Log in

View Full Version : Medicare supplement


LouGraf
11-16-2020, 04:37 PM
Hello, I would like to know if anyone has experience with Humana medicare advantage PPO in the villages? Will it be difficult to find Doctors that will bill Humana? Any help on this subject would be appreciated.

vintageogauge
11-16-2020, 04:47 PM
Tri-care, Florida Blue, and United are the only 3 they show on their site as being accepted. I have Blue Cross supplemental coverage so I cannot use their primaries however I can use any of their specialists.

retiredguy123
11-16-2020, 05:13 PM
Just to clarify, Medicare Supplement (Medigap) plans and Medicare Advantage plans are two entirely different products. A Medicare Supplement plan will cover the Medicare Part A and Part B co-pays, but you still have "regular" Part A and B Medicare. A Medicare Advantage plan will replace Medicare Part A, Part B, and Part D with one separate plan (Part C). Many people seem to confuse these terms.

LuvtheVillages
11-16-2020, 05:23 PM
Tri-care, Florida Blue, and United are the only 3 they show on their site as being accepted. I have Blue Cross supplemental coverage so I cannot use their primaries however I can use any of their specialists.

You seem to be talking about the Villages Health, a network of Medicare Advantage clinics here in The Villages. That is not what he is asking about. He is asking about a different Medicare Advantage plan through Humana.

Original Poster, you should check with your rep from Humana, or on their website, to see if their network extends into Florida and the availability of doctors here.

jojo
11-16-2020, 06:15 PM
My mother had a Humana plan. It worked well when she needed a doctor. However, it was a nightmare when she needed rehab after a hospital stay. The two worst institutions were the only ones they would approve in Sumter County. We have a supplement plan so that we can choose any doctor or facility.

villagetinker
11-16-2020, 06:15 PM
OP, you should also contact SHINE, www.floridiashine.org they offer unbiased information on all of then options for health care and they have local meetings, but I have no idea if these are now being held. The phone number is: 1-800-963-5337.

vintageogauge
11-16-2020, 07:41 PM
My mother had a Humana plan. It worked well when she needed a doctor. However, it was a nightmare when she needed rehab after a hospital stay. The two worst institutions were the only ones they would approve in Sumter County. We have a supplement plan so that we can choose any doctor or facility.

You can choose any doctor except The Villages Health System Primary Care Doctors. I too have the supplement and found it a little hard finding a primary other than Premier which I will not go back to for any reason. This is a perfect location for a few good younger primary doctors to open a business.

Stu from NYC
11-16-2020, 07:55 PM
We had HumanaAdvantage plan before we moved here earlier this year. Wanted to stay with them if possible.

Got a recommendation for DR but she would only accept Humana Gold.

Discussed this with the local office and we switched to it and happy with it.

However it is an HMO so we must go thru our primary care DR if we want to see a specialist and typically it will be in her group.

We have been referred to several specialists since we are arrived here and have been happy with all of them.

However in a strange move Humana has closed their local office. Has not been a problem as we deal with their customer service dept, who has treated us well but we find closing of the office to be curious.

Anniecacioppo
11-17-2020, 05:43 AM
I have Humana Medicare Advantage PPO and have had very good luck finding doctors in and near The Villages.

jedalton
11-17-2020, 05:49 AM
have Humana Gold for 4 years and no problems at all

Quixote
11-17-2020, 06:10 AM
I’ve heard too many unfortunate stories of persons who switched from regular Medicare Parts A, B, and D to an Advantage plan we’re shocked to discover when there was a serious issue just how limited—and limiting—Advantage plans are. As a result, at least until original Medicare is done away with, that is what I am sticking with, along with a Medicare Supplement.

Keninches
11-17-2020, 06:16 AM
So right. Medicare Regular or original is by far the BEST. Beware of Medicare Advantage. You will be limited. You get what you pay for.

Codysmom
11-17-2020, 06:18 AM
We have Humana PPO and are very happy. Have had no issues finding primary care doctors and specialists. Was a United Healthcare member for many, many years and changed due to good relationship with Shands. This was before UF came into The Villages. Husband just had knee replacement and was handled very well. No plans to change.

Keninches
11-17-2020, 06:18 AM
You get what you pay for.
Beware

Pedrocarrasco01@yahoo.com
11-17-2020, 07:23 AM
Hello, I would like to know if anyone has experience with Humana medicare advantage PPO in the villages? Will it be difficult to find Doctors that will bill Humana? Any help on this subject would be appreciated.

