Reply
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.....

26,111 Views
693
Report
Reply
Honored Social Butterfly


@ls63763447 wrote:

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.


Did you buy any of those optional Medigap coverages offered in the state of Wisconsin?  I think this is a good idea - you can up your coverage on the Medigap plan by item and then when premiums get too high perhaps begin to scale them back.  I assume you can do it this way since they are actually paid for with a separate premium.

 

From reviewing all the Medigap insurers listed in WI on the WI Dept of Insurance site for 2018, it seems they all are rated by attained age.  So come back when you are 80 / 85 and let us know how those premiums are going.

0 Kudos
2,274 Views
0
Report
Reply
Regular Contributor

Here's the latest news from my corner of the universe.  Last Sunday, Oct 27, 2018 I signed up with Blue Cross Blue Shield of Arizona for Plan F, which is the plan I had with AARP-United Healthcare.  BCBS-AZ coverage will start on Nov 1, 2018.  I didn't give them much notice and they won't have all the paperwork processed for another week or so, but they told me that my policy will be in effect on Nov 1 and they'll send me the paperwork in the next week or so.  I got this story from the drug plan side of BCBS-AZ and the Medicare supplement people at BCBS-AZ so I'm confident that they are giving me the straight scoop.

 

Today (Oct 30) I called AARP-United Healthcare and told them that I would be leaving effective end of day Oct 31.  The person I spoke to asked why I was leaving and I told her it was because of the absence of SilverSneakers in their 2019 package.  I told her I had done a fairly exhaustive evaluation of insurance plans before I signed up with AARP-United Healthcare and I had every expectation of being a long term customer, but this changed only 3 weeks later when they sent me a letter saying that SilverSneakers would be gone in 2019 and replaced with something much less appealing.

 

Whether hearing this will have any effect on what United Healtcare does in the future is anyone's guess.  My guess is that the corporate weenies who run the show have made a commitment that works in the favor of United Healthcare and this will make them shine in the eyes of their superiors, so the chances of anyone making an effort to restore SilverSneakers are likely to be zero.  There's always the chance that someone with commonsense and the welfare of their customers in mind will rock the boat and try to restore SilverSneakers to their Medigap customers, but in my opinion it's more likely that the Moon will fall into the Pacific Ocean long before that happens.

 

An interesting insight was offered by the guy I spoke to at BCBS-AZ.  He told that he's talked to a good number of AARP-United Healthcare customers who are looking at BCBS-AZ.  He said they typically ask two questions.  The first question is whether BCBS-AZ has SilverSneakers or something similar.  (His answer is yes, they have Silver and Fit.)  The second question is whether BCBS-AZ has any plans to discontinue Silver and Fit in the future.  (His answer is not as far as he knows, but things could always change.)  So it appears that others are considering changing their insurance provider.

 

The price for Plan F from BCBS-AZ is a couple dollars a month cheaper than AARP-United Healthcare.  Their drug plans are almost exactly the same price.  There will be an inflation-cost of living increase in April, which has been 2%-3% for the last few years.  Later in the year in the month of my birth there will a second adjustment that is due to me being a year older (and probably not a year wiser but we'll see...).  He told me what that amount would be and it was the same as what I would have paid with my AARP-United Healthcare insurance, but I didn't write it down.  About $20/month is the increase that comes to mind.  When I hit 73 the age related increases will stop and I'll be paying full price, which currently is $260.38/month.  (I happened to write it down so I have it at hand.)

 

I began my experience with AARP-United Healthcare in September and it will be coming to an end after only 2 months.  I'm glad that I found an alternative that is the same price and has the added benefit of Silver and Fit, but I'm unhappy that I had to go through all this nonsense because United Healthcare decided to ditch SilverSneakers and replace it with something that isn't nearly as good.  It may not have been important to them, but it's important to a subset of their customers and we are voting with our checkbook.

