AARP/UHC Renew Active change for 2025

[js22]

I was told by The Exercise Coach this morning that AARP/UHC has removed them as a gym for Renew Active for 2025.

I have looked online at Medicare.gov  as well as the AARP/UHC Plan G for 2025 but not seeing anything that specifies that there will be changes for 2025, other than premium.

I called AARP/UHC customer service and was assured that The Exercise Coach  was still an available gym for me for 2025.

I found a YouTube video that talks about 2025 changes to renew active. He read a letter that UHC sent to a renew active member over 2 weeks ago. What it stated was that gyms listed as premium locations will no longer be part of Renew Active. The YouTube video is here: https://www.youtube.com/watch?v=1gEIIHEES70 about the 3:39 time mark. He did do a follow up video that indicated that removal of premium gyms was location based.

I have not received any communication from AARP/UHC about this. I emailed them to ask if it is true that premium gyms are being dropped and how do we know what locations are keeping premium gyms for Renew Active.

[PeggyA147789]

 How do we find out how to do this?

[CtyGal]

I have been told we should hear something in the next few weeks.  Stretch Lab told me some pretty good pricing for a couple months…I encouraged them to make it permanent 🤔

[JenniferG108816]

Most owners are offering pricing close to the reimbursement rate of UHC.  Just ask your studio!! 

[PeggyA147789]

My studio says no price reduction. 

[JenniferG108816]

 I own StretchLabs. I assure you, this was not our decision. This has been a huge revenue loss for us and 1500 members of my studios that are affected by this decision. Other plans still offer StretchLab as a service - not sure what state you are in. It is through Optum and is provided by other plans such as Kaiser will still cover premium gyms. This is purely a United Healthcare decision. 

[PeggyA147789]

 Interesting. United is blaming the programs. 

[TerriM890870]

• The inflation reduction act is causing companies to make changes to try and recoup . They are doing this by cutting out extras such as gyms. Its a loss for us all and has resulted in unintended consequences. Thank heavens, we’re getting new leadership in Washington.

[Charlien24]

I don't see the connection. Please explain.

[GailL1]

@Charlien24 

See my post to @KathrynH488719  below - I tried to explain it 

[KathrynH488719]

Please provide exact data from the IRA that is causing this.

[GailL1]

@KathrynH488719 

This is affecting Medicare Advantage plans because in most all plans now available, the prescription drug coverage is WITHIN the plan.  Known as MAPD - Medicare Advantage with an included Prescription Drug Plan.  So the plan insurer is having to cover MORE of the cost of drugs in 2025 and going forward.  

KFF.org - 10/09/2024 - A Current Snapshot of the Medicare Part D Prescription Drug Benefit 

From the link:  

• Changes to the Medicare Part D benefit under the Inflation Reduction Act are taking effect in 2025, including a new $2,000 out-of-pocket cap, an increase in the share of drug costs above the cap paid for by Part D plans and drug manufacturers, and a reduction in Medicare’s share of these costs.

This is just one place - the other is the $ 35 per month insulin cost cap, which is also adding to their cost.   Another is having to carry a beneficiary’s time payments for their annual drug cost if necessary. 

So the insurers are trying to make up for their added cost brought on by the IRA  by changing their plans in ways that they can - 

• Some MA plans (total plan) in certain areas of the country just aren’t coming back at all in 2025.
• Formularies have been reconfigured with drug changes and drug tiers.
• Changes in “extra” benefits of whatever type.

From the same link (only listing those that affect a plan’s insurance sponsor)

Changes to Part D Under the Inflation Reduction Act

Provisions in the law include:

• Limiting the price of insulin products to no more than $35 per month in all Part D plans and makes adult vaccines covered under Part D available for free, as of 2023.
• Adding a hard cap on out-of-pocket drug spending under Part D by eliminating the 5% coinsurance requirement for catastrophic coverage in 2024 and capping out-of-pocket spending at $2,000 in 2025.
• Shifting more of the responsibility for catastrophic coverage costs to Part D plans and drug manufacturers, starting in 2025

They were also limited in how much they could raise premiums - IF THEY HAD PREMIUMS, some of them did not participate in the Part D Premium Stabilization Demonstration - and thus are doing other things to offset their increase in cost.

Many MAPD (Medicare Advantage with Prescription Drug Coverage) didn’t have a premium in 2024 at all because the insurers balance this all out within their plan structure - so if they are gonna continue to do this then changes have to be make in other parts of the plan.  

