Talk of The Villages Florida - Rentals, Entertainment & More
Talk of The Villages Florida - Rentals, Entertainment & More
#46
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I have a Medicare Advantage plan through Care Plus, and I'm very satisfied with it. I told my primary care physician that I was pleased with the plan, and he said "You should be pleased with it, you're very healthy." He told me that people with serious health issues would find major restrictions on their healthcare choices in any Medicare Advantage plan. His advice to me was to continue with Care Plus, but if any health issues should arise, change to original Medicare with a supplement plan at the next annual enrollment period. For me, I think that was good advice.
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#47
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1. You may/will be subjected to health questions. 2. Based on your answers to the above questions, you may/will be denied coverage for a period of time for specific health issues, or subjected to higher premiums (both Medicare and supplemental). 3. I do not recall if you could be completely denied getting back to Medicare based on the above questions. If you are considering this, I would call Medicare ( and or SHINE) and get info specific for your situation. Also, ALL of this is subject to major changes with the new administration after January 20th....... The above information is over 1 year old, and things may have changed.
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Pennsylvania, for 60+ years, most recently, Allentown, now TV. |
#48
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1. I think preventative medicine has a prominent place in healthcare and do not think I intimated otherwise. I merely offered an opinion to the effect The Villages Healthcare system is emphasizing same in conjunction with its efforts to attract young healthy seniors to sign up for its Advantage product. This statement was intended as an opening for the rest of my post. Everything you added was absolutely correct but I saw no need to provider a " primer " to define " preventative medicine ". 2. Here I do think you are incorrect. The provider network provided by Medicare is all encompassing and probably includes 99 % of all physicians practicing clinical medicine in the United States and pretty much with few exceptions most medical institutions of note. The institutions opting out can agree however to except the Medicare reimbursement scheme voluntarily and many do so. Physicians can opt out but most that do are mental healthcare specialists. It is estimated that 42% of them have done so. Furthermore, any insurance company which provides Medicare Supplement policies must honor the claims of any medical service provider if Medicare has first paid the claim. Medicare Advantage insurers on the other hand can as you indicated change their provider networks once each year. Medicare Supplement insurers have no say in the matter. The " so what " comment minimizes the importance in some cases of maintaining a trusted doctor patient relationship. 3. Okay you got me. I obviously misspoke and any re-pricing does have to be approved buy the state insurance departments. I am still under the impression however that once you opt out of Medicare Supplement insurance the insurance company can refuse to take you back if they feel you are medically not insurable. Welcome to the world of paying 20% of your medical expenses just at the point in time you are hard pressed to afford them. There are a couple of other posts dealing with why you might want to go back on this thread and I think they stand for themselves. Do you really believe all medical care is equal ? Personally I want the best for both my loved ones and myself. 4. I thought the point was to continue the post. If you think it superfluous, so be it. 5.Ahem ! I do not think you got me. I was a senior manager of a very specialized commercial insurer ( nothing to do with health insurance ) that for a period of time was the most profitable insurer of its type in the entire world. I, like the people at United Healthcare, was not dumb and did everything in my power to maximize " profits ". I am not going to get into politics with you since this is not the place to do so, but you might be very surprised. The " crux of my philosophy " indeed ! And you did offend me! 6. To quote your post " If you are seriously ill, it may save you a few thousand ". My response is simply a few hundred thousand is the more likely outcome. 7. I'll stand by the adage and its application. |
#49
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Never mind. I took it out. (I have got to stop writing posts about insurance.)
But I do think there are lots of things to think about here in this thread. But I need to shut up now. I already said my piece. Last edited by Boomer; 12-29-2016 at 07:27 PM. |
#50
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Actually, a good debate. I re-read my point 5 and I agree it was offensive. My only excuse is that after a year of campaigning by politicians advocating "free" health care, "free" college tuition, and "free" whatever (and sadly there are voters out there that are stupid enough to believe that anything is "free"), as well as telling us America is bad because of capitalism and corporations are bad because they make a profit I was oversensitive to the issue. My sincere apologies. I still would like to know how anyone on the UHC MA plan can rack up hundreds of thousands of uncovered bills, UNLESS they CHOOSE to go out of network without prior approval. |
#51
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Village Heath with Tricare
Interesting thread. I have original Medicare with Tricare as a supplement. You are all correct that it is fantastic IF you can find the correct physicians and their staff can figure out how to bill Tricare. The issue finding medical care points you to the Medicare website which is WORTHLESS often out of date or the doctors no longer take Medicare, incorrect contact information, etc. I have resorted to word of mouth recommendations with various results, some good, some bad. A common thread is over crowding, poor administration and lousy scheduling procedures. One can count on showing up on time, waiting at least 30-45 minutes to be seen and only a few minutes with a physician or PA. We came from Colorado with Kaiser HMO and I was never delayed and billing was always correct to Tricare. Never payed a cent with a major surgery and follow up radiation. All the docs had my complete history and I could email each one or get refills of scripts over the phone. This place is in the dark ages. JMHO Just wondering if The Villages Health will take Tricare secondary and handle the bills??
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