4,878 Views
1
Report
Reply
Honored Social Butterfly

@John85259

 

This is from BCBS Medigap - Arizona 2017 premiums and ratings outline  booklet.  You can see it at the link (end of booklet) since the pdf does not always  copy and paste completely correct, you can look at it there.  I could not find a more up-to-date one but I am sure you SHOULD have gotten one.

https://www.azblue.com/~/media/AZBlue/Files/Misc_PDFs/Med_Supp_Outline_of_Coverage_Broker.pdf

 

Make sure that everything is in writing from the horses mouth.  To make sure there is no misunderstanding down the road.

 

Read your policy very carefully This is only an outline describing your policy’s most important features. The policy is your Medicare supplement insurance contract. You must read the policy itself to understand all of the rights and duties of both you and Blue Cross Blue Shield of Arizona.

 

Right to return policy If you nd that you are not satis ed with your policy, you may return it to: Blue Cross Blue Shield of Arizona Enrollment Services Department P.O. Box 13466 Phoenix, Arizona 85002-3466 If you send the policy back to BCBSAZ within 30 days after you receive it, BCBSAZ will treat the policy as if it had never been issued and return all of your payments.

 

Policy replacement:   If you are replacing another health insurance policy, do NOT cancel it until you have actually received your new policy and are sure you want to keep it.

 

Notice • This policy may not fully cover all of your medical costs. • Neither Blue Cross Blue Shield of Arizona nor its contracted brokers are connected with Medicare. •

 

This outline of coverage does not give all the details of Medicare coverage. Contact your local Social Security Of ce or consult “Medicare & You” for more details.

 

Complete answers are very important When you ll out the application for the new policy, be sure to answer truthfully and completely all questions about your medical and health history. Blue Cross Blue Shield of Arizona may cancel your policy and refuse to pay any claims if you leave out or falsify important medical information.

 

Review the application carefully before you sign it. Be certain that all information has been properly recorded.

 

What Medicare.gov says about changing a Medigap policy -

 Medicare.gov - Switching Medigap Policies

 

How to switch Medigap policies

If you decide to change insurance companies, call the new insurance company and arrange to apply for your new Medigap policy. If your application is accepted, call your current insurance company, and ask for your coverage to end. The insurance company can tell you how to submit a request to end your coverage.

 

Medigap free-look period

You have 30 days to decide if you want to keep the new Medigap policy. This is called your "free look period." The 30-day free look period starts when you get your new Medigap policy. You'll need to pay both premiums for one month.

 

Don't cancel your first Medigap policy until you've decided to keep the second Medigap policy. On the application for the new Medigap policy, you'll have to promise that you'll cancel your first policy.

 

I am not doubting anybody here about their ability to switch to another Medigap policy /insurer without underwriting - but it does help to make sure that policies and ratings are understood correctly and you use the Protections in place if a problem does crop up.

 

 

 

5,078 Views
0
Report
Reply
Periodic Contributor

So my agent came over yesterday and we discussed the different plans.  And I decided to leave AARP/United Health Care and go with Medical Mutual (Anthem).  The plan was 0 cost to me and I have better benefits including Silver Sneakers which I am happy about.  Then she went and saw my neighbor and she has the same plan.  So out of 3 of us neighbors two of us left UHC.   I am curious as to how many leave due to the changes.  

4,345 Views
1
Report
Reply
Periodic Contributor

I ‘m leaving aarp/united healthcare also

signing up with anthem blue cross I have a medigap plan that will save me $100 a month plus have silver sneakers.  I’ve been with the previous plan since 2006

i’m glad aarp/united healthcare made the change.  They saved me a lot of money.

Happy I dropped them!