We do have it and have had it now for 4 years, happy enough that won’t look at any other plans. All Doctors that we have gone so far take Humana, love the no premium other than the Medicare payment, reasonable copays, had United Health Care PPO before, way too expensive, when I switched to Humana, I saved $400 per month, never again UHC. Love our over the counter drugs that we get free every month. Recommend it highly, had two surgeries at U of F in Gainesville (wanted the best Dr.) and wife had one at Advent in Orlando (again the best Dr, recommended by our MD) no issues, all hospitals here accept it as payment in full, but we chose to go to get it done right the first time, which it was done. Love it!!!!

biker1
11-17-2020, 07:49 AM
Are you saying that you had zero cost for the surgeries or you had zero cost because you had hit your out-of-pocket maximum prior to the surgery? The reason I ask is that Medicare Advantage Plans typically have pretty high out-of-pocket maximums (say around $6K).

We do have it and have had it now for 4 years, happy enough that won’t look at any other plans. All Doctors that we have gone so far take Humana, love the no premium other than the Medicare payment, reasonable copays, had United Health Care PPO before, way too expensive, when I switched to Humana, I saved $400 per month, never again UHC. Love our over the counter drugs that we get free every month. Recommend it highly, had two surgeries at U of F in Gainesville (wanted the best Dr.) and wife had one at Advent in Orlando (again the best Dr, recommended by our MD) no issues, all hospitals here accept it as payment in full, but we chose to go to get it done right the first time, which it was done. Love it!!!!

tombpot
11-17-2020, 08:15 AM
The more treatment that’s needed later on you will complain about your advantage plan.

BonnieLou
11-17-2020, 08:27 AM
My husband and I have had Humana PPO for a number of years - love it!
Never had an issue with doctors, services, or getting services approved.

chrissy2231
11-17-2020, 08:36 AM
get fl blue so you can use doctors in villages medicare advantage plan. Leonel Barron 352-729-3442. Dr. Uyen Nguyen 352-674-1710 for primary is the best doctor I've had in my lifetime. she also does osteopathic manipulations; much different and better than Chiro.

jrieker68
11-17-2020, 08:50 AM
Are you saying that you had zero cost for the surgeries or you had zero cost because you had hit your out-of-pocket maximum prior to the surgery? The reason I ask is that Medicare Advantage Plans typically have pretty high out-of-pocket maximums (say around $6K).

This poster said they paid no premiums; did not say they didn't pay any out-of-pocket costs.

Dan9871
11-17-2020, 09:34 AM
The reason I ask is that Medicare Advantage Plans typically have pretty high out-of-pocket maximums (say around $6K).

For 2021 the United Healthcare Advantage plan has a $2900 out of pocket limit.

biker1
11-17-2020, 10:16 AM
I was essentially asking him if he paid out-of-pocket expenses. Here is his statement:

Recommend it highly, had two surgeries at U of F in Gainesville (wanted the best Dr.) and wife had one at Advent in Orlando (again the best Dr, recommended by our MD) no issues, all hospitals here accept it as payment in full,

By "payment in full", I assumed he meant that the hospitals accepted his Medicare Advantage Insurance as payment in full (i.e. no additional cost). I don't believe this has anything to do with his premiums.

This poster said they paid no premiums; did not say they didn't pay any out-of-pocket costs.

biker1
11-17-2020, 10:19 AM
The HMO option has a $2900 out-of-pocket maximum.The PPO option has a $5900 out-of-pocket maximum.

For 2021 the United Healthcare Advantage plan has a $2900 out of pocket limit.

Roron123
11-17-2020, 10:39 AM
Enter your doctors names on the plan and the medications you are taking and see which plans come up for you specifically and then compare co-pays (best is United Healthcare then Blue Cross PPO compare with Humana PPO) but make sure your Drs are on the plan you choose and that your medications are covered!

KRM0614
11-17-2020, 10:57 AM
Just to clarify, Medicare Supplement (Medigap) plans and Medicare Advantage plans are two entirely different products. A Medicare Supplement plan will cover the Medicare Part A and Part B co-pays, but you still have "regular" Part A and B Medicare. A Medicare Advantage plan will replace Medicare Part A, Part B, and Part D with one separate plan (Part C). Many people seem to confuse these terms.
The confusion is in how it interacts with the mandated portion of Medicare Parts A and B for which the rate is 144.80 a month for the newbies by CMS. If the plan mentioned covers A B D then is the policyholder paying twice or coordinated with CMS?
Anyone who can do an example would be great. Made the mistake of turning 65 in 2020 and no ability to sit down at Social Security and review this.

