicker for additional money from Medicare.

 

Then there are all the legal maneuvers between CMS and UHC over money and the practices of each to each other - Think currently there are more than one whistleblower claim.

Reuters 02/13/2018 - U.S. can sue UnitedHealth in $1 billion Medicare case, judge rules

 

Star Tribune 04/14 / 2018 - UnitedHealth pushes back in whistleblower case

 

Star Tribune 09/10/2018 - Judge rules for UnitedHealthcare in Medicare overpayment case

 

I am sure you have read on this forum how many are very dissatisfied with the way their mail order pharmacy, OptumRx, handles their medication orders.

 

It is funny how UHC is so very big but yet has so many complaints in their Medicare insurance part of their business from beneficiaries.  But having the AARP name on many of these plans does help them and their business in the Medicare insurance realm.

 

Other insurers have this going on too - from a laymans point of view - it seems pointless - it should be a fair system to all parties - the government and the insurers - but it gets very complicated working with the government especially a government that needs to save money in a program and insurers that need to make money..  They do want private medicare insurers in the MA plans and the Prescription Drug plans to work down their cost as much as possible.  CMS wants savings from them in addition to the Traditional program. 

 

It is complicated but what isn't when extreme amounts of money is involved.

 

 

It's Always Something . . . . Roseanna Roseannadanna
Regular Contributor

Well said byboth of you!! 

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Regular Contributor

Well said! 

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Periodic Contributor

Well said.
Told AARP to take me off their mailing list for other products ( life insurance ).
I’m going with Blue Shield for Part D.
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Thanks.  I'm asking because in California, the AARP/UHC Plan F is Community Rated, which I believe is an advantage as we get older (I don't know anything about other states).  Now, because Plan F will not be offered after 1/1/2020, I am thinking that since there will not be any more younger people going into that plan, the premiums may go up quicker as we age.  May be time to rethink and look at Plan G when I get to my Birthday month.  In CA, within 30 days of our Birthday, we can choose a different Medigap Plan with the same or lesser benefits without medical underwriting.  I'm not sure if they can rate you differently than others due to those pre-existing conditions though.  I'm assuming that the Plan G is also Community Rated but have not looked into that yet.  Just trying to think way ahead since I can't do anything during this open enrollment period without penalty for pre-existing conditions.  If I've stated anything materially incorrect, I'd appreciate any comments/corrections.

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Regular Contributor

I too live in California and have RA. I got Plan F when I went on Medicare a couple of years ago at 65. I am desperately trying to figure out what I can and can't do! IF I'm reading your comments correctly, I CAN change to Anthem or someone else within 30 days of my birthday without going through underwriting! That means I'd only be stuck with United Healthcare until April. I think you're right that Plan G under United Healthcare will be community rated. The ONLY different is the payment of the $183 deductible. And if the premium cost is more than the $183, you're ahead of the game. I plan to call the CA Insurance Commission as I really don't want to do anything that messes me up and I can't seem to good answers from people!


Regular Contributor

We are in California (San Diego county) and have just wrapped up our review with our agent.  We will be changing to Blue Shield Plan F Extra.  I can change Jan 1 under the birthday rule (I do have a pre-existing condition) and my husband should be able to change at the same time because he doesn't.  We compared it to Plan G and the extra premium will be offset, probably a little more than offset, by the vision care allowance and there is a slight possibility we would take advantage of the hearing aid allowance (though it will probably be difficult to beat Costco).  We basically settled on comparing Blue Shield to Anthem. I have a preference for Silver Sneakers over Silver & Fit for our own needs so that eliminated some other carriers. Anthem had the better pricing for Plan G for our situation.  

 

I don't completely understand the Community Rating and know there is a possibility that 10 years from now, I might look at UHC pricing and think it looks better than whatever Age Attained rated plan we are comparing it too, but once I factor in the gym membership, I think it will look OK.  For now, UHC was going to increase $336 in April and our new insurance that includes Silver Sneakers and Vision Care we will definitely take advantage of will be $318/month for 2019.  Once I I settled on comparing just the 2 carriers, I could review their rates for the same plan at varying ages and wasn't totally scared by what I saw.  

 

If you don't have an agent to help you narrow down the choices and answer your questions, get one.  They are paid by the insurance companies, not you, and represent many companies.  If you are stuck with UHC until you can take advantage of the birthday rule and your birthdate wouldn't let you make the change this December, wait until a few days after December 7 Open Enrollment ends before contacting an agent - they are extremely busy right now with people reviewing their Avantage Plans.  

 

However, this is the time to review your medications and make any change to your Part D Plan.  I changed ours yesterday and will save over $200/year given our current prescriptions, all Tier 1 generics.  

 

Now I will just have to decide if the Denny's discount is worth keeping our AARP membership.  I do enjoy the magazine, but I am pretty mad at them right now so.......

Regular Contributor

I would love to talk with you and get information on your agent! The agent who sold me United Healthcare does NOT offer Anthem or Blue Shield, etc. etc. I really need to understand the "Birthday Rule."
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Periodic Contributor

Dont know anything about the "birthday rule", but my "agent" is Aon which is through my former employer.  I have signed up with Humana plan F which is cheaper than UHC and includes  Silversneakers. You may just want to look at the Humana web site.

