UHC even manages to be shady with their Medigap plans. Medigap should be the hardest kind of medical insurance for a company to be shady with, but they manage.

Brief background for people who have had no reason to know what the hell Medigap is: in the US if you choose traditional Medicare at 65 [1] it is pretty simple. Various preventative services are covered 100% with no deductible, and other services are covered with a $257 deductible and a 20% copay.

You can buy "Medigap" insurance from private companies that help cover your Medicare copay and sometimes other things Medicare doesn't pay. Medigap plans are standardized by the government named Plan A through Plan N which vary in what they cover and how much they cover it.

It should be hard to be a shady Medigap insurer because they are almost completely out of the loop. You go to your doctor, the doctor says you need say an MRI, you go get that done and the bill is $500. The MRI place sends the bill to Medicare, Medicare pays 80% ($400), and also notifies your Medigap insurer. The Medigap insurer then pays the remaining 20% ($100).

The Medigap insurer doesn't have a say in whether or not they have to cover it. If Medicare approves covering their 80% then the Medigap plan has to cover it too. No saying that you should have went to a cheaper MRI place, or your doctor should have done some other cheaper test instead of an MRI.

So if they can't be shady when it comes to coverage, what can they be shady on? They can be shady when trying to get you to sign up.

Suppose you are in Texas and are turning 65 and are shopping for a Medigap plan. You decide you want plan G. On Medicare.gov for zip code 75002 (first zip code I found when searching for "Texas zip codes") there are 44 plan G Medigap plans available from 33 different insurance companies.

30 of these companies are using "attained age" pricing. Premiums are low for younger buyers and go up as a function of age.

2 of them use "issue age" pricing. Your initial premium depends on your age when you buy, but does not then go up as a function of age.

Finally, one company, UHC, uses "community" pricing. With community pricing the premiums are not a function of age. If you buy a community priced plan with a $200/month premium at 65 you might be paying say $300 at 75, but that won't be because of your age. It will be because of inflation. In particular when you are paying $300 at 75 that is also what someone signing up at 65 that year will be paying. Hence why it called "community" pricing--everyone on that plan pays the same.

For someone at 65 typically an attained age plan will be cheaper than a community plan. So why would you ever buy a community plan? Buy an attained age plan, and a few years later when the price rises above the price of community plans switch plans, right?

The problem with that is that in most states if you are joining a Medigap plan other than in a window around when you turned 65 (and some other exceptional situations) the insurer is allowed to take age and pre-existing conditions into account. They can refuse to sell you a plan, or charge higher premiums, or exclude your pre-existing conditions from coverage.

That means if you are in such a state and either have expensive pre-existing conditions or will be unfortunate enough to develop some later you may be stuck with the Medigap plan you first buy. Then a community rated plan can make a lot of sense. If you are going to be stuck with your plan a $200/month community plan may be more attractive than an attained age plan that is $150/month now that will be rising to $350/month over the next say 20 years.

OK, so now imagine you are 65. You've entered 65 as your age in the plan finder at Medicare.gov. You see all those plan G attained age plans which start at $133/month, and the issue age plans that start at $166/month. And then there are the UHC community plans starting at $166/month.

That sure looks attractive. $166/month that doesn't change as a function of age will in a few years be a better deal than $133/month that goes up as a function of age.

When you follow the link to the plan website and fill in your information you will indeed be told it is $166/month (or close). But under that there is a line that says "$308.39 standard premium" with the $308.39 struck out. And below that it says "Includes $138.78 in discounts".

They are apparently claiming it is a community priced plan because everyone has a standard premium of $308.39, but then they give an age based discount. If you are 65-67 it is 45%. Then it goes down 2% a year through age 79. Then it goes down 3% a year until reaching 0 at age 86.

I fail to see how this is not in fact an attained age plan. Based on what I've read on /r/medicare and other forums where people new to Medicare seek advice I'm sure that there are people who will not notice this and buy that plan thinking the premium won't be going up as a function of age.

I believe that there are other insurers doing this same disguising of an attained age plan as a community plan, but is particularly scummy in the case of UHC because UHC has a deal with AARP to provide these plans under the AARP name.

Medicare.gov does know that the price actually does depend on age. If you change you info on Medicare.gov's plan search to say you are 75 it does show a higher price for the UHC plan just like it does for the attained age and issue age plans, so if you think to do that you might catch that something is fishy.

But if you are already predisposed toward UHC because of the AARP association and because you want community pricing, you might not see a need to try other ages since you would not expect that to matter.

I'm in a state where they don't do those shenanigans. In my state all plans are community rated and if you signed up for Medigap when you turned 65 you can later freely change plans and providers and the new provider has to accept you with no exclusions for pre-existing conditions and with the same premium they charge everyone else.

If UHC tried that discount trick here what would happen is people would sign up with them at 65 to get the 45% discount, and as soon as that discount has declined enough to where what they were actually paying was more than the plans of the other plan G providers they would switch to one of those.

More and more states are liberalizing their rules for Medigap plan switching. Only a few are as liberal as mine (Washington) but several do allow you to easily switch between providers of the same letter plan with no penalties for pre-existing conditions and no higher premiums, and that should be enough to make the discount trick a losing deal for them. It's currently I think around 16 or 17 states that do this. It's a mix of red and blue things so this doesn't seem to be a partisan thing.

[1] In "traditional" Medicare the government is the insurance provider. The alternative is "Medicare Advantage" where the government pays a private company to be your provider. Think of Medicare Advantage as a lot like what you get from plans with employer provided insurance or with plans bought on the ACA marketplace.