United Healthcare

[JimG454455]

Just curious when you guys are going to address and speak to this issue. My guess is many of your members are negatively affected by Advantage plans and more specifically the ones AARP endorses - United healthcare. I am currently living the nightmare of dealing with UHC. Their denial, delay and defend strategies have all been applied to my care which has had a significant negative impact to my care and recovery.  I joined AARP because of your advocacies for seniors. What is currently in the news about the horrors of our healthcare system that are affecting seniors most needs to be talked about.

The fact that AARP has been mostly silent on these matters AND endorses the worst offender is a disservice to your members. You lend your respected name, which I know your are paid handsomely for,  at the peril of your members.

The exposure and pressure to reform their cruel practices needs more coverage, not just a silent endorsement.

Please step up and help us on this issue.

Regards

Jim Groll

[alexajame]

AARP Services Inc is the subsidiary responsible for developing and managing member benefits, as well as handling licensing agreements.

[MichaelF913222]

So I'm one year in, and from July 2024 to July 2025 my Plan G policy from United HealthCare has gone up 30%. If this is typical, it will not be sustainable for me too much longer.

Is AARP even concerned about this enough to do anything? I'm still very much in the learning phase.

[TRL1111]

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@MichaelF913222 wrote:

So I'm one year in, and from July 2024 to July 2025 my Plan G policy from United HealthCare has gone up 30%. If this is typical, it will not be sustainable for me too much longer.

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And it's going to go up even more in future years because of the declining age-related discount you signed up for.  At least with that one, you know in advance what it will be.

Have you gone to medicare.gov to price other companies' Plan G supplements?  If you can pass medical underwriting, you can switch any time you want.  Or you might be in a state that has certain guaranteed-issue periods, where you can switch without medical underwriting.  Note that the open enrollment period at the end of the year has nothing to do with supplements.

If nothing else, you can use medicare.gov to look at what other supplements cost.  UHC is not the only one with big premium increases.  I read an insurance brokers' forum and ACE Insurance (Chubb) is having big increases.  One person reported 28% across the board in Oklahoma, for Plans A, F, G, and N.  (Even though N is assumed by most people to not go up as much because it presumably has a healthier risk pool.)  Another person said it's 18% in Georgia and 23% in Ohio and Alabama.  Someone else said in Illinois it's 47.6% for F and 39.7% for G. 

But realistically, there's nothing AARP can do about it.  The insurance companies set the premiums based on claims experience, and regulators approve them. 

[dkallen1333]

  I would also like to know AARP's stand on UHC.  In addition to the latest press, I received a notice recently that my AARP UHC Gap Plan premiums are increasing 30% this year due to increasing costs. This gap plan covers only 20% of my expenses, and I think it is outrageous that they can raise rates this much in one year.  Is AARP still standing behind this company? Please help us to bring out these issues and fight them. 

Deb Allen 

[GailL1]

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@dkallen1333 wrote:

  . . . .  I received a notice recently that my AARP UHC Gap Plan premiums are increasing 30% this year due to increasing costs. This gap plan covers only 20% of my expenses, and I think it is outrageous that they can raise rates this much in one year.  . . . . 

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This is what you have wrong - “20% of MY expenses” - NO, not just your expenses but 20% of everybody’s expenses that in the Plan with you.

They based the premium increases on their loss ratio - which is their cost of coverage as compared to the premiums they are bringing in.

Through 2024, you may have had only only a few medical expenses or even none but the guy across the street from you that also has your same plan had a whole lot of expenses - in and out of hospital, perhaps an operation or two and all that entails, rehab facility with PT / OT , plenty of doctor visits, a bunch of imaging and other test - anything that was medically necessary and approved by Medicare.

Insurance is a share and share alike program - you help pay for others and they help pay for you.  

If you can get by on paying your own “20%” or whatever, just cancel the GAP coverage and pay out of pocket - but pay attention to the “what If” scenario - 

20% of a large amount is still a large amount.

[CBtoo]

I think the poster was talking about 20% of her personal costs are covered by her gap insurance.

