Talk of The Villages Florida - View Single Post - Premier Medical vs The Villages Health
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Old 08-08-2021, 03:38 PM
Blueblaze Blueblaze is offline
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Originally Posted by villagetinker View Post
There were way too many limitations on available doctors, and specialists. Also, once you go to an advantage plan you may not be able to get back to Medicare and supplemental without going through underwriting. If you have significant medical problems or conditions this can be a very big deal.
Maybe I'm missing something, but for me the solution to both problems was an Advantage PPO instead of HMO. It also makes it possible to use an Advantage plan when you travel.

A PPO lets you go out of network. Yes, you will pay higher co-pays, but you're also backed up by the out-of-pocket maximum. When I did the math, I realized I would pay much more under a supplemental plan, even compared to going out of network, simply because the supplemental plans I looked at were like Medicare itself -- there is no out-of-pocket maximum. When you add-in another $300 premium per person, I couldn't figure out how they manage to sell the things. But like I say, I'm no expert. Maybe I'm missing something.

And, by they way, this thread is the first I've heard of someone being turned down by an Advantage plan for pre-existing conditions. I take a statin and a blood pressure pill, and my wife has had half her thyroid removed for cancer, not to mention a history of diabetes. We were on Humana in Texas and United here, and neither one even asked about pre-existing conditions.