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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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Geoff,

 

You state that you are "within" 30 days of your birthday.  California law is very specific on this but it is 30 day period after your birthday!.  IF Blue Shield is violating this statute, immediately call your agent AND call the CA Department of Insurance!

 

The Guranteed Issue Period is found in the Califonia Insurance Code - Section 10192.11 (h)(1).  The bottom line is that within the 30 day period AFTER your birthday each year, you CAN change to a Medicare supplement polcy of the same or lesser benefit and the insurance company cannot deny coverage!

 

(h) (1) An individual shall be entitled to an annual open enrollment period lasting 30 days or more, commencing with the individual’s birthday, during which time that person may purchase any Medicare supplement policy that offers benefits equal to or lesser than those provided by the previous coverage. During this open enrollment period, no issuer that falls under this provision shall deny or condition the issuance or effectiveness of Medicare supplement coverage, nor discriminate in the pricing of coverage, because of health status, claims experience, receipt of health care, or medical condition of the individual if, at the time of the open enrollment period, the individual is covered under another Medicare supplement policy or contract. An issuer shall notify a policyholder of his or her rights under this subdivision at least 30 and no more than 60 days before the beginning of the open enrollment period.

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I really don't think AARP cares or we would be hearing something already.  If you are in California and have a supplement (not advantage plan), open enrollment doesn't apply.  You can change ANY time you want.  If you are within 30 days of your birthday you can change with no underwriting.  I'm guessing your birthday may be in January - if so, you should be able to switch by Feb even if you have medical issues.  I am guessing your wife just missed the opportunity to change under the Birthday Rule, but if she doesn't have any big medical issues, she could change right away.

 

You need to speak with a good insurance agent that specializes in this.  Different companies have different underwriting questions.  We limited our search to companies that offer Silver Sneakers because we travel some and wanted the flexibility of multiple gyms. Aside from that, Silver & Fit is probably a reasonable option too.  

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I want to add my voice to those angry about this. I am also one of the ones who opted to go with United Healthcare due, in large part, to Silver Sneakers. I also did not receive the September mailing so am just learning about this. The difference in what AARP purports to value and what they actually support concerns me greatly.

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I will be cancelling my membership in AARP and hope that I can find an alternative supplementary insurance policy here in Pennsylvania to replace United Health Care.  Once again, AARP demonstrates its total lack of concern/interests for its members.

 

Ed Gragert

Milford PA

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Periodic Contributor

I am doing the same. I started doing research and stumbled across this guy on youtube. If you haven't found anything yet I would watch this video. Very informative

https://youtu.be/Ug_BMbO6TKk

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For AARP UHC supplement 2018 members in Ohio who have pre-conditions and find it hard to change, you can change anytime to Medical Mutual of Ohio anytime between now and June 2019!  If have a supplement plan Medical Mutual of Ohio will accept you without underwriting/pre-conditions and approval is within the hour.   Unlike Advantage plans which can only be changed between Oct and Dec., Medigap/supplement plans can be changed any month of the year.  I changed from AARP UHC plan N to medical mutual plan G and only paid $3 more for the much more coverage that plan G has (no co-pays and no excess charges).  If I stayed on N, 

Supplemental plans are secondary to Medicare so as far as I know, anyone that takes medicare will take your supplement.  Not true with Advantage plans which replace A and B with C and are primary.

I'm so happy to get silver sneakers next year and no longer have to use AARP non profit insurance company.

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Regular Contributor

Medical Mutual of Ohio did this in direct response to the actions taken by AARP anf UHC.  That is one of the reasons they extended the offer until later next year.  I plan on switching early next year after I see how everything falls out with the AARP UHC fiasco.  My insurance advisor told me he gets about 10 calls every day on this subject.  I really hope this hits them on the bottom line, that is all they care about.

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Regular Contributor

I still have AARP Walgreens prescription D plan and will use Medical Mutual of Ohio supplement Plan G.

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Regular Contributor

I already have checked and know that the Medical Mutual plan will be quite a bit less expensive even before I factor in the Silver Sneakers issue.

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Periodic Contributor

I wanted to pass along more information regarding the SilverSneakers Program that is being dropped by the AARP United Healthcare Medicare Supplemental Insurance program. 

I called UHC again today to nominate the gym I go to so I can continue my fitness program. My gym is the YouFit gym in AZ. They are not currently part of the new fitness program. However, yesterday I was told to gather some information from the gym and I could nominate the gym to participate. Today, after gathering said information, I called UCH again. They took the information and told me it would be 4-6 weeks before the gym would be contacted. I can join another participating gym, of course, but I like the YouFit gym and would prefer to stay there. However, I can't take 4-6 or more weeks off.  This is very disturbing to me. I'm really surprised that AARP didn't stand up for us in this matter. The new program will cost seniors more money. 

