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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 191 of 587

You can still change if you have a supplemental plan. 

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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 192 of 587

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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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 193 of 587

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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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 194 of 587

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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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 195 of 587

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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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 196 of 587

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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Valued Social Butterfly
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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 197 of 587

@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 -

* * * * * * * * *
MY SIGNATURE: "It’s Always something" - Roseanne Rosannadanna
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Re: Silver Sneakers being droped by AARP recommended insurer - Solution for Me in Ohio

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Message 198 of 587

Don’t be afraid to look into alternatives.  All supplements cover the same as mandated by Medicare.

 

Customer service does differ.  I switched from United Healthcare to Cigna and was very pleased with the customer service person I spoke to at Cigna shortly after signing up.  She said that she has spoken to many customers who switched from UHC to Cigna due to UHC dropping Silver Sneakers.  Cigna has Silver &Fit which is accepted at our local gym and I have access to all the Silver Sneaker classes.  

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

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Message 199 of 587

this was so helpful to me, thank you.     what scares me is making a change.     had a hip replacement this past year (my first and only operation!) and was very happy with the coverage.     so i thought having a 'history' would be a good thing.   but now, it seems things are changing.     don't really trust aarp anymore, or feel the same about united.    never did receive the 'early' notice of the silver sneakers deal, and it's a real conundrum to know what the best thing is to do for the long run.    

valerieb
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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 200 of 587

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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