Medicare Supplement/Doctor Referrals for Soon To Be Resident

[argos5usa]

Hi...I will be relocating to TV from out of state on approximately 10/1/15...I will also be turning 65 that month... I haven't fully figured out the Medicare maze yet but I was wondering if anyone had recommendations for the following:

1) A good Medicare supplement plan that's widely accepted in Florida;
2) Internist/GP;
3) Dentist; and
4) Dermatologist

Thanks for your help!

[Avista]

I would highly recommend you go with the Villages Health care. They have Care Centers throughout the villages--all connected. Here is the web site. Find a care center near you and Listen to the docs. If you go with an Advantage plan, Villages Health only takes their United. If you go,with a Medicare Supplement, they take most Supplements. BTW each care center has an insurance person to explain the differences. Also, United has stores in the Town Squares. They have helped us.
Here is where to start. Although it is the Colony Center, you can get to other centers from this site. Number of patients per doc is limited.


Colony Care Center | The Villages (http://www.thevillageshealth.com/colonycenter.php)

[LvmyPug2]

Talk with a SHINE (/serving the health insurance needs of elders) volunteer about understanding the best Medicare plan for you. It cost nothing and they don't promote any particular plan, they are just there to help you make good choices. They have several times each month counsellors are available to meet one on one Times and locations are listed in the paper.

[villagetinker]

Be careful with the United Heathcare HMO option, we got this for my wife, and there were a few local doctors/practices that would not accept this insurance. She had to change doctors. I have an AARP United Heathcare supplemental plan and have not had any problems.

We had to WAIT over 3 months to get into the Villages Health Care system, once in it it has been very good for GENERAL aliments. In general if you need a specialist you will get referred to someone OUTSIDE of Villages Health.
We came from the Lehigh Valley area of PA., and the health network there had all of the specialist IN THE NETWORK, which was what I was expecting here, no such luck.
Hope this helps.

[Avista]

Be careful with the United Heathcare HMO option, we got this for my wife, and there were a few local doctors/practices that would not accept this insurance. She had to change doctors. I have an AARP United Heathcare supplemental plan and have not had any problems.

We had to WAIT over 3 months to get into the Villages Health Care system, once in it it has been very good for GENERAL aliments. In general if you need a specialist you will get referred to someone OUTSIDE of Villages Health.
We came from the Lehigh Valley area of PA., and the health network there had all of the specialist IN THE NETWORK, which was what I was expecting here, no such luck.
Hope this helps.

Even though it took awhile for our first doctor appointment, we were told if we needed a doctor visit for something, we were in the system and would be seen.

[golfing eagles]

Even though it took awhile for our first doctor appointment, we were told if we needed a doctor visit for something, we were in the system and would be seen.

The Villages specialty care is associated with TV Healthcare and USF---most medicare supplement policies should be OK, but I would double check to be sure. Also, being out of the Villages Health system and being out of network are 2 different things, and probably only applies to TV advantage plans

For a primary care physician, Dr. Saul Rosenblum , director of the Santa Barbara Center is excellent, He was my business partner in NY for 27 years. He may not be taking any new patients, but I would be guided to anyone he might recommend. Also Dr. Thomas Sullivan, orthopedist, is at the Specialty Care Center. He also has been my friend and orthopedist for over 25 years in NY. No idea about podiatrists or dentists---sorry

[billybye]

Be careful with the United Heathcare HMO option, we got this for my wife, and there were a few local doctors/practices that would not accept this insurance. She had to change doctors. I have an AARP United Heathcare supplemental plan and have not had any problems.

We had to WAIT over 3 months to get into the Villages Health Care system, once in it it has been very good for GENERAL aliments. In general if you need a specialist you will get referred to someone OUTSIDE of Villages Health.
We came from the Lehigh Valley area of PA., and the health network there had all of the specialist IN THE NETWORK, which was what I was expecting here, no such luck.
Hope this helps.