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Being a fitness Club Owner this is super sad to see. UHC and AARP only caring about their bottom line and not the people. The Silver Sneaker Program at our Fitness Club has been a huge blessing to a lot of actively aging folks and now just to do away with it is a bit crazy. Not many facilities are going to lower their rates for seniors. This will not only be a huge Negative for AARP but also scar on UHC. To also make this known to members after the enrollment period was a poor choice, they should have rolled that news out long before to give people options. 

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Periodic Contributor

I was REALLY looking forward to using the Silver Sneakers benefit to get back in shape after having been laid up for the past 8 months. Come my birthday in June, I'll be looking for a company with the Silver Sneaker benefit. Too Bad, UHC.

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Newbie

Today received in snail mail a letter from United Health Care (conveniently mailed to arrive after the end of enrollment open season) informing me that my AARP/UHC Medicare Supplement plan will no longer cover Silver Sneakers beginning Jan. 1, 2019.  The letter stated that I was notified via a September mailing that this change was planned.  I DID NOT receive that notification.  I carefully searched the AARP/UHC web site during open enrollment to verify that Silver Sneakers would be covered in 2019.  I found nothing indicating that a change would occur, so I continued my AARP/UHC coverage unchanged.  Now I am seriously disappointed in my choice.  Now I am faced with paying gym membership of $65 a month, or stopping my regular exercise routine.  This is a bummer, and I am very disappointed in AARP/UHC.  

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Periodic Contributor

It is crazy what they're doing to us but still taking our money. I started doing some research online and came across a youtube video about this. If you're still looking for something similar to sneakers this guy has some good recommendations

 

https://youtu.be/Ug_BMbO6TKk

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Wow... Today I got nearly the same letter telling me what our new choices are to replace Silver Sneakers. What a joke!!! One is 20 miles away and the other one is close but the facility is the size of a shoe box! Some choice. Come on you guys KNOCK IT OFF and get us back in Silver Sneakers or next year lots of people will be making decisions you may not like. 

 

If this is monetary thing get in touch with the right  people and negotiate the issues with our large numbers instead of dumping it all on the members. 

 

 

 

 

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Contributor

Agree! Considered Silver Sneakers a reason to keep my expensive F Aarp United Healthcare supplement.. Silver Sneakers is being offered in Medicare Advantage plans by some companies.United Healthcare , I am disappointed. The alternatives you offer in my area are not geared to seniors. I am healthy and surely you want me to stay healthy. Bring Silver Sneakers back!

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Regular Contributor

You can still change if you have a supplemental plan. 

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Periodic Contributor

If you have an Advantage plan, the open enrollment applies to you, otherwise we can change a supplemental plan at any time. You may be required to answer health questions.

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I was told by insurance experts after telling them of health issues my wife has developed in the past 11+ years being on the UHC supplemental plan F that my wife had to remain at UHC. I called UHC and they recommended I change her plan from F to G but she would have to go through underwriting. I did this and was told that the premium for the new plan G would be lower. After suiting the paperwork to the underwriters I was informed that my wife was now on plan G but the premium ended up being 45% higher than her current expensive plan F. (230.xx per month and being increased to 249.xx per month in April 2019) So my attempt to save money turned into an increase from the current plan F premium of $230.xx monthly to $333.xx monthly for plan G plus the Part B deductible of $185.00 for next year. It took 2 calls to UHC to cancel the new Part G and  keep my wife on the Part F in the future. Wouldn't it be great if they could simply quote you a new monthly premium charge after underwriting so you could make a choice instead of just slapping you into a new plan with a much higher premium? 

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Honored Social Butterfly


@wonsettler wrote:

. . . . . Wouldn't it be great if they could simply quote you a new monthly premium charge after underwriting so you could make a choice instead of just slapping you into a new plan with a much higher premium? 


That 's why there is a Medigap Medicare Consumer protection rule to protect you ( your wife in this case ).  

If underwriting is required, that process has to be completed before the premium is known.  The protection is a 30-day look where you can go back to the previous Medigap policy.

Medicare.gov -Switching Medigap Policies

 

The insurer don't want to do the underwriting legwork unless they have some monetary assurance that there is a possible policy sale.  Be glad that the 30-day look is in place.

 

Personally, I would handle this switch back in writing but I have this thing with documentation to cover any potential problems.