4,989 Views
0
Report
Reply
Periodic Contributor

We were able to find another provider with Guaranteed Issue that will include SilverSneakers, Humana Connect.  I have switched to Plan F as is my husband.  It is a little more than we would pay next year with AARP United HC, but with Silver Sneakers we will save money.  I planned to switch to Plan F before it is eliminated for new enrollees Jan 1 of 2020 anyway, so I just did it a year early.  The representative said it was unlikely we would pass medical underwriting even by AARP United HC which tends to be a little more lenient. AARP is requiring medical underwriting to switch to Plan G effective Oct 2018 if you are on a lower plan at present.  I understand that companies are within their rights to change extra benefits, but those benefits weighed in our decision to pick them.  I will avoid using a Medicare Advantage plan for as long as I can bear the extra cost of using standard Medicare and a supplement or gap plan.  Medicare is very easy to use.  Having been a hospital CEO and RN I can assure you that Medicare Advantage plans are great until you have a catastrophic illness and want to go to somewhere outside your network or need a treatment or test for which Medicare allows, but your Advantage Plan does not. Being able to do so saved my husband's life. Traveling and living part of the year in more than one place as many retirees do can also be difficult.  AARP should have had things in place for a Silver Sneakers replacement. They are working on it, but many zipcodes are not served with an alternate at present. 

4,360 Views
4
Report
Reply
Regular Contributor

Is not a plan G identical to plan F except they don't pay the Part D deductable? And the part G premiums are low enough to easily cover that deductable plus some?

0 Kudos
4,072 Views
2
Report
Reply
Honored Social Butterfly


@wonsettler wrote:

Is not a plan G identical to plan F except they don't pay the Part D deductable? And the part G premiums are low enough to easily cover that deductable plus some?


Medigap Plan F is the same as Medigap Plan G except that under Plan G you have to pay out of pocket the Medicare Part B Deductible - $ 183 for 2018 and I think it is going to $ 185 in 2019.

And a few other things are different too - excess doctor charges, some foreign coverage - Plan F is the cadillac - 1st dollar coverage.

Chicago Tribune 09/10/2017 - Why seniors should choose wisely when selecting Medigap supplement insu...

 

As to the premiums for Plan G ( Medicare has "Parts" - Medigap coverage is by "Plans") -

The expense of the premiums is based on how they are rated initially, when you first sign up and how they rise afterward - and I guess the size of your pocketbook.

 

Medigap coverage is ONLY GAP insurance that works with traditional Medicare.

Only about 25% of seniors on traditional Medicare have a Medigap or supplemental plan.

Some have extra help because they are low income and others even lower income have Medicare and Medicaid.  Some beneficiaries just pay their Medicare 20% of the cost out of their pocket and try to keep their care cost low.

 

Others, about 30% (and growing) of all beneficiaries, use a Medicare Advantage plan to get their Medicare benefits. 

0 Kudos
3,982 Views
0
Report
Reply
Contributor

"Yes" to the first part of your question; and  "usually" to the second part.

0 Kudos
4,036 Views
0
Report
Reply
Regular Contributor

I'm looking at a Humana plan G. It appears the same as the AARP UHC plan F except it doesn't pay the Part B deductible. ($185 for 2019) The Humana G  premiums are currently $30.00 per month less than the UHC plan F and in April they will be $49.00 less per month less and Humana provides Silver Sneakers for 2019.

4,059 Views
0
Report
Reply
Periodic Contributor

The Medigap plans being offered are considered the "cadillac" of additional Medicare coverage as we are allowed to visit ANY doctor in the US who accepts Medicare and are not corraled into only visiting doctors who are in a Medicare Advantage network. And we also can go to Mayo and my plan G will cover the excess 15% that they are allowed to charge. As such, we are paying for this premium. Many Advantage plans do not have any additional payments because Medicare covers the cost. I believe the whole insurance industry is trying to coerce us into Medicare Advantage plans as they are like HMO's. With Medicare Supplement plans (Medigap) we do not have the option each year to change plans without going through underwriting unless we are still in our open enrollment period. So that is why we are so upset with joining AARP UHC and then losing the 1 benefit we joined for. I just changed to Blue Cross/Blue Shield in AZ that offers Silver and Fit which is comparable to Silver Sneakers at my YMCA, as I just started Medicare this summer.

2,710 Views
27
Report
Reply
Honored Social Butterfly

Perhaps those who are passionate about this (or any other) exercise program staying within Medigap plans should put forth effort to have this type of program added to the list of medically necessary items which Medicare covers.

 

At least then, all seniors within Medicare would be able to partake of this type of activity, instead of those more wealthy or more elite.

