Talk of The Villages Florida

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RVRoadie 10-01-2013 01:11 PM

Cancelled by Preferred Care Partners
 
Welcome to the Affordable Care Act. Got my letter today that my plan won't be offered in 2014.

This happened last year after United Healthcare purchased PCP. Don't know if this is the end, or will be forced onto a more expensive plan.

I thought Medicare Advantage was supposed to get a waiver in Florida as part of the ACA, even though the ACA was supposed to kill Medicare Advantage.

Apparently, many of the ladies a Curves got letters today from United Healthcare that Silver Sneakers would no longer be offered as part of their plans.

RVRoadie 10-01-2013 02:00 PM

Just heard from the sales lady at PCP that helped us purchase our original policy. She has left PCP and opened her own office. Doesn't look too promising for PCP customers.

ilovetv 10-01-2013 02:03 PM

"Monopoly" is what it looks like. But those seem to be desirable to many, nowadays.

Avista 10-01-2013 04:20 PM

United Healthcare The Villages Medicare Complete. Google this. it is the replacement for Preferred care Partners.

RVRoadie 10-01-2013 04:28 PM

Spoke with somebody that visited UHC office for info on replacement to PCP. It looks like about a $130 per month per person increase in cost, with loss of most vision benefits, loss of OTC allowance, loss of Silver & Fit, and some increase in copays including generic drugs.

Bogie Shooter 10-01-2013 04:55 PM

Quote:

Originally Posted by RVRoadie (Post 755728)
Welcome to the Affordable Care Act. Got my letter today that my plan won't be offered in 2014.

This happened last year after United Healthcare purchased PCP. Don't know if this is the end, or will be forced onto a more expensive plan.

I thought Medicare Advantage was supposed to get a waiver in Florida as part of the ACA, even though the ACA was supposed to kill Medicare Advantage.

Apparently, many of the ladies a Curves got letters today from United Healthcare that Silver Sneakers would no longer be offered as part of their plans.

Corporate buy out and they are reducing coverage. What does that have to do with Affordable Care Act?

gatherer47 10-01-2013 06:38 PM

I don't believe it has anything to do with Affordable Care Act.I did go to PCP's office today and talked to rep of United.Some good aspects and some bad.They will no longer give back anything that PCP did with regard to reimbursement of the $105 you pay to SS.PCP gave you $99 back.The generic drugs can still be had for $0 if you do ninety day mail order.The network for United covers way more than PCP and you'd get way more choice of physicians,dentists,and eye doctors.Plus the new Village Health Care system takes it.In fact United is all they take.So I have to decide to keep my doctor who takes United and give up the reimbursement or find a plan that still gives a reimbursement[Freedom gives you $72 p/month] and change doctors.My doctor doesn't take PUP,Freedom, or Optimum which I think still give you a partial reimbursement.A question to ponder.BogieShooter what should I do?

Indydealmaker 10-01-2013 06:58 PM

Quote:

Originally Posted by Bogie Shooter (Post 755888)
Corporate buy out and they are reducing coverage. What does that have to do with Affordable Care Act?

Probably more than you can at first see. In Indianapolis, Anthem is no longer insuring patients at the three largest hospitals in the metro area which also includes the Indiana University Riley Children's Hospital. They call it "narrowing" of their coverage and they did attribute it to the ACA.

Shirleevee 10-01-2013 07:02 PM

Quote:

Originally Posted by Bogie Shooter (Post 755888)
Corporate buy out and they are reducing coverage. What does that have to do with Affordable Care Act?

Nothing!

wendyquat 10-02-2013 12:36 AM

I believe you will find it DOES have everything to do with the ACA! Seems it's not so "affordable" after all! Somebody's got to pay for covering those with pre-existing conditions and those who will pay nothing! There's no free ride, especially in the medical field! I think we will find greatly reduced benefits also!

Btw, I have many years experience in the health insurance field!