(again from same link)

Annual growth in the base beneficiary premium is capped at 6% due to a provision in the Inflation Reduction Act. A new Part D premium stabilization demonstration for PDPs is also helping to moderate premium increases that Part D enrollees might otherwise have faced in 2025, as insurers adjust to higher costs associated with the new $2,000 out-of-pocket spending cap and increased liability for drug costs above the cap

Most MA-PD enrollees pay no premium beyond the monthly Part B premium (although high-income MA enrollees are required to pay a premium surcharge). MA-PD sponsors can use rebate dollars from Medicare payments to lower or eliminate their Part D premiums, so the average premium for drug coverage in MA-PDs is heavily weighted by zero-premium plans. In 2024, the enrollment-weighted average monthly portion of the premium for drug coverage in MA-PDs is substantially lower than the average monthly PDP premium ($9 versus $43).

Part D plans must offer either the defined standard benefit or an alternative equal in value (“actuarially equivalent”) and can also provide enhanced benefits. Both basic and enhanced benefit plans vary in terms of their specific benefit design, coverage, and costs, including deductibles, cost-sharing amounts, utilization management tools (i.e., prior authorization, quantity limits, and step therapy), and which drugs are covered on their formularies. Plan formularies must include drug classes covering all disease states, and a minimum of two chemically distinct drugs in each class. Part D plans are required to cover all drugs in six “protected” classes: immunosuppressants, antidepressants, antipsychotics, anticonvulsants, antiretrovirals, and antineoplastics.

In summary, the MAPD insurers are trying to make up for their added cost brought on by the IRA  by changing their plans in ways that they can - they are restricted by CMS and the law as to what they HAVE TO COVER - so they have only so many ways to make up for these added cost that have been placed on them by the IRA.

Wellness benefits maybe part of the plan but the location and nature of the gym / exercise program can be changed.  Any added benefits have a disclosure expressing the limits no matter what they are - if it is not dictated by CMS as to what has to be included, then it is an extra benefit provided from the insurer (I call them loss leaders) and the details of the plan can change or in some instances, removed all together, like in a Medigap plan.

[CherylA596421]

Honestly, it's frustrating and unacceptable that this is happening. Healthcare costs are already overwhelming, and now benefits are being reduced, with less coverage provided. This cannot be allowed to continue. When excuses are made to justify these actions, it only perpetuates the problem. We should not accept this as the norm and must continue to demand better from UHC.  

[TerriM890870]

Thank you for the explanation. I have not heard it explained as well as yours . Since you are so knowledgeable, can you also expand on another thing I’ve been reading that all of us are going to be facing Medicare premium  increases next year. But they hid it away in inflation reduction act not to take place until next year so it didn’t affect the election.  Could you clarify on this? 

[KathrynH488719]

Thank you for that explanation.  The reason people are so frustrated is that gyms like "Exercise Coach" were amazing! and very beneficial to seniors.

[DavidG962812]

The inflation reduction act was signed into law in 2022 and also had a cap on Part D plans in 2024 (granted, $3,300 which is higher than 2025) but we still had premium gyms. Did UHC not plan for the legislation. 

[KathrynH488719]

They just need to generate more than their $40 billion a year in profit

[GailL1]

@DavidG962812

The lions share of the changes that affected the Part D program began in earnest for CY 2025 - especially the Part D plans responsibility to cover more of the drug cost of their members.  So yes, they planned for it by what we are seeing now in their plan designs for 2025.

In some locations, the MAPD plan they were on just disappeared altogether.  For others, formulary changes.  So in the total scope of crucial medical needs, losing access to some gym locations is kind of small potatoes - So in a way, UHC plans did some trade offs.

[KathrynH488719]

Yes, they plan to make more than their $40 billion a year in profit

[LisaT742060]

You would think they would still make it part of the supplemental plan then because obviously that is an affecting their bottom line for supplements. It’s so frustrating

[GailL1]

@LisaT742060 

I’m not involved with this AARP/UHC Supplemental Renew Active stuff but it seems that they are cancelling just the premium gyms or the premium gym services in the Suppl;mental plans - so there should be some other gyms / services still available albeit different ones.  

The Disclosure reads:

These offers are available at no additional cost to you and are only available to insured members covered under an AARP Medicare Supplement Plan from UnitedHealthcare Insurance Company. These are additional insured member services apart from the AARP Medicare Supplement Plan benefits, are not insurance programs, are subject to geographical availability and may be discontinued at any time.

AARP/UHC Supplemental Ins. Plans - Wellness Extras 

[ChrisO646446]

True, there are still options but most are not even close to being appropriate for seniors.  I'm sorry but 24hr Fitness, Planet Fitness, LA Fitness are low end clubs that cater to 20 yr. olds.  The options they took away were all geared towards seniors.  This is a mess!