  • Including The ones within traditional Medicare who are so poor that they are supplemented with Extra Help or Medicaid.  NO Medigap policy for them.
  • Including The ones within traditional Medicare who are maybe a bit more well-off but still cannot afford a supplemental or Medigap plan which contains this benefit.
  • Including The ones within traditional Medicare who can only afford some of the lesser coverage Medigap plans because all insurers don't have to cover every plan in any specific area.

Would you get this exercise benefit if you had a Medicare Select plan or a High Deductible Plan F?  Don't think so -

 

Personally, I think people should pay for this program in any Medigap plan that it is offered within, perhaps with a discount for participation - to keep the price down for others who don't need or want such a program but do want Medigap (Gap coverage).  

 

if your doctor orders some type of physical therapy - that is available via traditional Medicare, medically necessary with a doctor's order.  For others it seems like a social network thing - no problem with that but the cost should not be born by others who don't use it - visit a tax payer provided senior center for your comraderie.

 

i will leave this to you all who want the program but don't want to spend money on it - just think about the many seniors who can't afford a Medigap policy at all and this "free" program - think about them every time you go to have fun, socialize or even keep your joints moving - that some poor(er) senior doesn't get this access to this program.

 

However, if it has been proven scientifically that it is a medical necessity - then work on changing Medicare to include it for everybody - NOT just for the ones who can buy an elitist Medigap policy to fill in their cost and get this "free" perk.

 

Medicare is a government health care program for seniors - why should some get access and others not to this program - especially if it is "free" - nothing offered is usually FREE - cost are just passed on to others especially for insurers that are ONLY covering the GAP aspect of Medicare.

 

Join a Medicare Advantage Plan - that way you can get all the extra benefits which they offer - you can change your plan EVERY YEAR with no underwriting to keep up with whatever you want in a plan -'doctors, other providers, medicine,

and any other benefit which thee insurer may offer in any given year.

 

Right now, the way I see it - you all want all your cake and eat it too - to H*** with other seniors that may not be in your class of Medigap seniors.

 

 

 

 

0 Kudos
2,197 Views
26
Report
Reply
Newbie

I strongly disagree with the suggestion that people who buy Medigap coverage should switch to Advantage plans in order to keep their Silver Sneakers benefit. What matters is the coverage itself, not the perks, and Medigap coverage is much better than Advantage. A good, top-shelf supplement has no co-insurance or co-pays while Advantage plans have both. While Advantage premiums may be lower, the co-insurance can make those plans far more expensive if and when you get sick. And remember, as you get older you are likely to incur your most expensive medical problems. The best coverage you can get is original Medicare plus a Plan F or Plan G supplement. Free gym membership may be nice but it should not be the focal point. And don't forget, with a supplement you usually have a lot more freedom to choose your doctors and hospitals.

0 Kudos
3,826 Views
12
Report
Reply
Periodic Contributor

Kind of a moot point, now that the Annual Election Period is over. There is, currently, no mechanism to join a Medicare Advantage plan, if you were not already on one, until next AEP (October 15 to December 7th to then take effect January 1).

As to the other part, about the best Medigap plans being Plan F or Plan G, the latest research clearly shows that this, too, is no longer the case. Plan F is not available to those new to Medicare as of January 1, 2020. This is due to the MACRA act. This means that those remaining on Plan F, after January 1, 2020, will begin to see rate increases based on an ever-shrinking pool of members still on that plan, and no new members, at 65 (young and healthy), joining Plan F after that point. 

In layman's terms, we call this a sinking ship. It is anticipated that this will increase the already-poor rate increase trajectory of Plan F, which has, thus far, been THE landing place for anyone losing employer coverage (think G.E., UPS, AT&T) and having to accept those folks as "Guarantee Issue". This has been largely responsible for the higher-than-normal rate increases, unique to Plan F.

Plan G has been a great alternative to Plan F, with all of the same coverages with only the very-small Part B Medicare deductible to pay and then full coverage. The problem is that, again, January 1, 2020, Plan G takes over as the defacto specified plan that must begin to accept Guarantee Issue business, again - those older retirees that lose their work coverage and must be accepted without health underwriting, nationwide. The current trend already shows that Plan G plans across the country are already accounting for this with higher trends in rate increases. This begin mid-2018 in anticipation for the January 1, 2020 implementation of MACRA.