Dr Winston O Boogie jr 10-02-2013 01:29 AM

Quote:

Originally Posted by gatherer47 (Post 755957)
I don't believe it has anything to do with Affordable Care Act.I did go to PCP's office today and talked to rep of United.Some good aspects and some bad.They will no longer give back anything that PCP did with regard to reimbursement of the $105 you pay to SS.PCP gave you $99 back.The generic drugs can still be had for $0 if you do ninety day mail order.The network for United covers way more than PCP and you'd get way more choice of physicians,dentists,and eye doctors.Plus the new Village Health Care system takes it.In fact United is all they take.So I have to decide to keep my doctor who takes United and give up the reimbursement or find a plan that still gives a reimbursement[Freedom gives you $72 p/month] and change doctors.My doctor doesn't take PUP,Freedom, or Optimum which I think still give you a partial reimbursement.A question to ponder.BogieShooter what should I do?

So. bottom line is that we're going to have to pay $105 per month. That's a $105 increase in our premiums.

Villages PL 10-02-2013 12:17 PM

Does anyone remember when Medicare was cut by 500 billion? It sounds like a lot but I believe it's 500 billion over 10 years, which may help to put it in perspective. Because of that cut, I was warned last year, by my agent (the man who signs me up for HMOs), that the monthly premium reimbursement would likely disappear in the future, along with other benefits like SilverSneakers. Well, he predicted it, and it has come true.

But there are other forces at work contributing to this. He told me last night that Preferred Care Partners had a loss (in our area) of $30,000,000.

If you are looking for a replacement HMO with some premium reimbursement, Optimum is the next best, assuming you have no major health issues. If you have a major health issue like heart disease, diabetes, or lung disease, Freedom Health will reimburse about $72. Otherwise, if you don't qualify for that, Optimum will reimburse about $39.00.

With Optimum, primary care will still be free of any charge to the patient. But seeing a specialist will go up to $30. from $25..

I'm not sure if it will offer SilverSneakers or not, but I'm not counting on it.

NotGolfer 10-02-2013 12:35 PM

Quote:

Originally Posted by Villages PL (Post 756388)
Does anyone remember when Medicare was cut by 500 billion? It sounds like a lot but I believe it's 500 billion over 10 years, which may help to put it in perspective. Because of that cut, I was warned last year, by my agent (the man who signs me up for HMOs), that the monthly premium reimbursement would likely disappear in the future, along with other benefits like SilverSneakers. Well, he predicted it, and it has come true.

But there are other forces at work contributing to this. He told me last night that Preferred Care Partners had a loss (in our area) of $30,000,000.

If you are looking for a replacement HMO with some premium reimbursement, Optimum is the next best, assuming you have no major health issues. If you have a major health issue like heart disease, diabetes, or lung disease, Freedom Health will reimburse about $72. Otherwise, if you don't qualify for that, Optimum will reimburse about $39.00.

With Optimum, primary care will still be free of any charge to the patient. But seeing a specialist will go up to $30. from $25..

I'm not sure if it will offer SilverSneakers or not, but I'm not counting on it.

thank you for that information!!! We have app'ts with both the UHC and Villages Ins. offices so will check these options with them. Being on PCP and going to the USF clinics we do have some concerns though not in a panic mode. It is what it is!! We knew "something" would be happening for 2014.

gerryann 10-02-2013 01:49 PM

Quote:

Originally Posted by Villages PL (Post 756388)
Does anyone remember when Medicare was cut by 500 billion? It sounds like a lot but I believe it's 500 billion over 10 years, which may help to put it in perspective. Because of that cut, I was warned last year, by my agent (the man who signs me up for HMOs), that the monthly premium reimbursement would likely disappear in the future, along with other benefits like SilverSneakers. Well, he predicted it, and it has come true.

But there are other forces at work contributing to this. He told me last night that Preferred Care Partners had a loss (in our area) of $30,000,000.

If you are looking for a replacement HMO with some premium reimbursement, Optimum is the next best, assuming you have no major health issues. If you have a major health issue like heart disease, diabetes, or lung disease, Freedom Health will reimburse about $72. Otherwise, if you don't qualify for that, Optimum will reimburse about $39.00.

With Optimum, primary care will still be free of any charge to the patient. But seeing a specialist will go up to $30. from $25..

I'm not sure if it will offer SilverSneakers or not, but I'm not counting on it.

Very informative post. Thanks much.:smiley:

gomoho 10-02-2013 03:12 PM

You forgot to mention PUP - they are still offering a part B rebate and silver sneakers, but would not be accepted at The Villages Health.