I agree - there are a lot better supplement plans than UHC Villages plan, which is all Village Health will take if you are on Medicare. I am pleased with Premiere Medical, even though they lost the best they had with Dr. Gegaj. They still have a pretty good staff and office personnel are pretty easy to deal with.

[golfing eagles]

I agree - there are a lot better supplement plans than UHC Villages plan, which is all Village Health will take if you are on Medicare. I am pleased with Premiere Medical, even though they lost the best they had with Dr. Gegaj. They still have a pretty good staff and office personnel are pretty easy to deal with.

I believe that UHC Villages Plan is the only MEDICARE ADVANTAGE plan they take. I think (and hope) they take traditional medicare with most medicare supplemental plans, including the 9 offered by UHC (which is what the website seems to indicate). Please correct me if I am wrong

[champion6]

I believe that UHC Villages Plan is the only MEDICARE ADVANTAGE plan they take. I think (and hope) they take traditional medicare with most medicare supplemental plans, including the 9 offered by UHC (which is what the website seems to indicate). Please correct me if I am wrongYou are correct. The reply from billybye is incorrect. In his defense, MANY people confuse Medicare supplement plans and Medicare advantage plans. They are apples and oranges, but have similar names.

[nodlorac]

I just turned 65 in July so had to deal with the whole Medicare issue, etc. I wound up with the AARP Medicare Plan from UnitedHealthcare. I can recommend an independent agent who works with all companies (no charge to you) who could steer you in the right direction for your personal needs. His name is Joseph Zutlas with Zutlas Associates in Ocala (he will come to your home). His number is (352) 873-7777. He makes it all very understandable.

A very good internist/GP is Dr. Fariborz Delbakhsh - or Dr. Del as he is known. (352) 307-9515.

Very good dentists but they are in Bushnell about 30 minutes from the center of The Villages, closer if you are going to be in the new area down south. Bushnell Family & Cosmetic Dentistry - (352) 569-0100.

Village Dermatology - 751-6565

Good luck!!

[billybye]

I agree - there are a lot better supplement plans than UHC Villages plan, which is all Village Health will take if you are on Medicare. I am pleased with Premiere Medical, even though they lost the best they had with Dr. Gegaj. They still have a pretty good staff and office personnel are pretty easy to deal with.

I was wrong I should have said Advantage plans, not supplement plans, but I believe most people find advantage plans to be their best bets.
I still think TV Health is overrated and you can do better looking around at private offices and not limit yourself to UHC Villages Insurance, sip the kool aid, but try other drinks also.

[Carla B]

Advantage plans may be the best bet for some people, simply because they can save a lot of money, but if it makes a difference which doctor you can see, Medicare supplement plans are the best. With a supplement plan you can see any doctor in the U.S. who takes medicare insurance. If you have to have a serious procedure, wouldn't you like to choose from the best?

The Villages Health Care takes AARP UHC Medicare Supplement and you are free to use them or see other doctors if you are in their system.

[billybye]

I wouldn't go to a health care professional to buy a house - why go to a builder to buy both health care and insurance.

[Avista]

We are on the Villages Advantage Plan. Although we are limited to their network, their particular network includes good doctors.

We would have to pay quite a bit more money per month to go with a supplement. Some find this easier to do than others.

The supplement would be about $300/month per person. The Pharmacy part would be over $50/ month.

So that would be at least $700/ month for a couple.

Some afford that easily. Others do not.

We pay nothing. No co pay for primary care doctor. $35 for specialists. You will also have a co pay for hospital stays etc.

One must make best choice for them and their circumstances.

We've found the Villages Care Docs to be the best.

[golfing eagles]

We are on the Villages Advantage Plan. Although we are limited to their network, their particular network includes good doctors.

We would have to pay quite a bit more money per month to go with a supplement. Some find this easier to do than others.

The supplement would be about $300/month per person. The Pharmacy part would be over $50/ month.

So that would be at least $700/ month for a couple.