You are talking about the increase has to cover everyone's costs to the gap plan so the plan stays out of the red and doesn't lose money.

Incidentally I must be lucky as my premium for G (eg June 1 increase) only went up 9.3%

[MarjorieM238987]

 My Plan G premiums increased more than 25% this year (premiums, not personal costs). This is not unusual. I'm seeing more reports of this across the country. And yes, I'm referring Plan G, not F. 

Let's face it folks, the insurance industry is fat and happy and some of it is coming out of our pockets. The UHC CEO received a $10 million bonus last year. 

 I have the AARP UHC plan and am underwhelmed by it. Like a previous poster I     want to know what AARP has to say about this. My guess is these so-called cobrand deals (where AARP puts its brand on commercial products) may be more a business deal than anything - as opposed to a true partnership where AARP has input. Regardless, AARP needs to respond to its members.     

[Tonster521]

@MarjorieM238987 The 25% increase is hard to accept. Many think the increases are contributing to the net profits of health insurance companies. However, many folks do not know about Medical Loss Ratios which is a contributing factor for setting next years premium. I am including a link from the NAIC which will provide you and other readers interesting statistics regarding how revenue (i.e., premiums, investments, etc.) and expenses (i.e., claims, administration, etc.) result in very low net profit margins for the health insurance industry. https://content.naic.org/sites/default/files/topics-industry-snapshot-analysis-reports-2023-annual-r... The NAIC Report is through 2023. I did not find a NAIC Report for 2024 on the internet. At any rate, you find that Net Profit Margins hover between 2% to 3%. In my opinion, that is not enough of an incentive to be an ongoing concern. As you know, medicine is a competitive business. And, with more and more States legislating adverse risk (ability to switch plans on a birthday or policy anniversary), the costs for that feature (adverse risk) is a contributing factor that affects the premium. I am not sure if the ACA requires health insurers to return 80% or 85% of the premium as benefits or claim payments. I am also not sure if this requirement affects Medigap Plans. So, does AARP have anything to do with the premium? I would say no. As GaiL1 pointed out, the AARP brand is a business deal (think Marketing). As I understand the deal, it is similar to a sports figure on a cereal box or a celebrity on cosmetics.

With regard to profit margins, I am including a link to another large public corporation in the electronics business. https://www.macrotrends.net/stocks/charts/AAPL/apple/profit-margins You should note that Gross Profits hover around 45%; and, after deducting expenses, net profits hover around 25%. Most of their products are built offshore which means no FICA and Medicare taxes are paid. I believe Apple as recently made a pledge to move some business to the USA. Isn't it about time.

Lastly, UHC is a public corporation. So, executive compensation is available on the internet. In 2024, their CEO received $26,339,215 in compensation. Salary was $1.5 Million. Stock Options were $5.75 Million. Stock Awards were $17.25 Million. Non-Equity Incentive Plan (I believe this may be called a bonus) was $1.5 Million. Other compensation was $339,215. Where did you get the $10 Million bonus figure? For comparison, Apple CEO received $74.6 Million. Salary was $3 Million. Stock Awards were $58.1 Million. Non-Equity Incentive Plan (bonus?) was $12 Million. Other compensation was $1.5 Million.

[GailL1]

@MarjorieM238987 wrote

.. . . .My guess is these so-called cobrand deals (where AARP puts its brand on commercial products) may be more a business deal than anything - as opposed to a true partnership where AARP has input. Regardless, AARP needs to respond to its members.  

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Their working relationship is all over the AARP website, it is shown on the actual explanation of coverage of the beneficiary’s plan.

“  DISCLOSURES

AARP commercial member benefits are provided by third parties, not by AARP or its affiliates. Providers pay a royalty fee to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. Some provider offers are subject to change and may have restrictions.”

https://www.aarp.org/membership/benefits/insurance/uhc-medicare-supplement/ 

[GailL1]

While 30% is a very hefty increase for any gap plan - there maybe more to the story.  The poster may have a Plan F which are getting pretty hefty increases since it is in essence a closed book plan but still 30% is unusual.