So what's left? Plan N.   Plan N also requires the payment of the Part B deductible once per year, and also has small co-payments when accessing services. Up to $20 for an office visit, $50 for Emergency Room. This means more participation in the plan costs, which also means a typical reduction of 20% or more in the monthly premiums. Those that are even relatively healthy will do far better being on Plan N with a lower monthly premium and out of pocket costs that only materialize at the point of service. Hospital admissions are still covered 100% without a deductible.

Plan N will not be subject to any Guarantee Issue provisions. Meaning, the only way someone can get Plan N (except in certain non-underwriting states) is to get onto Plan N via Open Enrollment when first eligible for Medicare; or, go through health underwriting questions. This means that the pool of those folks on Plan N will remain free of the mandate that Plan G will be under where they must accept some folks, regardless of health, and will not be a closed pool, like Plan F will be, to new, young Medicare recipients. 

You can see the research on this at http://PlanNMedicare.org


 

0 Kudos
3,801 Views
11
Report
Reply
Regular Contributor

Not a moot point, I switched away from UHC-AARP. I am disgusted with how they cancelled Silver Sneakers suddenly and without enough warning for many to change policies. I was able to switch to Medical Mutual AFTER the Dec 7 deadline because they have opened up a way to move over to them with NO health questions and open enrollment until I think June. If you are unhappy with this dirty trick, check into Medical Mutual now. I not only got Silver Sneakers back, but I am saving money every month!! Same Plan G, same great coverage. This applies to anyone who currrently has a Medicare supplement and wants to change to Med Mutual.

3,031 Views
8
Report
Reply
Contributor

well I myself got a call today from silversneakers and they told me that I could continue going to my gym, there seemed to be a confusion with everybody involved and they seemed to have panicked thed silversneakers members because today I went back to my gym after yesterday that they told me I couldn't so I am glad I am back on.

0 Kudos
2,871 Views
7
Report
Reply
Periodic Contributor

Who called you??  Your Gym or UHC?

0 Kudos
2,951 Views
6
Report
Reply
Contributor

Silver sneakers called me, and I had already gotten the green light from my gym that everything was a missunderstanding and I could go back to the gym, which I did yesterday.

0 Kudos
2,786 Views
3
Report
Reply
Periodic Contributor

A few UHC plans still have the Silver Sneakers, but the Advantage and Supplemental have been dropped. 

I talked with Silver Sneakers and the representative estimated that the cost to the insurance company was $20-$25 dollars per month per member. I'm sure the new plan must cost at least $1.19 per month. So if they loose enough people, their greed will be appropriately rewarded. 

Send the only message that UHC will understand - get a new policy with a different insurance company.

dcobb
2,824 Views
2
Report
Reply
Periodic Contributor

Though a little dated (December '18) here's a link to an article about just this topic: https://www.npr.org/sections/health-shots/2018/12/04/673249571/unitedhealthcare-customers-are-unhap...

0 Kudos
2,861 Views
1
Report
Reply
Periodic Contributor

Sorry - the link to the article from NPR did not work as expected.  Let's try this one:

 

https://www.npr.org/sections/health-shots/2018/12/04/673249571/unitedhealthcare-customers-are-unhapp...

0
Kudos
3804
Views
0 Kudos
3,115 Views
0
Report
Reply
Periodic Contributor

I was lucky, I had heard there was a change.  But when I phoned UHC they said "there is no date to end the program in Calfornia - but that it was happening in other states"

On my next visit to the gym they had put up notices suggesting that we check our coverage.  The NEXT time I called UHC they said that yes Silver Sneakers woul NOT be covered in 2019.

This was around December 1st - so I had a few days to change insurers - which I did.

Then around December 14th I got the official notice from UHC.

