Tagged Wellness

Seniors Steamed Over Cuts To SilverSneakers Fitness Program

John Garland Graves was taken aback when he walked into his McKinleyville, Calif., gym in October and learned that his SilverSneakers membership was being canceled.

Since 2014, Graves, 69, has enjoyed free access to the gym through SilverSneakers, the nation’s best-known fitness program for seniors. He was disturbed by the news, as are many other people who have recently learned they’re losing this benefit.

A controversial business decision by UnitedHealthcare, the nation’s largest health insurance carrier, is causing the disruption. As of Jan. 1, the company is dropping SilverSneakers — an optional benefit — for 1.2 million customers with Medicare Advantage plans in 11 states (California, Connecticut, Illinois, Indiana, Iowa, Kansas, Missouri, Nebraska, Nevada, North Carolina and Utah) as well as 1.3 million customers with Medicare supplemental (Medigap) insurance in nine states (Arizona, California, Connecticut, Illinois, Indiana, North Carolina, Ohio, Utah and Wisconsin).

Graves, who works out four to five days a week and has a UnitedHealthcare Medigap policy, decided to seek coverage elsewhere after the company raised his policy’s rates and eliminated SilverSneakers in California. He has signed up for a new policy with Blue Shield of California.

Starting next year, UnitedHealthcare will offer members a package of fitness and wellness benefits instead of paying to use SilverSneakers — a move that will give the company more control over its benefits and may save it money.

Seniors with UnitedHealthcare Medicare supplemental policies will get 50 percent off memberships at thousands of gyms across the country, telephone access to wellness coaches and access to various online communities and health-related resources. Those with Medicare Advantage policies can join Renew Active, UnitedHealthcare’s fitness program, with a network of more than 7,000 sites, at no cost, and qualify for an evaluation from a personal trainer and an online brain-training program, among other services.

Steve Warner, who leads UnitedHealthcare’s Medicare Advantage product team, explained the company’s move by noting that over 90 percent of policyholders who are eligible for SilverSneakers “never step foot in a gym” or use this benefit.

UnitedHealthcare wants to reach “a broader portion of our membership” with a “wider variety of fitness resources,” he said, noting that the company’s shift away from SilverSneakers began last year and has accelerated this year. (Altogether, more than 5 million customers have been affected. But the company is making market-by-market decisions, and nearly 675,000 UnitedHealthcare Medigap policyholders and 1.9 million UnitedHealthcare Medicare Advantage plan members will retain access to SilverSneakers in 2019.)

“I think it’s a smart move,” said Connie Holt, an independent broker with Goldsum Insurance Solutions of Pleasant Hill, Calif.

But many of the company’s customers aren’t happy that SilverSneakers, which offers group classes tailored to seniors in addition to gym access at 15,000 sites, is disappearing. And confusion about alternatives is widespread.

It’s one of the “top topics” that seniors have been raising over the past few months when they call Ohio’s Senior Health Insurance Information Program, said Chris Reeg, the OSHIIP program director.

Michael Chanak Jr., 69, of Wadsworth, Ohio, had problems getting through to UnitedHealthcare’s customer relations department several times when he called with questions — a common complaint. “The way this is being implemented is a train wreck,” said Chanak, who has a UnitedHealthcare Medicare supplemental policy and spends an hour every day exercising at his gym.

People are “extremely upset,” wrote Margaret Lee of Arroyo Grande, Calif., in an email. “That’s about the only topic of conversation at my water exercise class!”

AARP has also become a target of anger because it endorses UnitedHealthcare’s Medigap and Medicare Advantage insurance policies — an arrangement that yields substantial royalties for the organization.

In an email, Mark Bagley, a spokesman for the organization, said, “UHC [UnitedHealthcare], not AARP, operates these plans and determines the benefits.”

“I will be dropping my AARP membership when it is time to renew,” wrote Shelley Holbrook, 67, of Yorba Linda, Calif., a UnitedHealthcare Medigap policyholder, in an email exchange about the loss of SilverSneakers. “I am a Parkinson’s patient who has been prescribed this type of exercise program,” she explained. “This program is under the guidance of certified instructors that make sure the exercise routines are performed correctly. … An ordinary gym membership provides no instruction on how to use the equipment safely for seniors.”

“A health coach is not what I need,” Holbrook continued. “I have used the health coaches before, and have found them to be totally worthless.”

