Quote:
Originally Posted by rivaridger1
1. The Villages United Healthcare Advantage Plan is best for younger healthy seniors. The docs associated with The Village Healthcare system want to practice preventive medicine. Just read the material in the local paper every Sunday and that will tell what they are emphasizing.
2. Once you are in an Advantage plan the insurance company has the opportunity once a year to change the provider network and thus exclude access to expensive specialized care. The decisions to do this will be governed by the overall profits being generated under the plan.
3. If you get seriously ill and need very specialized services outside the Advantage provider network and as a result need to change back to Medicare and a Supplement policy, coverage can be denied and/or re-priced. If re-priced, the premium is whatever the for-profit insurer decides to charge. Whether you can afford it or not is not an issue.
4.No one in The Villages is getting any younger. All of us our going to pass on to join our ancestors. When we do from a medical perspective it will probably be something quite medically expensive to deal with that kills us.
5. The Villages Healthcare Advantage Plan is provided by the largest for-profit insurance company in the United States. The people that run it are not dumb and will do whatever is necessary in the future to assure its continued profitability including restrictions to network access if it such a change is needed.
6.Your red, white and blue Medicare Card and a Supplement policy to go with it are equal in value to a vault filled with gold bars when you are seriously ill. Some day, no matter what you do from a preventative standpoint, you are going to be seriously ill.
7. A lot of people are risk takers and prefer to put every available savings in their pockets when available. That is fine, but the old adage of penny wise and pound foolish might have some application when evaluating Medicare Advantage Plans.
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No offense, but I'd really like to know the basis upon which you came up with these 7 "talking points"
1. Don't you think "preventative medicine" benefits older seniors as well? Even the government concurs with this, hence all their chronic care management, Optum QA criteria and PQRI initiatives. Like most physicians, the doctors of TVH are well trained in treating chronic and serious illness, in fact, it is the preventative medicine issues that in general are newer to us.
2. The provider network can, and frequently does change somewhat every year in ALL insurance plans. The insurance company can decide to drop certain providers, and the providers can opt out of participation in an insurance plan, just as patients have the option to change insurers. So what. Most of the insurers changes are QA driven, profit being a secondary motive in that decision.
3. True, AFTER the first year it is harder to change back to supplemental policy, there may be underwriting criteria and there may be a premium increase--but it's not "whatever they want to charge". But why would someone really need to change back? If you get "seriously ill" , there are more than enough in network physicians to treat you. If you have a NEED for care that cannot be provided in network, 99.5% of the time the insurer will approve the out of network provider. The main problem is when someone WANTS, not NEEDS out of network care, with exception of certain states such as California
4. Yes, we will all die, and yes the bill can be expensive. What is your point---it is the coverage that counts, not the raw bill, and your exposure is limited under either plan
5. Aha! Now we come to the crux of your philosophy---you used that most vulgar word to the far left---PROFIT. Of course, when it comes to health care administration, insurers "profits" are far, far less than government waste. As far as single payer government health insurance goes, I'll take a pass on VA medicine for all.
6. Actually, your Medicare card and supplement will probably COST the average patient about $2000/yr. MORE than the MA plan. If you are seriously ill, it may save you a few thousand. IF you CHOOSE to go out of network without approval, then it will save you a fortune, but then that would be on you, not the insurer.
7. I agree with that adage, but if you look at the plans it detail, you will find it does not apply here.