Geoff

0 Kudos
2,841 Views
1
Report
Reply
Contributor

Is SilverSneakers giving a grace period.  I could still use the SilverSneakers at la fitness’ in California when are they going to cut us off

0 Kudos
2,862 Views
0
Report
Reply
Regular Contributor

I switched away from UHC-AARP. I am disgusted with how they cancelled Silver Sneakers suddenly and without enough warning for many to change policies. I was able to switch to Medical Mutual AFTER the Dec 7 deadline because they have opened up a way to move over to them with NO health questions and open enrollment until I think June. If you are unhappy with this dirty trick, check into Medical Mutual now. I not only got Silver Sneakers back, but I am saving money every month!! Same Plan G, same great coverage. This applies to anyone who currrently has a Medicare supplement and wants to change to Med Mutual.

2,819 Views
0
Report
Reply
Regular Contributor

Not a moot point. I switched away from UHC-AARP. I am disgusted with how they cancelled Silver Sneakers suddenly and without enough warning for many to change policies. I was able to switch to Medical Mutual AFTER the Dec 7 deadline because they have opened up a way to move over to them with NO health questions and open enrollment until I think June. If you are unhappy with this dirty trick, check into Medical Mutual now. I not only got Silver Sneakers back, but I am saving money every month!! Same Plan G, same great coverage. This applies to anyone who currrently has a Medicare supplement and wants to change to Med Mutual.

0 Kudos
2,769 Views
0
Report
Reply
Regular Contributor

Wow, I've been watching all these posts and observe GaiL1's posts becoming more and more condescending to those complaining about losing Silver Sneakers.  I would respond only for myself that I, too, am unhappy with the way this went down-they were NOT as forthcoming about their plans when they should have been.  I too, realize that there is no guarantee that I will get Silver Sneakers forever.  I, too, got my insurance with AARP/UHC because of the Silver Sneakers offering.  I do NOT think it is free.  I know that I paid a higher in premium because of that benefit.  But now they are taking that benefit away AND increasing my premium at the same time.  Please spare me your lecture on how the various insurance plans work and your inability to understand why people are unhappy.  I get all of that.  I'm more unhappy at the tone of your emails that imply that the rest of us are morons and selfish, of which I am neither.

2,434 Views
12
Report
Reply
Honored Social Butterfly

@ChristineS148307

 

Not condesending and not lecturing - just stating the truth and I will continue to say it.

 

 

The share of all Medicare beneficiaries with Medigap coverage varies widely by state—from 3 percent in Hawaii to 51 percent in Kansas in 2016 (Figure 3, Appendix Table). In 20 states, at least one-quarter of all Medicare beneficiaries have a Medigap policy. States with higher Medigap enrollment tend to be in the Midwest and plains states, where relatively fewer beneficiaries are enrolled in Medicare Advantage plans

 

 

Potential medical conditions for which a Medigap Insurer may deny coverage
without guaranteed issue protections

 

  • ALS (Lou Gehrig’s Disease)
  • Alcohol/drug abuse
  • Alzheimer’s disease or other dementias
  • Chronic lung/pulmonary disorders (e.g. chronic bronchitis, COPD, cystic fibrosis)
  • Cirrhosis
  • Congestive heart failure
  • Diabetes (insulin dependent)
  • Emphysema
  • End Stage Renal Disease (ESRD)
  • Fibromyalgia
  • Heart disease
  • Hepatitis
  • Immune disorders (e.g. RA, MS, Lupus, AIDS)
  • Kidney disease requiring dialysis
  • Mental/nervous disorder
  • Myasthenia gravis
  • Organ transplant
  • Osteoporosis (if severe/disabling)
  • Stroke
  • Advised by a physician to have surgery, medical test, treatment, or therapy
  • Implantable cardiac defibrillator
  • Use of supplemental oxygen
  • Use of nebulizer
  • Asthma requiring continuous use of 3+ medications including inhalers
NOTE: Uninsurable health conditions vary by plan. This list is not an extensive list of all possible conditions/reasons for denial.

SOURCE: Kaiser Family Foundation collection and analysis of numerous insurance companies’ 2016-2017 Medicare supplemental underwriting manuals/guides.