I did not take the posters comment as you did - 

[CBtoo]

Premium increase: there are two kinds of premium increases each year with supplements anyway. Each year you lose part of the age related discount on your birthday so rates go up for that reason. Then there is the increase that affects everyone on June 1 which is the annual increase due to costs. 

AARP doesn't stand behind this company or the other ones they endorse. It is strictly a financial arrangement where the other companies pay to use their logo. And, of course, if UHC pays them a ton that is worked into our premiums. They make about 1.2 billion off of endorsements by UHC, Oak Street Health, etc,

Do I wish AARP would only have arrangements like that with reputable companies that are honest and ethical? Yes. Unfortunately there is no law that I know of that regulates selling the use of their name. 

The 1.2 billion goes into the for profit arm of AARP (the membership we have is their non-profit arm) and pays for the bulk of what they do (they don't make all that much off of memberships). 

[GailL1]

AARP Services Inc  

This is the subsidiary that develops and manages the member benefits as well as the licensing agreements.

[GailL1]

Not all Medigap insurers offer a declining enrollment discount so they usually only have one increase in premiums per year based on their rating method for the plan, medical loss ratio, medical inflation or any changes government may be dictating.  

[CBtoo]

That is true but I was talking SPECIFICALLY about AARP/UHC ones and they do have declining discounts. 

[Winter2025VA]

[3/19/25] It seems things are getting "interesting" this year 2025.

Published March 18, 2025 6:17pm EDT.

📋AARP's partnership with healthcare giant faces backlash amid recent controversies (Fox Business).

FROM ARTICLE: 'Shameful': AARP's partnership with healthcare giant faces backlash amid recent controversies
AARP and UnitedHealthcare announced in 2017 that their partnership would run through 2025.

https://www.foxbusiness.com/fox-news-politics/shameful-aarps-partnership-healthcare-giant-faces-back...

[SethF456578]

Regardless of their legalese, slapping the AARP brand on it implies a tacit approval and must have significant value to UHC or they would not be paying AARP for the privilege. Therefore, AARP has a responsibility to its members, who they claim to be looking out for their best interests, to consider everything before allowing their brand association. They owe it to us, their membership.

This is certainly minor in the scheme of things, but even on the supplemental plans (i.e.: not the Advantage plans), UHC seems to have a bit of a cavalier attitude to what they provide. For example, one of the only 'perks' they offer is free gym membership at Planet Fitness and YMCA gyms. But recently, and without any notice, they just reduced the offering to the most basic level, so that I would now have to pay for the same benefits as I had just two months ago- and those using YMCA's have to pay to use them at all! No notice. No explanation.

When I asked the agent who sold me the UHC plan to ask about it, it took weeks to get a response, and that amounted to something akin to "so what, not our problem".  And this is something they offer in order to provide preventative options that will save THEM money from reduced claims!

Time for AARP to look after their members a little more than their wallets. I am sure another insurance company would love to step up and reach out to the members....

[Winter2025VA]

[Thursday 3/6/25] Seth @SethF456578 , gone are the days when AARP cared about people. NOW it is all about the age 18+ members and advertisements. Medicare is NOT a factor in their plans. Shame on that agent. It is THEIR PROBLEM!!! How can they sleep at night KNOWING they are referring "unsuspecting" old people to PLANS they know is suspect. Take care, Nicole  👵

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[*** @SethF456578 wrote:

Regardless of their legalese, slapping the AARP brand on it implies a tacit approval and must have significant value to UHC or they would not be paying AARP for the privilege. Therefore, AARP has a responsibility to its members, who they claim to be looking out for their best interests, to consider everything before allowing their brand association. They owe it to us, their membership.

This is certainly minor in the scheme of things, but even on the supplemental plans (i.e.: not the Advantage plans), UHC seems to have a bit of a cavalier attitude to what they provide. For example, one of the only 'perks' they offer is free gym membership at Planet Fitness and YMCA gyms. But recently, and without any notice, they just reduced the offering to the most basic level, so that I would now have to pay for the same benefits as I had just two months ago- and those using YMCA's have to pay to use them at all! No notice. No explanation.