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After a new series of phone calls I have some more info about Mayo Clinic.  Generally speaking, Mayo Clinic doesn't accept Medicare for primary care which includes physicals and that sort of thing.  They will make an exception if you had been a primary care patient at Mayo Clinic within the last 3 years, but they won't accept new Medicare patients in the primay care department.  Other departments at Mayo Clinic have different policies and may very well accept Medicare patients.  The information I received is for Scottsdale-Phoenix, Arizona and will likely be the same at other Mayo facilities.

 

This is far from the original topic of this thread but maybe it will be of value to a few people.

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Thank-you John85259, the Az mayo info is of help to me.

Also, for a total bill of approx $160 for my primary care Dr, I paid only about $3.00. The amount is very low, Medicare and my F plan paid the rest. It's just a little extra effort in the accounting, but it works!

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In case there's any doubt about this here is the letter from UHC that I received this morning.  Dated December 14th conveniently a week after open enrollment finished.  Neither my wife nor I saw the notification referred to in September.  Neither it seems did anyone else

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The article on the Kaiser webpage said that Humana had tried to get rid of SilverSneakers but customer complaints convinced them not to.  Maybe Humana felt they couldn't afford to lose any customers while United Healthcare thinks the few people they lose won't be enough to worry about.

 

Here's an update on Silver & Fit:  They don't have an ID card that shows a gym that you're a member.  The lady I talked to at Silver & Fit said that I'd just need to take in my ID number and that's all that would be needed.  They also have an index of gyms on their webpage from which you can select one as "your healthclub" and print out a letter of introduction that you can show them.  I didn't see anything that would keep you from printing out a letter for several gyms.  I like the ID card that SilverSneakers has.  It simplifies things.  Maybe Silver & Fit will eventually choose to have one too.

 

After only 2 months with United Healthcare I changed to Blue Cross - Blue Shield of Arizona.  I could do this because I was still within the window of my initial sign up with Medicare.  I haven't used any benefits from either United Healthcare or BC-BS AZ so I can't comment on whether one is better than the other in that arena.

 

Here's my experience with Mayo Clinic in Scottsdale, AZ in case anyone else is considering using them.  When I called them to ask about the "Introduction to Medicare" visit they said they don't offer something like this.  I was transferred to their new admissions office and put on hold.  About 15 minutes later the call was terminated.  I don't know if it was caused by a problem with the phone system at Mayo or somewhere further downstream.  My phone was okay and I've never had a problem with terminated phone calls so I don't think it was on my end of things.  I went to the Mayo webpage and found a link to a page where you can inquire about setting up an appointment.  I filled out the info and said I was a new Medicare patient and had BC-BS AZ insurance and wanted to see a general practictioner for a review of my current health situation.  I received an email the next day that said " Mayo Clinic is not accepting new patients with government insurance in the specialty department you requested..." and gave a phone number I could call with any questions I might have.

 

I decided to try a different direction of attack.  I called Medicare and talked to a nice lady there about my situation and she suggested that I use their doctor directory to see if any doctors at Mayo are in their list.  As we were talked we both walked through the process of searching their doctor directory and we both found that for general practice there were 10 or 11 doctors at Mayo in Scottsdale, AZ listed as accepting Medicare patients.

 

Armed with this information I called Mayo again and asked to have an appointment with one of these doctors.  During our conversation I mentioned that I had been a patient at Mayo in the past.  It was over 10 years ago and they supposedly purge their records after 10 years so I didn't think I was still in their database.  The woman I spoke to showed some initiative and found in their records that I had called them within the last 10 years to the doctor who had done my physical a question.  So, I was still in their database and had a patient ID number, therefore I was still a patient of Mayo Clinic.  This was good news.  Then the lady at Mayo asked for my insurance info and looked it up and said my insurance with BS-BC AZ was good at Mayo Clinic and they'll pay everything Mediare doesn't cover.  Then  she asked me if I'd like to set up a visit for a physical.  We scheduled one and that was it.

 

It was somewhat of an ordeal to get hooked up with Mayo Clinic again but the phone call I made almost 10 years ago saved the day.  I have no idea whether they'll accept new patients with BC-BS AZ or other insurance for general medical care like physicals and that sort of thing.

 

I have several friends who had serious health problems and were referred to Mayo Clinic by their doctors and they were accepted very quickly and received excellent care, so it appears they are more flexible when dealing with people who really need them for something serious.  Since I'm in good health and don't take any medications maybe the folks at Mayo want more of a medical challenge than I can offer them.

