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Re: Silver Sneakers being dropped by AARP recommended insurer

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Message 241 of 593

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.

 

 

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Re: Silver Sneakers being dropped by AARP recommended insurer

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Message 242 of 593

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.

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Re: Silver Sneakers being dropped by AARP recommended insurer

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Message 243 of 593
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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Re: Silver Sneakers being dropped by AARP recommended insurer

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Message 244 of 593

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.......

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 245 of 593
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!


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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 246 of 593

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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Re: Silver Sneakers being droped by AARP recommended insurer - Solution for Me in Ohio

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Message 247 of 593

Through a local Ohio senior benefits company, I was able to switch to a similar medigap policy through Medical Mutual Insurance Company, which has and continues to offer Silver Sneakers.  But not only that, but for this enrollment period only, Medical Mutual does not ask any medical questions whatsoever, accepting anyone who currently is enrolled in AARP/United Healthcare, no questions asked and therefore no rerating based on medical history.  Additionally, my monthly premium for Plan F for my 70 year old self is actually $181.41/month versus AARP/UHC's monthly premium of $ 204.12, a monthly savings of $22.71. 

 

However, I did not go with Medical Mutual's Plan F, choosing rather to go to Plan G.  Plan G's coverage is identical to Plan F, except I'm responsible for paying the Medicare Part B deductible, which for 2019, is $185.  But, the Plan G monthly premium is just $134.58, a monthly savings of $46.83 over Med Mutual's Plan F.  If you do the math, the annual premium savings is $561.96, so if I agree to pay the $185 part B deductible myself through Plan G, I realize a net annual savings of $376.96.  This is the option I chose. 

 

This means that I can bid AARP/UHC a not-so-fond farewell at the end of the year and go with a provider that actually seems to care about it's policy holders.

 

Good riddance, AARP.

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 248 of 593

I currently have UHC Medicare Complete in Missouri.  I contacted UHC after receiving my new membership card last week but never getting any information on changes to my plan.  I specifically asked the representative if Silver Sneakers was being dropped from my plan.  She said she had no knowledge of any changes to the program in my plan.  Obviously she lied to me or is totally clueless because when I kept hearing rumors of UHC dropping Silver Sneakers I contacted UHC again and did an online chat session.  The rep informed me that yes, Silver Sneakers was being dropped from my plan.

If UHC lied about this, what else have they lied about or will lie about?  I'll be switching to Essence Health Care and hope that they have better morals. 

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 249 of 593

Sorry but you seem to misunderstand what AARP is.  AARP is an insurance sales company no different from your local agent but set up as a non-profit to avoid taxes.  It does not represent AARP members, it represents the interests of the insurance companies and the wealthy people they appoint as directors.  You are not a member of an organization - you are a customer.  You get no say in the BOD selection - have you ever received a notice to vote on the BOD?  No you haven't and never will, and you get zero input to policies and procedures.  The otherwise profits that would be taxed are paid to the owners - the insurance mogels and the BOD who are paid multi-million salaries to own the company.  AARP has always been a scam, the scam has had some benefits for their customers, but really you can buy insurance without them, and then you don't have to get all their marketing nonsense.

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Re: Blue Shield's Plan F "Plus" costs less than Plan F & has SilverSneakers!

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Message 250 of 593

@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 - Roseanne Rosannadanna
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