When I asked the agent who sold me the UHC plan to ask about it, it took weeks to get a response, and that amounted to something akin to "so what, not our problem".  And this is something they offer in order to provide preventative options that will save THEM money from reduced claims!

Time for AARP to look after their members a little more than their wallets. I am sure another insurance company would love to step up and reach out to the members.... ***]

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[GailL1]

@Winter2025VA @SethF456578 

Personally, I think people should buy what they need and can afford and get the best coverage for their needs and forget many of these bells and whistles which just ups the price of [whatever-type Medicare] policy.

I put the blame pretty much on the insured beneficiary for not learning about Medicare and how it works - sometimes for them and sometimes against them.

I believe that since so many people had employer coverage while working that they really didn't have a lot of deciding on which policy and thus never learned how to pick what they need rather than what bells and whistles they are getting.  

I have never found a membership benefit [any group] to be any better than what I might be able to find on my own.  

[MarjorieM238987]

Sorry GailL - we're not talking about bells and whistles, we're talking about coverage for basic health care and life threatening illnesses. My 25% premium increase this year was for basic, bare bones coverage. Want to tell me how predict and plan for future increases? 

My best guess is we should probably talk to UHC's lobbyists in Washington. 

By the way, things like gym memberships actually Lower healthcare costs. 

[GailL1]

@MarjorieM238987 

I assume you are speaking about Medicare Supplemental coverage or Medigap.  Medigap really isn’t health insurance, this type of coverage does not make any healthcare calls - it’s basis is purely under the Medicare lead - Medicare pays, Medigap pays.  Medicare does NOT pay, Medigap does NOT pay.  

Medigap coverage is more financial protection insurance to protect one from a financially catastrophic medical event paid up to the Plan of choice’s coverage - all or some - since the traditional program of Medicare has no annual or lifetime limits in what a beneficiary may have to cover as their part of the cost;  some definitely need some protection.

Remember that if you have a AARP-UHC Medigap plan that has a declining premium discount based on age,  that % increase may also be in the increased premium mix depending on your anniversary date.

Yes, this has been an especially high cost year for Medigap plans - not just AARP-UHC - Allstate has terminated itself from the Medigap market.  They will sell no more of these policies.  From my understand ACE, which use to be a subsidiary of CHUBB, don’t know their relationship now, who offered some  Medigap plans in some states, raised their premiums by 38%.  

A recent NAIC report showed that a lot of medicare supplemental plans have a bad risk ratio - IOW, they are not doing well as a medigap insurer - more claims than they planned fior - 

Much of the financial rules of a Medigap insurer is in the hands of the various states.  Pass the Plan benefit definitions and the basic initial enrollment period and who is covered by Fed law (65 and over) - everything else is under the state control.  States can add additional enrollment periods (guaranteed issue - without underwriting) and a few have continuous enrollment no matter what - they can also review their premium increases and they can set the reserve amount which the insurers have to maintain.  So if your state has made any of these type changes to a medigap insurer - your premiums will increase.  Some states also legislate that those less than 65 years old can buy any Medigap plan they want - these are people with disabilities so they could be high Medicare users and thus high Medigap users.  

But of course, health care cost under Medicare is also getting more expensive - not so much in how much is paid for a particular procedure or providers but the added cost of new discoveries - like the image testing of people if their doctor thinks they may have the beginnings of Alzheimer’s and then the monitoring images if they are put on the medication to test its results.  It all adds up.  

Then there is the usage of Medicare benefits - more and more people are going into the program and more and more are using the services provided and if they are in the same group for a Medigap plan then cost go up for the chosen plan.