ROCKETMAN 10-03-2013 07:41 AM

Then it's pup for me. With no major health issues, I don't need dr. welby.

gpirate 10-03-2013 07:56 AM

Quote:

Originally Posted by Villages PL (Post 756388)
Does anyone remember when Medicare was cut by 500 billion? It sounds like a lot but I believe it's 500 billion over 10 years, which may help to put it in perspective. Because of that cut, I was warned last year, by my agent (the man who signs me up for HMOs), that the monthly premium reimbursement would likely disappear in the future, along with other benefits like SilverSneakers. Well, he predicted it, and it has come true.

But there are other forces at work contributing to this. He told me last night that Preferred Care Partners had a loss (in our area) of $30,000,000.

If you are looking for a replacement HMO with some premium reimbursement, Optimum is the next best, assuming you have no major health issues. If you have a major health issue like heart disease, diabetes, or lung disease, Freedom Health will reimburse about $72. Otherwise, if you don't qualify for that, Optimum will reimburse about $39.00.

With Optimum, primary care will still be free of any charge to the patient. But seeing a specialist will go up to $30. from $25..

I'm not sure if it will offer SilverSneakers or not, but I'm not counting on it.

Great information to have. Thanks for the research.

Bizdoc 10-03-2013 08:45 AM

PCP's business model of giving money back was so successful that ... they basically went out of business in this area. Great business model. Make sure that you pick another equally savvy company.

You get what you pay for.

RVRoadie 10-03-2013 10:17 AM

Quote:

Originally Posted by Bizdoc (Post 756855)
PCP's business model of giving money back was so successful that ... they basically went out of business in this area. Great business model. Make sure that you pick another equally savvy company.

You get what you pay for.

They didn't go out of business. They sold out to UNH for an undisclosed amount. I suspect that they made out very well.

ActsOfKindness 10-05-2013 01:34 AM

please write me or anyone else seeing this post. my husband and i had pcp too ..this has nothing to do with the obama care situation just so you know. this has to do with the villages health care system, and profits imho. united health care has other products and you can go into the stores in the town squares to discuss what options you have. there are two that i know of and both are decent. HOWEVER, if you are like us and looking for a rebate on the premium part b, which preferred care partners did for two years in a row, the only medicare advantage program i found after 48 hours of non stop computer research is PUP (PHYSICIANS UNITED PLAN) AND THE ONE that gives a rebate is pup rewards hmo..for 90$ back in your pocket. very very similar to the preferred care partners program AND HAS THE SILVER SNEEKERS DEAL TOO. I DO NOT CHECK ONLINE TOO MUCH WITH THIS FORUM..so please write me at flowerpower55@gmail.com if you want any more information. right now i am trying to sign up shortly for the PUP medicare advantage program, but there are no agents to assist me. everything is united healthcare here in the villages..its a monopoly somehow. i hate to enroll online , im a bit nervous about doing that and sending it out with the postal mail. thanks for reading this...and if you or anyone else has any suggestions let me know. i do not represent pup in any way....except that i was pcp too and got my letter as well...and want to stay on a similar plan. this is all i could come up with.

ActsOfKindness 10-05-2013 01:42 AM

NOT BEING ARGUMENTIVE HERE.HOWEVER...freedom health has rebate programs...that friends of ours are signing up for...and PUP physicians united plan is very similar to pcp (preferred care partners that is no longer active starting 2014) pup rewards hmo its called. i spent hours on the internet this week after getting my divorce letter from pcp this week....to try to find another plan. i do not know why....people think obamacare has anything to do with insurance company profits. pcp simply did not want to rebate money anymore for premium part b...which for two years in a row they did. when united health care took over...they are all now under the umbrella of the villages health care system, university of south florida..and the developer. there are two specific health plans , one is aarp complete 2, with united health and another one..the villages medicare hmo...i think they just underwrote, and both just take your premium part b. i dont think l04 $ is that expensive a premium for health insurance. and i think freedom medicare advantage and PUP physicians united plan are fantastic for people on a limited fixed income...because both give premium part b rebates...the latter is 90$ just like pcp did. anyhow..my comment is...there are medicare advantage programs out there. there are affordable premiums. my only problem with pup to enroll is ...there are no agents in the villages area it seems to assist me and i hate to do this online and mail it in...i feel more comfortable with an agent..so still searching . thanks for reading this and good luck to everyone out there ....that had preferred care partners..dont panic...THERE ARE other medicare advantage programs...and freedom and pup....are two that rebate still. God bless.