 

I can say that 95% of the time I've received really great service from everyone I've dealt with in my transition to Medicare.  I've called Medicare at least 5 or 6 times with questions and always received excellent service.  Same with United Healthcare when I was begining my coverage with them and when I called to tell them I was leaving.  The people I've spoken to at BC-BS AZ were equally helpful.  And last but not least the folks at Mayo Clinic in Scottsdale have also been good to deal.  Thought I'd give all of them a pat on the back in a public forum.  Customer service from people who care definitely makes a difference.

 

 

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Periodic Contributor

thank you for such great indepth experiences!      it's much appreciated in the confusion of insurances!

valerieb
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Diane and Valerie and Everyone Else,

 

I scheduled my physical at Mayo Clinic - Scottsdale for Jan 22 so it will be a while before I get over there.  When I'm there I'll see if I can find someone who will give me the straight scoop on how they handle new patients and what the financial details are.  I'd like to know how the money moves around and if there are any gaps in coverage that I need to know about.

 

My first thought is that I should post what I find out on this thread because it could also be of interest to people who live in other parts of the country too.  But it's wandered off quite a bit from the original topic and might deserve it's own thread.  If anyone has any preferences about this make a posting here and let me know.

 

I failed to mention in my previous posting that the two people who were quickly admitted to Mayo - Scottsdale for serious health issues were both around 70 years old.  I know for sure that one of them had never been there before and I'm pretty sure the other hadn't either.  So it appears that Mayo will take new patients in our age group if their particular situation warrants it.

 

Diane, what are the odds that there would be two people in the same area who are exactly the same age and have the same insurance (or maybe we should say "had") and are dealing with the same primary health care organization and are talking about it on the same internet forum?  My guess is somewhere between one in a million and never.  It shows the benefit of having the internet at our disposal to share what we know and benefit from the knowledge of others.

 

And while we're sharing knowledge feel free to pass along any hot stock tips you might have too.

 

John

 

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Honored Social Butterfly

@John85259

 

Mayo Clinic have specific ways they treat different Medicare plans especially in Florida and Arizona - traditional Medicare or varieties of Medicare Advantage plans.

 

Read this link

Mayo Clinic - About Medicare - Billing and Insurance at Mayo Clinic

 

It does not sound like they take Medicare Part B under the traditional program for the clinic and associated physicians on an ASSIGNMENT basis  EXCEPT for certain services.  They do take both Medicare Part A and B for hospital services.

 

If you have traditional Medicare and are looking for the clinic or affiliated physicians to act as your primary physicians, since they don't accept assignment, Medicare will only cover part of the fees for their services for many things.  You will have to sign an ABN  ( Advanced Beneficiary Notice of Non-Coverage ) acknowledging this and they will send you a bill of what is due.

 

Do you understand what it means if a doctor or other health care provider takes or does not take "assignment" in Medicare?  It means that by taking assignment the agree to accept the Medicare payment amount for their service - then Medicare pays their 80% of this amount and the beneficiary or their supplemental plan picks up the remaining 20%.  If they don't accept assignment then the beneficiary may have to pay what they charge over and above that amount.

 

Yes, it can also go by specific services too.

 

From the link:

 

Hospital services

 

If you are hospitalized, Mayo Clinic will file your Part A (hospital inpatient and outpatient services) and Part B (physician services) claims for you. You will receive a Medicare Summary Notice from Medicare when it processes your claim.

 

Clinic and physician services

 

Although Mayo Clinic doesn't participate with Medicare Part B in Arizona and Florida, Medicare will help pay for services provided at all Mayo Clinic sites regardless of whether they participate with Medicare Part B. Claims will be filed to Medicare Part B and supplemental or secondary insurance companies on your behalf. In some cases, Medicare Part B and supplemental or secondary insurance payments may be sent directly to you. When this happens, patients will be responsible for reimbursing Mayo Clinic for any payments they receive and any balances not covered by their insurance.

 

Medicare assignment

 

Mayo Clinic is required to accept assignment for Medicare Part B for certain services designated by government regulations (for example, clinical laboratory, drugs and biologicals).

 

Medicare supplemental or Medigap insurance crossover

 

If you expected your claims to cross over from Medicare to your supplemental or Medigap insurance and this did not occur, please contact your Medicare supplemental or Medigap insurance organization to inquire.

 

Medicare Advance Beneficiary Notice

 

Before certain items or services are provided, Medicare patients may be asked to read and sign an Advance Beneficiary Notice (ABN) that explains Medicare payment restrictions and estimate of charges. By signing the ABN, you assume financial responsibility in the event Medicare denies payment.

 

Noncovered services, such as eye refractions, foot care, hearing aids, screening exams, preventive medicine services and elective procedures, do not require prior notification and are not subject to the ABN requirement. Patients are financially responsible for all noncovered services.

