Looking at Aetna or AARP/UHC

[audreyh1]

Where does the insurance company review your medical records? Is there a medical clearing house? Thanks

That’s what medical underwriting is all about.

 

[harllee]

DW has a hip replacement in a few weeks, and I have a colonoscopy in May, so I don't want to change until those events and payments are complete. So we expect to be shopping in July. Thanks.

One of the reasons my DH could not pass underwriting is that he previously had a knee replacement and had been advised he "might need a second knee replacement in the future."

 

[FiveDriver]

Just to refresh my memory, have we determined that AAARP/UHC Plan G is still using 'Community-based Pricing' with the associated lower premiums ?

And that they are not 'closing the book' on segments of their insured population ??

 

[CRLLS]

Just to refresh my memory, have we determined that AAARP/UHC Plan G is still using 'Community-based Pricing' with the associated lower premiums ?

And that they are not 'closing the book' on segments of their insured population ??

I cannot speak to all states. According to Illinois SHIP website, all AARP/UHC supplement offerings are community rated pricing.

 

[walkinwood]

In Colorado, it looks like the AARP/UHC plans are the only Community Rated ones


https://drive.google.com/file/d/1iMgDgxNHiVWE28jEq63XMTOkdCmrU9mb/view


The above is a link from this page: https://doi.colorado.gov/insurance-products/health-insurance/senior-health-care-medicare

 

[walkinwood]

Is there a source where you can find out if companies "Close the book" or how often they do it?

 

[sengsational]

Where does the insurance company review your medical records? Is there a medical clearing house? Thanks

When you apply, they ask you about health history. You can lie, I suppose, but when you have a claim, they'll see you lied and, you having fraudulently entered into the deal, they don't need to honor the deal.

Is there a source where you can find out if companies "Close the book" or how often they do it?

You might be able to get a list of all active Medigap companies in your state. You already have access to recruiting companies in your state, right on medicare.com. The ones that are still operating, but not selling are closed pool. This is theory, BTW; I haven't done this and could be fraught with problems. Then you look for versions of the same company name in the list. Or simpler: just ask the insurance commissioner's office.

 

[RetMD21]

The insurance company could require you to consent to a Medical Information Bureau report, right?

 

[savory]

I do not know enough about the various issues stated earlier. But addressing your question, we signed on with Aetna beginning January. No problems so far but we have not requested any services.

Our premium is zero. In the meantime we have been making money, about $300 so far by selecting Aetna and agreeing on specific health exams. I am not sure that program is the same everywhere.

I am concerned there might be an ulterior motive as one does not typically receive something for nothing. On the other hand, if I am having a problem, I would like to know.

After several years of not being on traditional Medicare, I am going to take a closer look next year given the choice of doctors. But I’m still not convinced I know enough about doctor performance to make a good choice between them.

 

[isisdave]

I like to suggest to folks considering Plan G to compare the numbers from Plan N, especially if they have relatively few in-office doctor visits.

When I signed up, it was several hundred a year cheaper. The only real difference is that Plan N has a co-pay of up to $20, but it only applies to regular in-office visits ... not to procedures, or labs, or radiology, etc. [I have never seen a "Part B Excess Charge" and I know they are not permitted in about 8 states.]

There's a good discussion here.

 

[Texas Proud]

I do not know enough about the various issues stated earlier. But addressing your question, we signed on with Aetna beginning January. No problems so far but we have not requested any services.

Our premium is zero. In the meantime we have been making money, about $300 so far by selecting Aetna and agreeing on specific health exams. I am not sure that program is the same everywhere.

I am concerned there might be an ulterior motive as one does not typically receive something for nothing. On the other hand, if I am having a problem, I would like to know.

After several years of not being on traditional Medicare, I am going to take a closer look next year given the choice of doctors. But I’m still not convinced I know enough about doctor performance to make a good choice between them.

Do you have an advantage plan? I cannot believe there is a gap plan with zero premium...

 

[Calico]

DW has a hip replacement in a few weeks, and I have a colonoscopy in May, so I don't want to change until those events and payments are complete. So we expect to be shopping in July. Thanks.

Just know that you're one scan, or one blood test (*) away from being unable to pass underwriting. Once that's in your medical record, that could be "it".

(*) or one polyp

 

[RetMD21]

Do you have an advantage plan? I cannot believe there is a gap plan with zero premium...

Exactly, and Aetna MA has nothing in common with Aetna supplements. He does say that he has been off traditional Medicare ie on MA.

I don't care what people do but this idea of switching to traditional Medicare when you start using more medical services is risky.

 

[Dawg52]

Just know that you're one scan, or one blood test away from being unable to pass underwriting. Once that's in your medical record, that could be "it".

Yep. In my case I was treated(immunothearpy) for a low grade bladder cancer last Summer. I'm doing well and everything appears clear but there is always a chance for it to return. I know I'm stuck with the supplement I have but it pays everything it's supposed to and haven't had any problems with them. My total premium(B and G) is still a lot less than what I was paying pre-medicare and I had a $10k deductible. So that's my positive take.

 

[yclipse]

Aetna does have its own Medigap policies, but they are issued by subsidiary companies. From the web site: "Aetna is the brand name for insurance products issued by subsidiary insurance companies. The Medicare Supplement insurance plans are insured by Continental Life Insurance Company of Brentwood, Tennessee, American Continental Insurance Company, Aetna Health and Life Insurance Company, or Aetna Health Insurance Company."

 

[Pluperfect]

Aetna does have its own Medigap policies, but they are issued by subsidiary companies. From the web site: "Aetna is the brand name for insurance products issued by subsidiary insurance companies. The Medicare Supplement insurance plans are insured by Continental Life Insurance Company of Brentwood, Tennessee, American Continental Insurance Company, Aetna Health and Life Insurance Company, or Aetna Health Insurance Company."

But as Texas Proud noted, it would be very very very highly unusual for a Medigap policy to have a $0 premium. Hence the conclusion that Savory's Aetna plan with a $0 premium AND $300 back for taking certain medical tests is Medicare Advantage and not a supplement/Medigap policy.

 

[savory]

But as Texas Proud noted, it would be very very very highly unusual for a Medigap policy to have a $0 premium. Hence the conclusion that Savory's Aetna plan with a $0 premium AND $300 back for taking certain medical tests is Medicare Advantage and not a supplement/Medigap policy.

That's correct. It is a Medicare Advantage provided by Aetna.