Some afford that easily. Others do not.

We pay nothing. No co pay for primary care doctor. $35 for specialists. You will also have a co pay for hospital stays etc.

One must make best choice for them and their circumstances.

We've found the Villages Care Docs to be the best.

I'm glad that you found a plan that fits your needs, there can be an advantage to advantage plans, but I've just reviewed the Villages plan and like most things, it is not and cannot be a one size fits all arrangement.
I'm happy you like the docs, I only know 2 of them, but that is for 30 years and they are the best. I also doubt either of them would have agreed to participate in a second rate practice. While I cannot speak for any of their other doctors, I have had an inside look at their SYSTEM, and they are building a first class health care delivery model of the future. The developers have poured millions into this enterprise for the benefit of TV residents; no, this is NOT going to a builder for healthcare, the people running VHC know exactly what they are doing.
As far as advantage vs supplements, advantage is cheaper. UHC plan F is 173.25/month and part D another 52.70, total 225.95 or 451.90/ month for a couple (not 700+), but still adds to the cost of living substantially.
The advantage plan, however, has multiple co-pays that can wipe out the savings if you get sick. There is $275 copay for each of the first 6 hospital days. There is a 20% copay on CT/MRI, there is 20% co-pay on radiation oncology, $16 x ray, $13 lab, $30 physical therapy and the list goes on. Out of pocket costs is capped at $4500/year, but the fine prints states no all money out of pocket goes toward this cap, and I see no list of what doesn't count. You also are paying all the prescription co-pays beyond the 4500 and that can add up in a hurry
Bottom line---if you are pretty healthy, on minimal meds, and generally will only consume preventative services and the occasional short term illness/injury, the advantage plan should suit your needs. If you already have a chronic illness that could become complicated, take a lot of meds or need specialized care, I would consider the medicare supplements

[jnieman]

I'm glad that you found a plan that fits your needs, there can be an advantage to advantage plans, but I've just reviewed the Villages plan and like most things, it is not and cannot be a one size fits all arrangement.
I'm happy you like the docs, I only know 2 of them, but that is for 30 years and they are the best. I also doubt either of them would have agreed to participate in a second rate practice. While I cannot speak for any of their other doctors, I have had an inside look at their SYSTEM, and they are building a first class health care delivery model of the future. The developers have poured millions into this enterprise for the benefit of TV residents; no, this is NOT going to a builder for healthcare, the people running VHC know exactly what they are doing.
As far as advantage vs supplements, advantage is cheaper. UHC plan F is 173.25/month and part D another 52.70, total 225.95 or 451.90/ month for a couple (not 700+), but still adds to the cost of living substantially.
The advantage plan, however, has multiple co-pays that can wipe out the savings if you get sick. There is $275 copay for each of the first 6 hospital days. There is a 20% copay on CT/MRI, there is 20% co-pay on radiation oncology, $16 x ray, $13 lab, $30 physical therapy and the list goes on. Out of pocket costs is capped at $4500/year, but the fine prints states no all money out of pocket goes toward this cap, and I see no list of what doesn't count. You also are paying all the prescription co-pays beyond the 4500 and that can add up in a hurry
Bottom line---if you are pretty healthy, on minimal meds, and generally will only consume preventative services and the occasional short term illness/injury, the advantage plan should suit your needs. If you already have a chronic illness that could become complicated, take a lot of meds or need specialized care, I would consider the medicare supplements

Thank you to our resident TOTV doctor for spelling it all out for us. I will be helping my 95 year old mother-in-law choose a plan in the next couple of months and always thought she should have an Advantage plan. She has several illnesses and now I see that a supplement may be the way to go for her.

[Carla B]

JNieman, if the rules are the same now as they were a few years ago, in the case of AARP UHC supplement, there were six health questions that had to be answered in order to be accepted. Can't remember them and don't have their literature any longer, but one had to do with the number of days since being a hospital inpatient, for example. You might want to call AARP and ask about the rules on behalf of your mother-in-law. If a person applies for a supplement within six months of turning 65, admission is guaranteed.