ActsOfKindness 10-05-2013 01:48 AM

i hate to be repetitive..i was not aware of optimum and will check it out..but my posts...i will repeat...PUP which is called physicians united plan.......and available in lake marion and sumter counties now....has a rebate for its medicare advantage plan that is known as pup rewards hmo....for 90$. and very similar to preferred care. the urgent care centers are zero co payment to walk in....in the 2014 plan benefits..doctors are zero. specialists 30$. the hospital stay for the united health care packages are a fortune...the one with aarp complete 2 is 395.00$ a day wow. with pup i believe its 195.00. i will look into optimum. is there an agent...that will come to the house to enroll us.?? pup has a drawback in that i cannot find an agent..and to print out the enrollment or have them mail it out to us..we have to mail it back and i do not feel comfortable with that at all i told them on the phone. still trying to find an agent to assist us. thanks for reading this and please could you write me at my email ...
so appreciate that... flowerpower55@gmail.com
i am feeling very badly for the thousands of villagers that had preferred care partners...and do not know what to do . of course you can on board..with the villages health care system, and enroll in a united health care program. they look decent but take the premium part b.....and the hospital stay is very expensive to say the least. also i want to go on record here..all i heard was hype about how wonderful the villages health care system is going to be. and no waits ..to be seen right away. i have an appt that was scheduled out 3 months into late november with a primary care physician..and my next door neighbor will be waiting 4 months to see a doctor in this system. huh??? that is crazy.

ActsOfKindness 10-05-2013 01:56 AM

i didnt realize someone else knew about pup/ i have been posting a bunch of responses here to other posters. the problem i have and we want desparately to sign up for pup rewards hmo..it gives back the rebate of 90$ for the premium part b .....very similar to preferred care..has the sneekers , and my husbands doctors in their provider list. i cant find a bloomin agent to assist us...to enroll us. it seems it has to be done online...the enrollment form , printed out and mailed to them. or they can send an enrollment packet and you have to MAIL it back which is stressing me out terribly. what if they dont get it or process it or i made a mistake in how i filled it out. i dont have insurance. geeeesh. im not thrilled with the villages health care system at this point. i think its alot of hype. i have to wait 3 months to even see the doctor ...i couldnt get an appointment over at colony care, and insofar as them accepting united health yes..duh...united health care...and the villages health care system, the university of south florida and last but not least THE DEVELOPER ARE ALL TIED TOGETHER....that is why you see the stores thruout the townsquares now...that will be enrolling folks into medicare advantage programs thru united health. united health is THE only medicare advantage plans ...that are accepted thru...the villages health care system.. but there are other insurances that are also accepted....i believe the system will be very inundated..the villages health care system, the doctors that participate in it......and all the hype about getting same day appointments..and a stronger doctor/patient relationship , and less patient overload for the doctors ....im not buying it. i think its going to be overloaded here....not enough doctors and too many people on board. i hope im wrong.

Mimivillager 10-05-2013 05:32 AM

Yes,your initial appointment is 3 months out to meet the dr but if you need to see the dr sooner, you can get in same day.

rockyisle 10-05-2013 06:05 AM

I've said it before, I'll say it again. The Villages Health Care System takes MANY more insurance companies than United Health Care. Look at their website. It's there in black and white type! And I'll say this again, while Harvard Pilgrim is not on their site, they take it.

gomoho 10-05-2013 07:32 AM

PUP is giving the $90 rebate this year, but will discontinue in 2015. It will be difficult to find an agent to write the policy because there is no commission for them on this policy. You might be able to call and enroll over the phone if you are not comfortable doing so via the internet.

Villages PL 10-05-2013 03:46 PM

Quote:

Originally Posted by gomoho (Post 757909)
PUP is giving the $90 rebate this year, but will discontinue in 2015. It will be difficult to find an agent to write the policy because there is no commission for them on this policy. You might be able to call and enroll over the phone if you are not comfortable doing so via the internet.

I went to their website and tried to find a primary care doctor in Sumter but it didn't work. I believe I looked at their plan in previous years but didn't join because of a lack of doctors in this area. Anyway, I got their toll free phone number from their website and will check it out to see how far I would have to go to get to a primary care doctor. For an extra $50, over and above the others, it might be worth it. I seem to remember that most of their doctors are in the Ocala area.