 

see more at the link:

https://www.kff.org/medicare/issue-brief/medigap-enrollment-and-consumer-protections-vary-across-sta...

 

2,494 Views
0
Report
Reply
Regular Contributor

You've got that right.  AARP/UHC has reduced benefits (i.e. Silver Sneakers) while increasing their rates for 2019.  This has pushed me into looking for another gap plan, from another insurer.  There is one more point that the moderator (and AARP/UHC) seem to be missing: Silver Sneakers (i.e. going to the gym and working out) is PREVENTATIVE health care. You strenghten your heart, and can work on strengthening your ankles and knees.  By doing so, you can help retain balance and the possibility of falls.  It costs UHC a lot more to cover Part B overages for broken limbs (or worse) than it does to cover a subscriber's gym membership!  Just like going to the dentist and having your teeth cleaned helps maintain oral health, going to the gym helps keep the rest of the body working properly. Many gyms also offer nutrition classes, yoga, and other classes that help keep Seniors healthy.  That's what the Silver Sneakers program accomplishes. That reduces the cost of healthcare for everyone. 

2,499 Views
10
Report
Reply
Honored Social Butterfly

@johngraves01

So if the benefit of a fitness program or health and fitness program for ALL seniors is scientifically proven as a preventive measure, why does Medicare not cover it under Part B? 

That's all I am saying - because if it is a valuable preventive care - then everybody should have it, right?  Not just the ones that have access to a Medigap plan that offers it as an extra program.

 

This is the only preventive protocol which is covered under this health and fitness heading - as you can see it does NOT cover everybody and it does not recommend an action other than behavioral counseling interventions.

US Preventive Service Task Force: Healthful Diet and Physical Activity

 

reference the link for all the details. 

Final Recommendation Statement Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors: Behavioral Counseling

Recommendation Summary
 
Summary of Recommendation and EvidencePopulation Recommendation  - Grade   B
Adults who are overweight or obese and have additional CVD risk factors

The USPSTF recommends offering or referring adults who are overweight or obese and have additional cardiovascular disease (CVD) risk factors to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention.

 

 

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.  Not all beneficiaries of Traditional Medicare can afford a Medigap plan - some just pay their 20% and deductibles out of pocket and keep down their medical cost.  Others with very low income are supplemented with Medicaid - sure doubt if Medicaid furnishes fitness programs.

 

If this program is important to you, it is available in many Medicare Advantage plans - don't like the plan offering in a particular year - you are free to change your Medicare Advantage plan during the annual open enrollment to whichever one has what you want.

WOW - Just look at what they are offering in 2019 - Avalere Press Release on 2019 Medicare Advantage...

As a result of additional flexibilities granted to Medicare Advantage plans by CMS, Medicare beneficiaries will have access to new types of supplemental benefits through Medicare Advantage,”  “Our research finds that almost half of all Medicare Advantage plans will offer new types of supplemental benefits in 2019.”

 

Supplemental benefits are additional services offered by MA plans that are not covered under Medicare Part A, Part B, or Part D,

 

Beginning in 2019, MA plans are permitted to cover a broader array of items and services as supplemental benefits so long as they are used to diagnose, prevent, or improve the effects of injuries or health conditions, or reduce avoidable emergency department visits. Previously, many of these services designed to improve patients’ day-to-day lives could not be covered as supplemental benefits under Medicare.    

 

Some higlights of a selection to be offering from various MA plans in 2019

  • At least 40% of plans will offer new types of supplemental benefits, such as nicotine replacement therapy (NRT), at no additional cost to beneficiaries. 
  • transportation to physician visits,
  • coverage of over-the-counter drugs,
  • adult day care services,
  • and other supplemental services that promote beneficiary health and wellness. 
  • caregiver support services (e.g., counseling and training courses for caregivers).
  • Other supplemental benefits offered for the first time include in-home support & personal care services,
  • home safety devices & modifications (e.g., shower stools, mobility ramps, night lights, etc.)  
  • social worker phone line,

 

 
2,442 Views
9
Report
Reply
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 costly medical procedures and pharmacetical drugs!

3,415 Views
0
Report
Reply