Regular Contributor

The "birthday rule" is currently only available in California and Oregon.  Basically, the rule allows Medigap enrollees a 30 day window following their birthday each year when they can switch, without medical underwriting, to another Medigap plan with the same or lesser benefits.  If you live in one of  those states you still have the regular open enrollment period as well, but are subject to the medical underwriting during that period.

 

In New York and Connecticut, Medigap plans are guaranteed issue year-round.

 

 

Regular Contributor

Thanks for some useful information. In Ohio my independent health advisory insurance company is suggesting Plan G over F as well. F will not be available to new applicants starting in 2020. They are saying G is the same as F except for the $183 deductable and is significantly cheaper. (I do wonder once F is gone how much the deductable will be raised...)Some of the You Tube videos are saying the same thing. One of them showed a graph of how F, G, and N go up as we age. F went up something like 9% and G and N went up 3.5%. I seriously don't know why this has to be so complicated! 

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Thank you, that was my video (comparing Plan F, Plan G, and Plan N over the last few years with their rate increases). I'm glad it was helpful. (Link removed due to TOS - no advertising).

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Supplemental is always community rated. AARP UHC begins at a discounted rate but as you pass 75 it really increases. It's will be $249 per month each stating in April 2019. It's currently $230 monthly. 

 

They can also deny you coverage based on health and the enrollment period does not apply to supplemental.  For instance, Humana will not cover my wife on any supplemental plan since she  previously had cancer. I'm 77 and my wife is 76 and we will begin Aetna plan G on 1/1/19 to avoid being charged the Part B deductable this year. The premiums are  considerably less than our AARP U HC. The Aetna plan is not a discounted rate.

 

My insurance agent informed me that plan G is cheaper because people have to pay the Part B deductable and won't go to a doctor everytime they have the sniffles.

 

As I previously stated, we're also changing from a AARP UHC Part D to a AARP UHC Medicare RX Walgreen plan which is $1,400 cheaper annually.

 

Total savings for us is a little more than $3,000 annually. 

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Actually, I don't think your comment that "supplemental is always community rated" is correct.  Maybe in your state it is?  I know that in California most supplemental policies are rated using age at issue or age attained.  AARP/UHC is one of the only companies that offer community rated policies (at least in my community in California).  Everyone should figure that the Part B Deductible will go up every year as well as the basic Medicare premium and the bump that higher-income people have to pay.  It's amazing to me the differnce in premium prices of the same Medigap Plans by geographic location. 

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Periodic Contributor

ps - also planning to discontinue AARP membership.     

valerieb
Contributor

Same here.
Contributor

I think that in Indiana the AARP/UH Plan G is community-rated. Therefore, theoretically, after the 12-year discount period ends (age 77), the premium should no longer increase (except for increses caused by the loss and risk experience of the Plan G community as a whole). This should be an advantage in the long run. Let me know if you disagree.

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I agree with that because the Plan G will continue to take on younger people.  With Plan F being closed to new people, it will mean that the average age of policy holders will continue to rise, therefore the premiums would likely rise faster.

Regular Contributor

I'm curious what others think:  What premium method is better and why?

 

Attained Age

Issue Age

Community Rated

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Honored Social Butterfly

@ChristineS148307

 

I just posted a Consumer Reports article on just this subject

https://community.aarp.org/t5/Medicare-Insurance/HOW-TO-CHOOSE-THE-BEST-MEDIGAP-PLAN-Consumer-Report...

 

and here are some examples from Medicare.gov

Medicare.gov - Cost of Medigap Policies

 

ALL of the plans increase with medical inflation - hard for an individual to have much control there - that's more of a government and industry issue.

 

Also, all states don't dictate that each of these methods have to be used within a state - they may only pick one or two rather than all three for the insurers to use.

 

Personally, I would determine which of these rating methods are available in my state.  

  • Community Rated will probably be the cheapest for the longterm because there would be a constant supply of new enrollees, especially now with the baby boomers coming on board, to help keep premiums lower.
  • Next would be issue-age rated, although it might be more expensive in the beginning, it should be a better value as age creeps up.
  • Last would be Attained age rated because it will creep up as you age - but is probably the cheapest in the beginning.  Over the long term, this is the most expensive because you are hit with not only medical inflation but with an increasing age rated premium.

Then determine what my expected (guess) longevity might be based on familiar traits and my general health and any adverse lifestyle choices.

 

Then pick from the state offerings which method is the most advantageous for you and compare those policies for the best rate.

 

You have to either consult your state Dept of Insurance or ask your Medicare insurance broker or agent which method is being used for different insurers.  I looked up Wisconsin Dept of Insurance - Medigap and they had a  list of each insurer and their rating method -'all attained age.

 

Wisconsin and a couple of other states don't have the same Medigap plans like other states.  No plan F, G, etc. - you buy a basic benefit package and then add whatever other coverage you want with a premium added for theses choices.  So you kind of design your Medigsp policy up to what Medicare approves as Medigap coverage.