For policyholders like Holbrook, the situation is complicated by another factor: Federal laws don’t ensure that seniors can switch Medicare supplemental insurance plans without undergoing new medical evaluations after an initial “guarantee issue” period. (This period occurs six months following a person’s enrollment in Medicare. Changes are allowed under a few specific circumstances and by laws in a few states.)

If seniors can meet medical standards, they’ll find SilverSneakers available from other insurance operators. In 2019, Tivity Health is offering the program through more than 65 health plans covering more than 15 million older adults and introducing a new digital platform that emphasizes its social benefits: SilverSneakers Connect.

“There are people we’ve learned who are alone but don’t want to go to the gym,” and the new platform can help them connect with each other as well as activities in their communities, said Donato Tramuto, Tivity Health’s CEO. Recent research suggests that SilverSneakers may help reduce isolation and loneliness in seniors who go to classes and form new relationships, he noted.

Whether UnitedHealthcare’s health plans will be less appealing because of the shift away from SilverSneakers is yet to be determined. Several years ago, Humana, another giant insurer, also began reducing the number of plans that offered SilverSneakers, but it faced a backlash from members and sales representatives. “The membership perceives [SilverSneakers] as a valuable benefit despite the fact that not everyone uses it,” said George Renaudin, Humana’s senior vice president of Medicare.

Humana subsequently reversed course and is now making SilverSneakers broadly available to about 3.5 million Medicare Advantage and Medigap policyholders.

Ray Liss, who retired seven years ago, just changed over from UnitedHealthcare to a Humana Medicare supplemental policy with his wife. The loss of SilverSneakers precipitated the switch, which has an unexpected benefit: The couple will save almost $60 a month next year on their new policy.

In an email, Liss, who declined to say where he lives, was philosophical about the value of exploring his options, writing, “I was pretty mad at the time, but it worked out for the best.”

We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips.


KHN’s coverage related to aging and improving care of older adults is supported in part by The John A. Hartford Foundation.

Seniors Steamed Over Cuts To SilverSneakers Fitness Program

John Garland Graves was taken aback when he walked into his McKinleyville, Calif., gym in October and learned that his SilverSneakers membership was being canceled.

Since 2014, Graves, 69, has enjoyed free access to the gym through SilverSneakers, the nation’s best-known fitness program for seniors. He was disturbed by the news, as are many other people who have recently learned they’re losing this benefit.

A controversial business decision by UnitedHealthcare, the nation’s largest health insurance carrier, is causing the disruption. As of Jan. 1, the company is dropping SilverSneakers — an optional benefit — for 1.2 million customers with Medicare Advantage plans in 11 states (California, Connecticut, Illinois, Indiana, Iowa, Kansas, Missouri, Nebraska, Nevada, North Carolina and Utah) as well as 1.3 million customers with Medicare supplemental (Medigap) insurance in nine states (Arizona, California, Connecticut, Illinois, Indiana, North Carolina, Ohio, Utah and Wisconsin).

Graves, who works out four to five days a week and has a UnitedHealthcare Medigap policy, decided to seek coverage elsewhere after the company raised his policy’s rates and eliminated SilverSneakers in California. He has signed up for a new policy with Blue Shield of California.

Starting next year, UnitedHealthcare will offer members a package of fitness and wellness benefits instead of paying to use SilverSneakers — a move that will give the company more control over its benefits and may save it money.

Seniors with UnitedHealthcare Medicare supplemental policies will get 50 percent off memberships at thousands of gyms across the country, telephone access to wellness coaches and access to various online communities and health-related resources. Those with Medicare Advantage policies can join Renew Active, UnitedHealthcare’s fitness program, with a network of more than 7,000 sites, at no cost, and qualify for an evaluation from a personal trainer and an online brain-training program, among other services.

Steve Warner, who leads UnitedHealthcare’s Medicare Advantage product team, explained the company’s move by noting that over 90 percent of policyholders who are eligible for SilverSneakers “never step foot in a gym” or use this benefit.

UnitedHealthcare wants to reach “a broader portion of our membership” with a “wider variety of fitness resources,” he said, noting that the company’s shift away from SilverSneakers began last year and has accelerated this year. (Altogether, more than 5 million customers have been affected. But the company is making market-by-market decisions, and nearly 675,000 UnitedHealthcare Medigap policyholders and 1.9 million UnitedHealthcare Medicare Advantage plan members will retain access to SilverSneakers in 2019.)

