[mahjwh51]

Turning 65 soon and have spent the last month or so trying to educate myself as to Advantage vs. Supplement, deciding on the latter. I've heard AARP (UHC) is decent and realize that UHC has an extremely broad network of physicians and facilities that contract with UHC. It seems all "F" supplement plans provide the same coverages so you're really just shopping for best price. Found one with somewhat lesser premiums (offered through The American Legion) and am therefore considering Transamerica that is self-administered. Wondering if anyone here has a plan with this company and what your thoughts are. Spouse is eligible also even though not a Legion member. Thanks for your help.

[villagetinker]

IMHO, call SHINE (Seniors Health Information Network(?)), the Florida health system, especially, The Villages Health system are very confusing. You need to make sure that they will accept your choice, and the villages health care is very selective. The villages has their own "advantage" plan with UHC. Look this over carefully, you are only covered for NETWORK doctors, so if you need a specialists, be prepared to travel (Ocala, Orlando, Leesburg are typical). I had a supplement, my wife went with the villages advantage plan, we dropped the advantage plan and got a supplement for her, there were way too many restrictions, and she had to change 3 doctors as they would NOT accept the villages plan.
SHINE will give you an unbiased assessment of your situation and are a great resource.
Also, there was a news article a few months ago that UHC was looking into dropping ADAVANTAGE plans, no idea what that would/will do to the villages health plan.
Finally, that are lots of prior posts on this site with comments (pro and con) on the villages health system.
So, please before you make a decision, ask lots of questions.
Hope this helps.

[mahjwh51]

Thanks for your response. Moved to The Villages about 7 mo. ago, made an appt. with Villages health at that time (even though it took 6 months to get in to see anyone). Shortly after, they changed to UHC Advantage only but we were already considered patients because we had that upcoming appt. and therefore grandfathered in and will accept whatever. So, not really looking at the Advantage plans. I will try to contact SHINE though. Thanks.

[villagetinker]

If you search this site using SHINE, you should get the previous message with the website and the phone number.

[villagetinker]

OH, welcome to paradise.

[John_W]

My wife had Medigap through United Health and it cost $184.50 a month and she went to Premier Medical, two locations in TV. I have United Health Medicare Advantage and go to the Villages Health at Pinellas. She wasn't getting anymore service than I was with my free plan. She tagged along with me on an appointment, and liked my medical facility a lot more. She met my doctor and really liked her. She had not really cared for her doctor at Premier, and she was now going to have to get a another doctor. She switched in November to Medical Advantage and has my doctor and saves us $184.50 a month.

[Fredster]

OP, You might want to Check out Mutual of Omaha for a Medicare supplement.
I started out with BCBS plan F but switched to M of O plan G quite a few years ago, and have been very happy I did.

[yabbadu]

Have UHC thru AARP and willing to pay and can go anywhere by my choice. Not as defined by an Advantage program.

Those that refer to the Advantage programs may not be so happy if and when they are really ill and want choices of care.

It is NOT a slam dunk if in the future your health changes and one wants to go from an Advantage program to a Supplement program. Underwriters get involved!

BOTTOM LINE: Choose wisely based on your health now and your spouses . Don't just look at premiums cost. Look forward as you age.......where and what and who do you want to handle your health needs?

[villagetinker]

[QUOTE=yabbadu;1164984]Have UHC thru AARP and willing to pay and can go anywhere by my choice. Not as defined by an Advantage program.

Those that refer to the Advantage programs may not be so happy if and when they are really ill and want choices of care.

It is NOT a slam dunk if in the future your health changes and one wants to go from an Advantage program to a Supplement program. Underwriters get involved!

BOTTOM LINE: Choose wisely based on your health now and your spouses . Don't just look at premiums cost. Look forward as you age.......where and what and who do you want to handle your health needs?[/QUOTE]

These are very wise words, and in a nut shell was the discussion we had with SHINE. We had an advantage plan, but changed BEFORE THE YEAR WAS UP and therefore avoided the whole underwriters concern. My wife was very annoyed with the need to stay in network, and had to change 3 of her doctors because of this.

[mahjwh51]

Totally agree with yabbadu that folks with Advantage plans may not be so happy should they have a serious illness which is why we are choosing a Supplement instead. One can choose otherwise "based on health now" and everything could change the very next day!

One area where I have some confusion is...Do the various companies still have contracts with individual physicians or groups of physicians and health facilities like they do pre-medicare. Or are there not negotiated costs at this point?

[Fredster]

Originally Posted by mahjwh51

Totally agree with yabbadu that folks with Advantage plans may not be so happy should they have a serious illness which is why we are choosing a Supplement instead. One can choose otherwise "based on health now" and everything could change the very next day!

One area where I have some confusion is...Do the various companies still have contracts with individual physicians or groups of physicians and health facilities like they do pre-medicare. Or are there not negotiated costs at this point?

I can only speak about my experience with Medicare and a plan G supplement.
The way I understand it...if a medical provider accepts Medicare, they accept Medicare's payment structure for a particular procedure or service, and my plan G supplement covers what Medicare doesn't.
The one thing a plan G doesn't cover is the Part B deductible
which is about $150. Plan F will cover the Part B deductible, but the monthly premium is a lot more. Plus I can go directly to medical specialists.
This is just my understanding, based on my experience.

[rubicon]

We carry Florida Blue Plan F. It appears to be a solid plan based on the favorable responses from many of our medical providers.

[spuds51]

If you haven't made a decision yet you may want to look into the plan F High Deductible. The premiums are low, somewhere around 60 a month for a male and 55 or so for female. The deductible is 2180. Sounds like a lot but you almost pay that in the difference of the premiums. In most years you will save money. In bad years where you have like $10,000 or more in medical bills it will cost a little more than a plan F. Plan F pays 100% of all cost, plan F HD pays 100% of all cost after deductible is met.

For me the plan F was $173.00 The Plan F HD was $60.00. The Advantage Plans are the cheapest. You can get those for no cost if you want an HMO. As long as you don't have any serious health concerns it would be the way to go. My problem with those are if you was to have a serious issue like cancer or needing heart surgery or something you don't have the option of going to the best centers for treatment. Your doctor does not have the final say as to what treatment or tests you get either. The insurance co. decides what is medically necessary. For me paying the $60 bucks a month gives me peace of mind that if anything bad happens to me or my wife we can go anywhere in the country that accepts Medicare.

[Carla B]

Spuds51 raises an interesting point about looking into Plan F high deductible. Another thing to consider is that insurers that offer Medigap plans do not price them the same. We're with AARP but whenever I've checked on others' rates, they've been higher.

[Phanatic Luvr]

Attend a SHINE Meeting. They are held a few times per month at Lake Miona and Eisenhower Rec Centers. They are very informative and you sit down with a counselor and they explain to you one on one. Look in the Recreation Newspaper that comes out on Thursdays for the times and days. The meeting we attended a few weeks ago was empty and the gentleman said this is the time of the year that not many attend. They get much busier come Sept. & Oct. when it is open enrollment period.