I would plan for it to continue to go up.  There is little a medigap insurer can do about the health care cost that they pay - that’s what Medigap does pays the part that Medicare does not cover.  They can try to set fair premiums - not too high and not to low - because those with low “intro” type premiums do go up eventually.  And I don’t see what lobbying would do for the Medigap market - every insurance marketplace has its own numbers -

You might be right that gym membership lowers healthcare cost at least for some -so you can pay for that benefit if they continue to offer it - it isn’t legislated as a benefit, only a cost - maybe a loss leader as in BUY ME !! 

[SethF456578]

While I generally agree with the idea that you should be mindful and research your options, my point is that I did just that and they changed the benefit with no notice mid term and then acted like ‘so what’.

if you bought a car including oil changes for 2 years and 14 months in the said ‘no more free oil changes’, you might be a bit annoyed. Some would even sue. My point is they did just that and didn’t care at all. 

I don’t think anyone would disagree that our healthcare system is failing. Just look at the facts. We are rank terribly compared to the rest of the developed countries in pretty much everything from infant mortality and maternal mortality to financial destitution as a result of a bad health incident. I am not expecting AARP to fix this. But I do expect them to vet their partners and ensure those that they allow to use their seal of approval, their brand, are doing the best for AARP members. But apparently that is too much to ask these days. 

It’s a shame. 

[GailL1]

@SethF456578 

One must be careful to separate what is contractual and what is a lost leader - You get the contractual cause that has law behind it but as for those “extras” you have to read the small print indicating that they can cancel these at any time.

[SethF456578]

Not to belabor the point, but my issue was not that they couldn’t cancel it (although that sucked) but that there was no notice of any kind and their customer service was unsatisfactory to say the least.

[Winter2025VA]

[Thursday 3/6/25] Seth @SethF456578 , that should NOT be allowed!!!

YOU WROTE: They changed the benefit with no notice mid term and then acted like ‘so what’.

Take care,

Nicole  👵

[DirkB349973]

I didn't choose an Advantage plan for some of the reasons you mentioned. Here is an article on the pros and cons of Advantage plans.

https://www.consumerreports.org/money/health-insurance/pros-and-cons-of-medicare-advantage-a68341678...

[GailL1]

@DirkB349973 

Good article and I will add a bit more in describing how Medicare, the whole program works. 

i work as a volunteer patient advocate and I will say that prior approvals and denials of services are usually cleared up with some work.  

1,  Sometimes the provider of the service had their codes mixed up.  OR their records haven’t been fully updated with the patient’s diagnosis and plan of care and the procedure or treatment looks like it is just pulled out of thin air.

2.  The reason for a denial is important because both Traditional Medicare and Medicare Advantage insurers should be working from the same best practices info.  So initially, that’s where the investigation has to start - with the CMS.gov -  Medicare National or Local Coverage Determination.

3. Then if the procedure is definitely not covered - it isn’t covered under either  Traditional Medicare or a Medicare Advantage plan.   Then comes the explanation to the patient as to why something isn’t covered- and that is probably the hardest part.

Many times the process is long and detailed.  The Center for Medicare and Medicaid Services is the government entity that makes all the rules for both Medicare and Medicare Advantage plans.  They are also the ones that pays the insurers in the managed care part of Medicare - Medicare Advantage plans.  CMS supports utilization management in Medicare Advantage plans - but sometimes they do leave an opening when the insurers can add to the amount they are paid be that a bonus for a high star rating or a higher payment if the MA beneficiary brings with them a higher risk.  

As with anything government, it is very complicated and personally I think it could be simplified but even more than that, there is a need for beneficiaries to understand how Medicare [all parts of it] actually work.  

[SusanM664094]

Another post recently removed...That's how they're dealing with it....

"DwightH318517 (Newbie) posted a new reply in Medicare & Insurance on 12-12-2024 10:34 AM:

Re: Stay Away From United Healthcare"

[CBtoo]

I clicked on the Re:Stay away from uhc link in your post and got "access denied". LOL I guess they don't want to hear about negatives about one of their money makers for them (eg from royalties). 

[LisaS961881]

https://www.cnn.com/2025/05/15/business/unitedhealth-stock-ceo-investigation