Why underwriting if you change from AARP UHC Plan G w/wellness benefits to without

[WilliamL207263]

When I signed up for AARP UHC Plan G a few years ago, they didn’t have an option for declining the wellness benefits. It seem like they do now and it can save some money. I have been told you need to go through underwriting for this. Given that it is the same Plan G, why can’t you just decline the extra benefits (which I don’t use)?

[CarolynBI]

What they told me is that the original G with the alleged free benefits )which clearly aren't free since the G without them is much cheaper) and the new G without the "free" benefits are actually not offered by the same subdivision of United Healthcare so we can't just switch. We have to undergo medical underwriting. To me that is a loophole that is unfair as they claiming something is free when it isn't (since the plan without is cheaper). That should mean we have guaranteed issue rights. When I questioned that they said since they were different companies, even though owned by the same parent company the two plans and their rates have nothing to do with each other and we still have the extra benefits. I argued but they aren't free since the G without is $70.mo cheaper. They told me again different companies different plans so no deception. Sigh. A bunch of X&@#. 

[GailL1]

@CarolynBI @joostmw @WilliamL207263 @j186060m 

Yes, there are (2) different UHC affiliate companies that offer Supplemental Plans - the company that you choose will have different items covered which are outside of the Federal requirement which each Medigap plan (Medicare Supplemental) has to cover in each of the plans.

To go from one (company name) to another (company name), depending upon your state, you would have to go thru underwriting.

UHC.com - AARP UHC Medigap Plan Differences 

As you can see and read in the link - 

AARP Medicare Supplemental Insurance insured by United Healthcare are under

1.  United Healthcare Insurance Company of America. OR

2.  United Healthcare Insurance Company 

#1 United Healthcare Insurance Company of America - offers the supplemental plans WITH A DISCOUNTED PREMIUM STRUCTURE

#2 United Healthcare Insurance Company - offers the supplemental plans WITH WELLNESS EXTRA BENEFITS

A beneficiary should be able to look at their Explanation of Coverage document and see which of these companies are writing the AARP/UHC Supplemental plan which they have.

The one that has premium discounts (United Healthcare Comany of America) available have different types of them and are used as to which is the better one for your situation when 1st signing up.

The one that has the wellness extra benefits (Untied Healthcare Insurance Company) specifies the type of wellness benefits but does not commit to what company would be supplying them - so that can change.

It is also VERY important to always read the footnotes and the disclosures so you know exactly what you are getting when you sign up -  This is really not any different than other types of insurance of whatever type.

[CarolynBI]

Thank you for that information. When I signed up in 2018 this state ONLY had the G with extra benefits. The G without them was first introduced in this state June 1, 2023. As a result my choice was G or some other different alphabet letter medigap from AARP UHC and not between two different G's. When I signed up - and it STILL says this - it says FREE wellness extra benefits. The word FREE is in the description. Clearly they are not free or the G with them would cost what the other G without them does. Also when I signed up I was told, and had in writing that we have a declining "discount" on our premium based on age. So the G I have also has the discounts ages 65-75 so that is not different either. There may be state differences and so it may be different in your state, but this is what the case is in my state. I also confirmed this more than once with them when calling about this issue.

[GailL1]

@CarolynBI 

Look at your Explanation of Coverage (EOC) and see what (affiliated) company issued it.  It could have been under a different set up at that time with even another affiliated company writing business for AARP/UHC Medigap plans.  

Now, there could be another (afflliated) company in your state that writes new business with [whatever] benefits.  So to switch from what you have now to another AARP/UHC Plan G, depending upon your state, may require underwriting.

Also read all the footnotes and disclosures and disclaimers - you may still get the “free” wellness benefits unless they have discontinued them - they have this right if it is shown in your EOC that they can be cancelled at anytime.  If you do still have them, the insurance company still controls the narrative as to the where, when and how.

The only thing that is legally set in stone is the Federal benefits that come with your chosen Medigap plan.  The rest is superficial (I call them loss leaders) because they aren’t really contractual but more promotional.    So there is a lot of leeway in the design of wellness benefits.

Your declining discount is more about money and therefore more set in stone IF it states the discount in your contract with UHC.    

Again, you will have to read your specific contract to find out any specific extra inclusions, special circumstances in your plan and how it is worded.  

Checking with your state’s DOI - Consumer Health Division - they might be able to give you more info on any state requirements.  

Underwriting is subjective by insurance companies - they each have the ability to determine acceptance or denial, increased premiums based on health condition, or even the pre-existing condition wait period.  Nothing wrong with trying to switch if health isn’t a big concern.  Just don’t cancel the old one until you have the new one in hand and with a stated new premium.  You have to keep paying the premiums on the old one until the new one is in place and you have paid the 1st month of the new one.  Even if you have to pay for both for one month and then hopefully get a refund of the one that is cancelled.  

Came back to EDIT and add

These are your Medicare Medigap Guaranteed Issue Rights -

At the link, read the imbedded link titled:  

It is about half way down the page. 

What Are Guaranteed Issue Rights? 

Now those are the Federal ones.  

Your state DOI should know if your state has added special times when a Medigap can be Switched and to what.

Like this:  (courtesy of AI)

States like Connecticut, Massachusetts, New York, and Maine offer expanded Medigap rights, allowing individuals to purchase or switch plans at any time with guaranteed issue protections, meaning they cannot be denied coverage based on their health history; several other states including California, Idaho, Illinois, and Oregon have "birthday rules" allowing policyholders to switch plans around their birthday each year with certain limitations. 

Key points about expanded Medigap rights in different states:

• Continuous open enrollment:

  Connecticut, Massachusetts, and New York allow individuals to buy a Medigap plan at any time without being denied due to their health status. 
• Annual guaranteed issue:

  Maine requires insurers to offer a Medigap Plan A during an annual open enrollment period, essentially guaranteeing access to a Medigap plan. 
• Birthday rule:

  Several states including California, Idaho, Illinois, Maryland, Nevada, and Oregon allow policyholders to switch plans around their birthday each year, typically with restrictions on the type of plan they can switch to. 

There may be a few other states that have special rules for switching - like Missouri or Louisiana. 

[CarolynBI]

The AARP UHC two different G's are with 2 different subsidiaries of the parent company. That is the catch with respect to switching without medical underwriting since there is no guaranteed issue rights involved in my case. Because they sold mine with free benefits, that they continue to state is part of it, they can't cancel those without substantially changing the plan which would give me Guaranteed Issue to change to another one. My guess is that they aren't going to do that.

I am also guessing adding as alleged freebies was meant to compete with advantage plans with respect to some of the "extras". Of course they also offer advantage plans but the big issue with those is networks and massive (eg more than the premiums for G and the B deductible and D premiums and deductible/out of pocket) out of pockets if you actually need to use your health care. G without the extra crap is cheaper and for those also influenced by premium cost (along with total costs) this is another niche for them.

[joostmw]

I just ran into the same issue.  Did you ever get an answer?  

[j186060m]

Good question.  When I initially purchased my UHC Plan G Medical Supplemental insurance I did so via a salesperson and declined at that time.  She has been in contact with me this year as it is renewal time.  Are you in contact with your UHC salesperson?  If so, make contact with UHC to confirm.

Hope this helps.