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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 241 of 638

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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Re: Silver Sneakers being droped by AARP recommended insurer

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Message 242 of 638

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 243 of 638

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 244 of 638

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 245 of 638

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 246 of 638

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 247 of 638

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 248 of 638

@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 -

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: Silver Sneakers being droped by AARP recommended insurer - Solution for Me in Ohio

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Message 249 of 638

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 250 of 638

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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