[golfing eagles]

Thank you to our resident TOTV doctor for spelling it all out for us. I will be helping my 95 year old mother-in-law choose a plan in the next couple of months and always thought she should have an Advantage plan. She has several illnesses and now I see that a supplement may be the way to go for her.

Just read the fine print and compare the plans closely, the devil is in the details. Since UHCs website give a pretty good plan summary for each plan, you might be able to look at your Mom's bills from last year and "guestimate" what her costs would be under each of them

[CFrance]

I'm glad that you found a plan that fits your needs, there can be an advantage to advantage plans, but I've just reviewed the Villages plan and like most things, it is not and cannot be a one size fits all arrangement.
I'm happy you like the docs, I only know 2 of them, but that is for 30 years and they are the best. I also doubt either of them would have agreed to participate in a second rate practice. While I cannot speak for any of their other doctors, I have had an inside look at their SYSTEM, and they are building a first class health care delivery model of the future. The developers have poured millions into this enterprise for the benefit of TV residents; no, this is NOT going to a builder for healthcare, the people running VHC know exactly what they are doing.
As far as advantage vs supplements, advantage is cheaper. UHC plan F is 173.25/month and part D another 52.70, total 225.95 or 451.90/ month for a couple (not 700+), but still adds to the cost of living substantially.
The advantage plan, however, has multiple co-pays that can wipe out the savings if you get sick. There is $275 copay for each of the first 6 hospital days. There is a 20% copay on CT/MRI, there is 20% co-pay on radiation oncology, $16 x ray, $13 lab, $30 physical therapy and the list goes on. Out of pocket costs is capped at $4500/year, but the fine prints states no all money out of pocket goes toward this cap, and I see no list of what doesn't count. You also are paying all the prescription co-pays beyond the 4500 and that can add up in a hurry
Bottom line---if you are pretty healthy, on minimal meds, and generally will only consume preventative services and the occasional short term illness/injury, the advantage plan should suit your needs. If you already have a chronic illness that could become complicated, take a lot of meds or need specialized care, I would consider the medicare supplements
And God forbid you should suddenly come down with a catastrophic illness--which remember, life can turn on a dime.

Another thing to consider is how much you travel. Advantage plans are local only, and if you become ill while out of your plan's area, the medical costs that fall to you to pay will go up.

With a supplemental plan, there are no out-of-plan fees. You can see any doctor in the US who takes Medicare.

[jnieman]

JNieman, if the rules are the same now as they were a few years ago, in the case of AARP UHC supplement, there were six health questions that had to be answered in order to be accepted. Can't remember them and don't have their literature any longer, but one had to do with the number of days since being a hospital inpatient, for example. You might want to call AARP and ask about the rules on behalf of your mother-in-law. If a person applies for a supplement within six months of turning 65, admission is guaranteed.

Thanks Carla that is good to know.

[jnieman]

And God forbid you should suddenly come down with a catastrophic illness--which remember, life can turn on a dime.

Another thing to consider is how much you travel. Advantage plans are local only, and if you become ill while out of your plan's area, the medical costs that fall to you to pay will go up.

With a supplemental plan, there are no out-of-plan fees. You can see any doctor in the US who takes Medicare.

I definitely have some homework to do. Thanks for the info.

[champion6]

<snip> As far as advantage vs supplements, advantage is cheaper. UHC plan F is 173.25/month and part D another 52.70, total 225.95 or 451.90/ month for a couple (not 700+), but still adds to the cost of living substantially. <snip>You forgot about your $104.90 Medicare Part B premium. So your monthly total is $330.85 or $661.70/month for a couple.

[golfing eagles]

You forgot about your $104.90 Medicare Part B premium. So your monthly total is $330.85 or $661.70/month for a couple.

Yes, but you have to pay that anyway, even with an advantage plan, so I was referring to the difference in cost