No commission explains why my agent didn't mention it.

Villages PL 10-05-2013 04:03 PM

Google the following: Physicians United Plan reviews

Then read the "Ripoff Reports" and tell me what you think.

RVRoadie 10-05-2013 05:25 PM

Quote:

Originally Posted by rockyisle (Post 757873)
I've said it before, I'll say it again. The Villages Health Care System takes MANY more insurance companies than United Health Care. Look at their website. It's there in black and white type! And I'll say this again, while Harvard Pilgrim is not on their site, they take it.

There are a number of Medicare Advantage plans available, however The Villages Health Care System doesn't take any of them except for United Health Care. So... "if you wan't to keep your doctor..." forget it unless you pay up to United Health Care.

gomoho 10-05-2013 05:48 PM

Quote:

Originally Posted by Villages PL (Post 758214)
Google the following: Physicians United Plan reviews

Then read the "Ripoff Reports" and tell me what you think.

I took your google suggestion and wasn't overly alarmed by the two reviews I found. I think I was more alarmed people with complicated physical issues would choose a plan that doesn't offer a wide range of providers.

Insurance is a gamble and you better understand what you are getting into before signing on the dotted line. I believe my husband and I will go with PUP this year to take advantage of the $180 we save monthly as a result of their rebate. However we are 64 and 66 with no health issues so we are willing to take the gamble and hope for the best. His doctor currently takes PUP and we will contact him for his opinion on their service.

ActsOfKindness 10-06-2013 05:41 PM

again not being argumentive here..but i will have to clarify something you just shared.this is important information...and people need to get l00% factual information..this is an important time of our lives open season with plans such as preferred care partners closing on us.
after the initial apppointment which again to reiterate is 3 to 5 months out to schedule if you are a new patient in the villages health care system(no one in the country which they are bragging....that they will be a role model for all of america..this health care system..does it take to see even a specialist that long ..months to go by for an appointment for a senior citizen) ..i was EXPLICITLY TOLD AT COLONY CARE ..one of the villages health care centers..set up rite now....that..if i need to see a same day appointment or a timely one....even after....the initial one...to wait so long for.
THAT A PA..WILL SEE ME.
hello? i dont need the villages health care system to see a PA
i can do that very nicely in any number of health plans or doctors offices perhaps.
that is ridiculous
please do not say..that after the initial appointment..you will be seen...by your primary care physician
that may NOT be the case..and people need to know this and be made aware of it now.
a PA is not the doctor
there are good PAs out there..but again to reiterate one more time!! you may not get into see your pcp..................even after getting established with the villages health care system..that is why they have an office staff of PA's in place.
forget that.
for the record i do not......see a doctor more than once a year..thank thank God...im blessed right now in life...but if i had an issue..i would not wait to see a pcp.....once im established and i mite as well just go to an urgent care center.
DOES ANYONE READING THESE POSTS KNOW IF THE NEW VILLAGES MEDICARE COMPLETE HMO OR REGIONAL COMPLETE PPO....WITH UNITED HEALTH even has an urgent care center..for us??????!! we have so many around the villages now which is a God send rather than waiting in hospital emergency room here in the villages....
but insofar as i know..and i cant find one provider directory online..for 2014 for either one of these plans....it seems you have to go in person or have an agent....to know what doctors are on board with the united health care plans for our area...
PUP physicians united..and other medicare advantage plans are right there online ...to view..and to also see the provider list for 2014.
YOU GOTTA MAKE INTELLIGENT DECISIONS PEOPLE.
IF YOU GO ON BOARD WITH UNITED HEALTH BEING PUSHED HERE IN THE VILLAGES MAKE SURE YOUR DOCTORS YOU HAD WITH PREFERRED CARE PARTNERS OR OTHER PLANS YOU WERE ON...ARE STILL INTACT WITH THESE PLANS.
THAT IS MOST IMPORTANT.
SOME OF US HAVE DOCTOR/PATIENT RELATIONSHIPS....THAT WE FOSTERED THROUGH PREFERRED CARE PARTNERS..THAT ARE NOT AVAILABLE WITH PERHAPS THE NEW VILLAGES MEDICARE COMPLETE HMO
IF THEY ARE ON BOARD THAT WILL BE WONDERFUL.
BUT AGAIN TO REITERATE THAT IS ANOTHER PROBLEM RITE NOW..
WE DONT KNOW.
WE ARE FLYING BLIND.
PERHAPS ON THE 15TH THEY WILL RELEASE THAT INFORMATION TO US...BEGGERS OUT THERE..THAT WANT TO KNOW IF OUR DOCTORS WE HAVE NOW ..ARE ON BOARD WITH THE HMO OR PPO THRU UNITED HEALTH IN THE VILLAGES
THANKS FOR READING THIS.