 

Could we make it anymore complicate - Ya Think???????  Woman Frustrated

 

 

It's Always Something . . . . Roseanna Roseannadanna
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When I purchased the AARP Plan during my open enrollment period, I relied on two factors, the Silver Seakers program and the ability to change plans without medical underwriting. Recently, and without notice, AARP deleted both factors (requiring medical underwriting on Plan G). I would switch to a different provider too, but because of a surgery earlier this year, I am effectively locked into my current AARP/UH Plan even though it is more than $300 per year more expensive than a couple other Plans that do provide the Silver Sneakers benefit. I feel that I am a victim of a bait and switch strategy. I am sure that I am not alone. Does anyone know of any governmental agency investigating this? Alternatively, if anyone knows that I could switch to Anthem or Cigna without medical underwriting, please let me know.   

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Honored Social Butterfly


@m926465s wrote:

When I purchased the AARP Plan during my open enrollment period, I relied on two factors, the Silver Seakers program and the ability to change plans without medical underwriting. Recently, and without notice, AARP deleted both factors (requiring medical underwriting on Plan G). I would switch to a different provider too, but because of a surgery earlier this year, I am effectively locked into my current AARP/UH Plan even though it is more than $300 per year more expensive than a couple other Plans that do provide the Silver Sneakers benefit. I feel that I am a victim of a bait and switch strategy. I am sure that I am not alone. Does anyone know of any governmental agency investigating this? Alternatively, if anyone knows that I could switch to Anthem or Cigna without medical underwriting, please let me know.   

 Whatever type conditions you wanted would have to be in-writing in your policy to be enforcible.  Check your policy.

 

I am almost 100% sure that ALL (state specific) AARP / UHC Supplemental Plans contain the following language in their policy concerning any extra benefits - Silver Sneakers is an EXTRA benefit .

 

These are additional insured member services apart from the AARP Medicare Supplement Insurance Plan benefits, are not insurance programs, are subject to geographical availability, and may be discontinued at any time.

 

Check your policy

 

The Government (Medicare ) defines the parameters of Medigap (Medicare Supplemental) plans - what's covered within each of the plans and when and what the insurers are allowed to do when certain situations occur with the beneficiary.  Since this is only GAP coverage, it is left up to the insurers as to how it will handle underwriting, within Medicare and state rules.

 

They can determine a pre-existing condition and write a new policy anyway WITH OR WITHOUT non-coverage of this condition for a specified time period or they can refuse to cover you at all - if they do write you, the premiums could be higher.

 

 The ONLY time when they cannot do this is when you are in your INITIAL enrollment period (when you sign up for Part B) - the initial sign up period when blanket guaranteed issue is in place and you are 65 years old at least. 

 

(From the Medicare.gov link below)

Outside open enrollment

If you apply for Medigap coverage after your open enrollment period, there's no guarantee that an insurance company will sell you a Medigap policy if you don’t meet the medical underwriting requirements, unless you're eligible due to one of the situations below.

 

See this link for those conditions which trigger an additional guaranteed issue period:

Medicare.gov - When Can I Buy Medigap?

 

However, if you were just wanting to move your coverage from Plan F to Plan G under the same insurer, it seems that should have been ok because I believe you can change to a plan of LESSER coverage with the same insurer ( abeit there is pretty slight difference in Plan F and G ) without underwriting as long as the initial policy is still in effect.  That is my understanding.

 

 They have a right to cancel a Medigap policy for only two reasons and neither are health related:  

1.  Non-payment of premiums or

2.  For materially leaving out something on the application - like something health related, which borders on fraud.

 

You might want to run this latter particular event past your own state's Dept of Insurance.  But again - what does your policy say?

 

 

It's Always Something . . . . Roseanna Roseannadanna
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It is best to contact an agent. I am able to switch to Cigna Total Choice Supplemental without underwriting. It might depend on the State you are in.  

 

You should fill fill out a complaint form Tom the Medicare website and also write to your state insurance commission. 

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Periodic Contributor

Bye bye, UHC.  Going to Humana, changing plan to G from F, saving money AND keeping Silver Sneakers. 

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Regular Contributor

My wife and I are  dropping UHC F and going with Aetna G and a different Part D with UHC.  Although there is no Silver Sneakers, we save so much money that we save over $3,000 annually even with the gym expenses and Part B deductable added.

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Good bye United Healthcare.  You drop my benefits and increase my costs and you will not have my business.  My gym membership is $40/month which means my costs are going up by 25% just with this change.  I have had United Healthcare coverage for many years through my employers and enjoyed my suplemental policy very much.  I hate to leave this company but they have forced my hand.  I hope your loss of members is worth it United Healthcare!!!

Regular Contributor

Also dropping UHC due to their decision to not offer Silver Sneakers as an added perk.  Switching to Cigna Total Choice which includes Silver Fit, is accepted at our local Rec Center, and the premium is actually less for the same coverage and does not require underwriting.  I would have happily stayed with UHC and not even checked other options if UHC had not eliminated Silver Sneakers from their Supplemental policies.  I was with them for 4 years.   I am in Wisconsin.  Also found a less expensive Part D - WellCare for $14 per month versus Humana for $26.40 per month.  All in all, quite a savings.

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