[TRL1111]

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@ChrisO646446 wrote:

The options they took away were all geared towards seniors.  

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Orangetheory, the most prominent one that's not owned by Xponential, is most definitely not geared toward seniors.  

Renew Active is keeping locations that are the most senior-friendly--YMCAs and community recreation centers. As I've said, their network starting on January 1 will closely resemble the Silver Sneakers network, and nobody ever claims Silver Sneakers' network isn't senior friendly.

Also, Renew Active IS keeping some more bespoke studios.  There are some independent pilates and yoga studios in my area that as far as I can tell are going to stay in the Renew Active network (as premium locations); they're like Club Pilates and Stretch Lab were, in that you get a certain number of classes a month (usually four).  I already belong to one, and will obviously check out the others.

I'm going to dearly miss Club Pilates, but outside of paying for a membership myself, there's nothing I can do.  I'd be shocked if UHC goes back to paying Club Pilates $31 every time I walk through the door.  So I'll just use alternatives.  I'm lucky that I'm currently in an area with a robust community recreation center culture, and I regularly go to yoga and pilates classes at three of them.  Without Renew Active (or Silver Sneakers), I would have to pay for a separate membership at each one, or a drop-in fee every time I wanted to go.

I obviously prefer the pre-2025 Renew Active network, but I still find a lot of value in what's left.  Then again, I looked at my home town, out in the sticks, and there's only a handful of locations, including the local hospital's fitness facility and the YMCA, plus Planet Fitness and a couple I can't easily get a read on because Renew Active's links for are almost always dead.  But then again, there was never a Club Pilates or Orangetheory or Stretch Lab there, so there's no change for 2025.  It's just a town with "typical" fitness options.  And FWIW, I checked Silver Sneakers' network in that town, and it's almost identical to Renew Active's.

[CherylA596421]

@ChrisO646446 wrote:

The options they took away were all geared towards seniors.   You are not correct -- Club Pilates, Pure Barre and many more are not geared towards seniors. Please check it out yourself. As @TRL1111 mentioned -- Orangetheory is not geared towards seniors.  In fact, I am the minority when I go to Club Pilates, Bar Method or Pure Barre.  It's disappointing -- the changes that have occurred. However, regardless -- these premier fitness locations should not be dropped.  I don't want to go to a typical gym -- which offers no guidance and less experienced fitness instructors. 

[TRL1111]

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@CherylA596421 wrote:

However, regardless -- these premier fitness locations should not be dropped.  I don't want to go to a typical gym -- which offers no guidance and less experienced fitness instructors. 

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How much would you be willing to pay in order for them not to be dropped? 

Silver Sneakers doesn't offer them, and Silver & Fit offers them but you have to pay extra for each membership.  Paying $31 every time a Renew Active members walks through the door of a Club Pilates just isn't financially sustainable, and even less so if the members also go to other expensive gyms like Yoga Six and Pure Barre, or multiple Club Pilates locations.  Silver & Fit makes you pay for each one of those memberships.  

FWIW, UHC is keeping its One Pass program for employer-provided insurance plans, and it does include places like Club Pilates, BUT membership in One Pass costs an additional amount over and above the insurance premium, and there are tiers of membership and you have to pay for the highest tier of One Pass membership to get places like Club Pilates.  So they've obviously decided that providing Club Pilates, etc. for free is what's got to give.  

[roberth122727]

keep in mind supplement G is the same across any insurers platform.  The only reason someone should select x company is price and extras.  Reducing some premium gyms is an extra they are taking away.   Members need to keep contacting them to reconsider.  If they take away extras another insurance company is an option without losing any benefits.

[CarolynBI]

If you live in one of the many states that don't let you change once a year, you will need to pass medical underwriting to change. Many won't pass and so are trapped for life paying for things they no longer have. 

[roberth122727]

I just contacted UHC, and they informed me that it was the clubs that did not renew.  I am sure it's based off of the clubs not getting the money from each member they would like.  if this is the case, then the clubs are the ones at fault.  

[CtyGal]

Don’t think it was the individual club’s decision…believe it was made by the parent company and UHC.

[PeggyA147789]

 Each one is pointing fingers at the other.

[JenniferG108816]

 They are not being truthful with you. I own StretchLab and this is a huge revenue loss for our company and thousands of our members are being effected. True it was less then other members pay, but It was still enough to cover the service. Other Health plans will continue to cover premium gyms such as Kaiser and Physicians Mutual. Call other plans and ask for OPTUM coverage. Optum is the provider UHC buys the product from. I hope everyone that benefits from this product can find a plan that offers it.