“I think it’s a smart move,” said Connie Holt, an independent broker with Goldsum Insurance Solutions of Pleasant Hill, Calif.

But many of the company’s customers aren’t happy that SilverSneakers, which offers group classes tailored to seniors in addition to gym access at 15,000 sites, is disappearing. And confusion about alternatives is widespread.

It’s one of the “top topics” that seniors have been raising over the past few months when they call Ohio’s Senior Health Insurance Information Program, said Chris Reeg, the OSHIIP program director.

Michael Chanak Jr., 69, of Wadsworth, Ohio, had problems getting through to UnitedHealthcare’s customer relations department several times when he called with questions — a common complaint. “The way this is being implemented is a train wreck,” said Chanak, who has a UnitedHealthcare Medicare supplemental policy and spends an hour every day exercising at his gym.

People are “extremely upset,” wrote Margaret Lee of Arroyo Grande, Calif., in an email. “That’s about the only topic of conversation at my water exercise class!”

AARP has also become a target of anger because it endorses UnitedHealthcare’s Medigap and Medicare Advantage insurance policies — an arrangement that yields substantial royalties for the organization.

In an email, Mark Bagley, a spokesman for the organization, said, “UHC [UnitedHealthcare], not AARP, operates these plans and determines the benefits.”

“I will be dropping my AARP membership when it is time to renew,” wrote Shelley Holbrook, 67, of Yorba Linda, Calif., a UnitedHealthcare Medigap policyholder, in an email exchange about the loss of SilverSneakers. “I am a Parkinson’s patient who has been prescribed this type of exercise program,” she explained. “This program is under the guidance of certified instructors that make sure the exercise routines are performed correctly. … An ordinary gym membership provides no instruction on how to use the equipment safely for seniors.”

“A health coach is not what I need,” Holbrook continued. “I have used the health coaches before, and have found them to be totally worthless.”

For policyholders like Holbrook, the situation is complicated by another factor: Federal laws don’t ensure that seniors can switch Medicare supplemental insurance plans without undergoing new medical evaluations after an initial “guarantee issue” period. (This period occurs six months following a person’s enrollment in Medicare. Changes are allowed under a few specific circumstances and by laws in a few states.)

If seniors can meet medical standards, they’ll find SilverSneakers available from other insurance operators. In 2019, Tivity Health is offering the program through more than 65 health plans covering more than 15 million older adults and introducing a new digital platform that emphasizes its social benefits: SilverSneakers Connect.

“There are people we’ve learned who are alone but don’t want to go to the gym,” and the new platform can help them connect with each other as well as activities in their communities, said Donato Tramuto, Tivity Health’s CEO. Recent research suggests that SilverSneakers may help reduce isolation and loneliness in seniors who go to classes and form new relationships, he noted.

Whether UnitedHealthcare’s health plans will be less appealing because of the shift away from SilverSneakers is yet to be determined. Several years ago, Humana, another giant insurer, also began reducing the number of plans that offered SilverSneakers, but it faced a backlash from members and sales representatives. “The membership perceives [SilverSneakers] as a valuable benefit despite the fact that not everyone uses it,” said George Renaudin, Humana’s senior vice president of Medicare.

Humana subsequently reversed course and is now making SilverSneakers broadly available to about 3.5 million Medicare Advantage and Medigap policyholders.

Ray Liss, who retired seven years ago, just changed over from UnitedHealthcare to a Humana Medicare supplemental policy with his wife. The loss of SilverSneakers precipitated the switch, which has an unexpected benefit: The couple will save almost $60 a month next year on their new policy.

In an email, Liss, who declined to say where he lives, was philosophical about the value of exploring his options, writing, “I was pretty mad at the time, but it worked out for the best.”

We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips.


KHN’s coverage related to aging and improving care of older adults is supported in part by The John A. Hartford Foundation.

In Grandma’s Stocking: An Apple Watch To Monitor Falls, Track Heart Rhythms

For more than a decade, the latest Apple products have been the annual must-have holiday gift for the tech-savvy. That raises the question: Is the newest Apple Watch on your list — either to give or receive — this year?

At first glance, the watch appears to be an ideal present for Apple’s most familiar market: the hip early adopters. Its promotional website is full of svelte young people stretching into yoga poses, kickboxing and playing basketball.