RVRoadie 10-07-2013 11:20 AM

Ok, here is my calculation of additional costs for my wife and I to switch to United Health Care medicare advantage program that is replacing our current Preferred Care Partners plan. These are based on what we actually received in 2013.

$2,399 - Part B premimum (loss of rebate, $99 each per month)
$750 - Vision benefits ($300 for glasses, free exam)
$402 - Dental (2 free exams each year)
$392 - Medicine (no copays on generic drugs)
$504 - Silver Sneakers (my wife goes to Curves)
$80 - Specialist copay (16 copays at $5 increase)
$200 - OTC products ($25 per quarter, each)

$4,727 - Total additional out of pocket costs to switch plans based on 2013 expenses.

Fortunately, our old primary care doctor is willing to take us back. Not sure what plan we will go to, but $4,727 per year is too much to continue with The Villages Health System.

Villages PL 10-07-2013 04:10 PM

Pup
 
I called Physicians United Plan (PUP) today and requested information on their HMO health plan. Their toll free number is: 1-888-U-ASK-PUP

I made sure to ask for their booklet of providers. If you don't ask for it, you might not get it. And I think it will be important to actually call some of the providers to make sure they are participating in the plan.

They said I will get all the information in 7 to 10 days. Once I get it and read it I'll be glad to give my opinion of it.

Shirleevee 10-07-2013 05:11 PM

Quote:

Originally Posted by RVRoadie (Post 758264)
There are a number of Medicare Advantage plans available, however The Villages Health Care System doesn't take any of them except for United Health Care. So... "if you wan't to keep your doctor..." forget it unless you pay up to United Health Care.

from The Villages Healthcare site:


If you are eligible for Medicare, we want you to know that the only Medicare Advantage plans The Villages Health participates in are those offered by Preferred Care Partners and UnitedHealthcare®. UnitedHealthcare® Insurance Company is the same Medicare insurance provider that many Villagers already rely on for AARP® Medicare Plans.

We also accept most major health insurance plans.

Accountable Health Plan
AARP
Avmed
Blue Cross & Blue Shield

• Federal
• Blue Options
• Empire
• Health Options
• Preferred Patient Care
• Traditional

BCE Emergis
CCN
CCN/One Source
Champus/Tricare
ChampVA
Cigna
Coventry Health Care/First Health
Evolutions Healthcare
First Health
First Health Mail Handlers
GHI
Great West
Humana
Humana PPO
Interplan
Mail Handlers
MEDICARE
Multiplan
NALC
One Health Plan
Pacificare
Preferred Care Partners
Private Healthcare System/PHCS
Proamerica
Railroad Medicare
Southcare
Up & Up
United Healthcare

Most major Preferred Provider Organization Plans

gerryann 10-07-2013 05:32 PM

Quote:

Originally Posted by Shirleevee (Post 759436)
from The Villages Healthcare site:


If you are eligible for Medicare, we want you to know that the only Medicare Advantage plans The Villages Health participates in are those offered by Preferred Care Partners and UnitedHealthcare®. UnitedHealthcare® Insurance Company is the same Medicare insurance provider that many Villagers already rely on for AARP® Medicare Plans.

We also accept most major health insurance plans.

Accountable Health Plan
AARP
Avmed
Blue Cross & Blue Shield

• Federal
• Blue Options
• Empire
• Health Options
• Preferred Patient Care
• Traditional

BCE Emergis
CCN
CCN/One Source
Champus/Tricare
ChampVA
Cigna
Coventry Health Care/First Health
Evolutions Healthcare
First Health
First Health Mail Handlers
GHI
Great West
Humana
Humana PPO
Interplan
Mail Handlers
MEDICARE
Multiplan
NALC
One Health Plan
Pacificare
Preferred Care Partners
Private Healthcare System/PHCS
Proamerica
Railroad Medicare
Southcare
Up & Up
United Healthcare

Most major Preferred Provider Organization Plans

There are changes to this for 2014

gomoho 10-07-2013 07:49 PM

Does anyone else find it a little ironic that those supporting "Florida's Healthiest Hometown" aka United Health Care The Villages Medicare Advantage are the same group that has dropped silver sneakers (free gym membership)???