 

Any questions regarding a noncovered item or service should be directed to Medicare at 800-633-4227 (toll-free).

 

Medicare Advantage plans

 

Medicare Advantage plans are plans offered by private companies that contract with Medicare to provide all of your Medicare Part A and Part B benefits. In most cases, Medicare Advantage plans also offer Medicare prescription drug coverage. There are various types of Medicare Advantage plans, including HMO, PPO, cost-based, HCPP, Medicare Medical Savings Account and private fee-for-service plans. If your plan is considered out of network, your out-of-pocket expenses will be higher. As a general rule, Medicare Advantage plans should process the same as Medicare.

 

The following Mayo Clinic campuses limit access to some of the Medicare Advantage plans:

 

Mayo Clinic's campus in Arizona. Patients covered by any types of Medicare Advantage Plans (exception Cost share/HCPP) that are not contracted may not be seen. Patients cannot be seen on a self-pay basis.


Mayo Clinic's campus in Florida. Patients covered by Medicare Advantage HMO plans without authorization may not be seen. Patients cannot be seen on a self-pay basis.


Mayo Clinic's campus in Rochester, Minnesota. Patients covered by Medicare Advantage HMO plans without authorization may not be seen. Patients cannot be seen on a self-pay basis.


Medicare Advantage HMO plans require authorization prior to scheduling appointments at the Mayo Clinic site that is contracted or that has accepted your plan; without authorization, the patient will be financially responsible.

 

Mayo Clinic's campuses in Arizona and Florida do not agree to the terms and conditions of noncontracted Medicare Advantage plans, due to administrative and financial challenges. Please refer to your Medicare Advantage plan for a list of in-network providers.

 

read more at the above link -

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Periodic Contributor

John85259,

I read your previous post, which helped me tremendously. I too am in Az , started medicare in September,  and HAD UHC plan F.  I am also a Mayo patient.

 

Thanks to you, I realized I could switch my F plan without going thru underwriting (I most likely would not have had a problem, if I had to answer questions,  but who knows) as I was also within the first few months,  I switched to Humana effec 12/1/18 because of Silver Sneakers and lower rate (see my other post).  A note for you, we in Az can change our supplemental plan ANY time of the year, but may be subject to underwriting (answering health questions). I looked into Silver and Fit, but was told by the YWCA that we could still go to more than one gym, but could only be signed up for one gym at a time, and that I would have to dis-enroll from one to sign up for another. I liked the idea of being able to try different gyms, maybe within the same week.

Here's another tip for you on Mayo. Here's my understanding of Mayo in Az,  they will only take you st medicare age if you've previously been going there.

Billing for Mayo ...I just spent time on the phone with Medicare trying to figure out why a Dr bill was not paid at 80% of what medicare approved. (My F plan will pay the diff between what Mayo charges and what Medicare approves (this is called part B excess) as Mayo does not accept assignment of medicare in AZ. My plan F will also pay the 20% that medicare does not pay. Now this is the confusing part....Medicare calculates 80% of the amt they approved, then they deduct 2% of the 80%, then cut a check to me for that amount. They called it 'sequestration' because AZ Mayo does not accept assignment of medicare. One needs a finance degree to figure this out. I've considered looking for another family care dr as I don't want to be recieving checks, then havkng to pay the bill (I believe it's only the dr bills, Bills for labwork was paid directly.  It is quit convoluted and confusing! Good luck to you, Diane

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I have applied to switch from UHC to Anthem BC/BS in Indiana. I am switching from Plan F to Plan G to save some money. Plus, Anthem does include Silver Sneakers with all of their supplement plans. If I had gone with Aetna I would have saved even more money, but they do not include SS in our area. What a hassle it is to shop around and get on the phone with these companies. But it's worth it.

 

I've spoken to agents for 3 companies and they all said they've been inundated with UHC people who are up in arms about the premiums rising and the benefits dropping.

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Periodic Contributor

I also have switched from UHC plan F to Humana plan F in Arizona (same exact basic coverage, all F plans are the same), Humana still has Silver Sneakers. It saved me about $20 a month on premiums plus if I had kept UHC and paid 1/2 of my YMCA premium it would have been $30 a month. So switching has saved me $600 a year! I did not have to worry about underwriting because I had only been on medicare for 3 months.

I go through a broker, which I recommend....as it does not cost us, they are paid by the insurer.

 

My broker said we can change a Medigap plan anytime of the year (there may be underwriting....meaning you may have to answer a health questionnaire.) 

The things that CAN only be changed during open enrollment are Medicare part D (prescription) and Advantage plans.

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