But when Apple unveiled its latest model in September — the Series 4, which starts at $399 — it was clear it was expanding its target audience. This Apple Watch includes new features designed to detect falls and heart problems. With descriptions like “part guardian, part guru” and “designed to improve your health … and powerful enough to protect it,” the tech giant signaled its move toward preventive health and a much wider demographic.

“The health care market is obviously important to Apple,” Andy Hargreaves, an Apple analyst with KeyBanc Capital Markets, wrote in an email. The fall prevention and electrocardiogram apps are a “play to sell people more stuff” and bring health-monitoring apps beyond just “fitness people” to baby boomers who want to keep themselves and their parents healthy, he added.

This watch could be a perfect present for those older people, said Laura Martin, a senior analyst with Needham. “People who wore watches their whole lives, plus fall monitoring?” Martin said. “Voilà! It creates another on-ramp for another consumer in the Apple ecosystem.”

The Inner Workings

The fall-monitoring app uses sensors in the watchband, which are automatically enabled for people 65 and older after they input their age. These sensors track and record the user’s movements, and note if the wearer’s gait becomes unsteady.

If a fall is detected, the watch sends its wearer a notification. If the wearer doesn’t respond within a minute by tapping a button on the watch to deactivate this signal, emergency services will be alerted that the wearer needs help.

That minute also gives the wearer time to prevent false alarms, such as a dropped watch.

Many geriatricians and medical experts agree that this app could help older consumers.

Falls can cause fractured hips and head injuries, but even fear of falling can prevent older people from living on their own or participating in activities.

Fall deaths in the U.S. increased 30 percent for older adults in the past decade, and 3 million older people go to the emergency room for fall injuries each year, according to the Centers for Disease Control and Prevention.

Dr. Armin Shahrokni, an internist with Memorial Sloan Kettering Cancer Center who describes himself as “tech-savvy,” is excited that older patients might get into wearable technology.

“In older cancer patients, my area of expertise, all the chemo can make them fall more,” he said, making detecting falls and balance important.

The other app, the ECG monitoring app, also uses sensors in the wristband to monitor a patient’s heartbeat and send alerts if it gets too fast or too slow. Specifically, the app is meant to detect atrial fibrillation, which is a type of arrhythmia, also described as a problem with the speed or rhythm of the heartbeat.

Here is how the app works:

The watch’s sensors can detect a heart rhythm in 30 seconds, creating a “waveform” readout. It also allows the user to note how they are feeling — lightheaded, winded, full of energy — at that moment. This combination, according to Apple, will help people have better conversations with their doctors about symptoms and heart patterns.

The Food and Drug Administration cleared this function for people 22 or older. However, it’s rare for anyone younger than 50 to be diagnosed with atrial fibrillation, noted Eric Topol, a cardiologist at the Scripps Research Institute.

Doctors have expressed concern that scores of panicked Apple Watch users would flood emergency rooms with every heart rhythm notification and blip.

“It’s mass use of a tool, and with that is going to come lots of unintended consequences,” Topol said. “It’ll lead to a lot of anxiety and expense and additional testing, and even then some people will get blood thinners inappropriately,” he added.

“This is the opposite of individualized medicine, where you are using something on exactly, precisely the right person,” Topol said.

Wearables Unleashed

The watch represents the beginning of what analysts agree will be a wave of new health apps and wearable health trackers.

Consumers can expect more ways to track vital signs, like blood sugar, and more apps that will use those numbers to help people prevent medical emergencies, said Ross Muken, an analyst with Evercore ISI. While health tracking isn’t a new concept, putting that data into an algorithm to help change behavior and get ahead of a health crisis is the next big frontier for wearable health technology products.

Experts caution, though, that while the FDA “cleared” these new apps, it hasn’t actually “approved” them, which is a bureaucratic distinction that means they haven’t faced as much rigorous testing as something that has gained the agency’s formal OK.

For example, there are no findings from studies or trials that offer evidence of the fall prevention or ECG apps’ benefits, Topol said. “We don’t have any data to review. These are unknowns.”

Someday, he added, he expects the “medicalized smartphone” to be more common, cheaper and accessible to seniors. Right now we’re seeing the very beginning of this technology be put into use. “Technology is way ahead of medical practice,” Topol said.