Bizdoc 10-08-2013 09:40 PM

Quote:

Originally Posted by gomoho (Post 759487)
Does anyone else find it a little ironic that those supporting "Florida's Healthiest Hometown" aka United Health Care The Villages Medicare Advantage are the same group that has dropped silver sneakers (free gym membership)???

Not at all. In order to hold down costs for the Medicare Advantage plan to a premium folks can live with, not everything can be paid for.

I see a really interesting trend that the same folks who want more benefits also want lower premiums. You have to pick one or the other. The costs have to be covered from somewhere. The plans that try to do both (like PCP) tend to lose a lot of money and go away.

gomoho 10-09-2013 05:55 AM

PCP only went away in our counties to make room for United Health Care - they are still alive and well in other parts of Florida.

ActsOfKindness 10-09-2013 11:30 PM

Quote:

Originally Posted by Dr Winston O Boogie jr (Post 756119)
So. bottom line is that we're going to have to pay $105 per month. That's a $105 increase in our premiums.

MY husbands doctors and my urgent care center which saved my life, 441 urgent care, are not i believe on the new villages health medicare advantage program ...either one, i believe there are two .one is hmo the other ppo....and we love our doctors...and dont want to change. in addition..the rebate really helped us on our fixed income. we are not one of the more wealthier villagers living here in alligator land , so having said that. i spent the greater part of 2 days..48 hours almost non stop on the computer researching medicare advantage plans for our area. it is true...that freedom gives back a rebate of i believe 72$ or 74$ and so does optium...but both those plans YOU MUST be a special needs person.. have a heart condition. diabetes i forgot the other criteria. to receive the rebate on your part b premium taken out of your social security check every month. it is also true....that....there are more doctors on board with the united health plans..however..the villages health care centers will be unbelievably impacted with so many new patients and not enough doctors. i decided because pcp is accepted with them..rite now i still have it until january to go on board with one of their pcp primary care physicians. guess what i had to wait over 3 months to get to see dr carla noel so please...even though there are more doctors in network doesnt mean you will get in to see them in a prompt timely manner. and not wind up with a PA instead sigh. that is the villages h ealth care system they are ranting and raving about here..which is overkill in my humble opinion. the only MEDICARE advantage program i found..is PUP..rewards hmo with the plan number 024. i could not find one agent to sign me up...its enrollment in the mail. which im very uncomfortable with but the rebate without any criteria..meaning just straight up and down...rebate..like preferred care had for the past two years....IS 90$ which is not too shabby. the doctors are the same as we have with preferred care INCLUDING the urgent care centers. now having typed all of this..a neighbor of a neighbor gave us the name of an independent agent we are seeing tomorrow....to try to sign up for PUP rewards hmo. if it works out..i will be thrilled and relieved and have some peace of mind. i only need one doctor...one hospital , one urgent care center. insofar as specialists..they are out there even on pup rewards. if you or anyone is interested in pup ..please go to the website...askpup.com
everything is explained there.including who the doctors are in sumter or marion countys. i hope i can sign up...with the agent tomorrow....if you wish to speak to me further, i dont usually go on the forum alot. i was here...and answering alot of posts earlier..but usually i let months slip by and i forget to come back to this forum. my email is flowerpower55@gmail.com . good luck to everyone who needs to switch plans..make an intelligent decision.....and dont go by hype or fear. God bless all.

gadaboutgal 10-13-2013 02:24 PM

Quote:

Originally Posted by Bizdoc (Post 760054)
Not at all. In order to hold down costs for the Medicare Advantage plan to a premium folks can live with, not everything can be paid for.

I see a really interesting trend that the same folks who want more benefits also want lower premiums. You have to pick one or the other. The costs have to be covered from somewhere. The plans that try to do both (like PCP) tend to lose a lot of money and go away.

Well said. I couldn't agree with you more.


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