KRM0614
11-17-2020, 11:04 AM
have Humana Gold for 4 years and no problems at all
How much do you pay for Humana gold ? Is this in addition to CMS part A and B of Medicare of 144.80 per month

biker1
11-17-2020, 11:07 AM
Regardless of whether you choose a Supplemental Plan to Medicare (aka Medigap) or choose to signup for a Medicare Advantage Plan (which relieves Medicare of any responsibility for your healthcare costs), you will still pay the $144.80 to Medicare. Typically you will see the following:

Option #1: Medicare plus Supplemental - $144.80 + cost of Supplemental Plan (typically around $150-$200), per month

Option #2: Medicare Advantage Plan - $144.80 + $0 or a small premium, per month

There are, of course, differences between Option #1 and Option #2 with regards to the network, co-pays, out-of-pocket maximums, etc. There are several different Supplemental Plans and numerous Medicare Advantage Plans.

The confusion is in how it interacts with the mandated portion of Medicare Parts A and B for which the rate is 144.80 a month for the newbies by CMS. If the plan mentioned covers A B D then is the policyholder paying twice or coordinated with CMS?
Anyone who can do an example would be great. Made the mistake of turning 65 in 2020 and no ability to sit down at Social Security and review this.

Altomama
11-17-2020, 11:09 AM
Almost everyone in TV will take Humana. I had it for a few years. Liked it. Only changed to get a better rate on specific meds. I had to take. Within TV I have found that most Medicare Advantage plans are accepted by most doctors. If I need to see a specialist that is out of network they will usually work with me and adjust the fees.

marmick2
11-17-2020, 12:16 PM
We have had the Humana PPO, which is a Medicare Advantage Plan, for many years and love the fact that we don't need a referral to see a specialist, can travel and still see any doctor in their plan, have never had a problem finding a doctor here. All at Premier Medical accept it I believe as well as many others. You can also use it at the UF Hospital and Specialists. The HMO is not good if you travel which is why we have the PPO.

retiredguy123
11-17-2020, 12:43 PM
Regardless of whether you choose a Supplemental Plan to Medicare (aka Medigap) or choose to signup for a Medicare Advantage Plan (which relieves Medicare of any responsibility for your healthcare costs), you will still pay the $144.80 to Medicare. Typically you will see the following:

Option #1: Medicare plus Supplemental - $144.80 + cost of Supplemental Plan (typically around $150-$200), per month

Option #2: Medicare Advantage Plan - $144.80 + $0 or a small premium, per month

There are, of course, differences between Option #1 and Option #2 with regards to the network, co-pays, out-of-pocket maximums, etc. There are several different Supplemental Plans and numerous Medicare Advantage Plans.
With Option 1, you would need to add the cost for a prescription drug plan, which is Part D. Option 2 would usually include prescription drugs.

Also, the $144.80 cost is not for everyone. It is based on income and many people pay a lot more than that.

biker1
11-17-2020, 01:02 PM
Yes, the Medicare Part B varies with income but the poster seemed to indicate that $144.80 was the amount he would be paying.

With Option 1, you would need to add the cost for a prescription drug plan, which is Part D. Option 2 would usually include prescription drugs.

Also, the $144.80 cost is not for everyone. It is based on income and many people pay a lot more than that.

Pedrocarrasco01@yahoo.com
11-18-2020, 07:29 AM
Are you saying that you had zero cost for the surgeries or you had zero cost because you had hit your out-of-pocket maximum prior to the surgery? The reason I ask is that Medicare Advantage Plans typically have pretty high out-of-pocket maximums (say around $6K).

Hospital is $250 regardless of days there that is all. Emergency Room is $90, Regular Dr copay is $5, Specialist is $35 those are the copays, never had to pay any more than that (wife stayed 8 days in hospital), I am EXTREMELY happy to the point that I am not even considering anything else, I had United Health Care for 2 years for wife and I $400 per month and we still had copays one of my great mistakes, changed to Humana after that plus we get over the counter meds Free, we order them from Humana

Pedrocarrasco01@yahoo.com
11-18-2020, 07:41 AM
I was essentially asking him if he paid out-of-pocket expenses. Here is his statement:

Recommend it highly, had two surgeries at U of F in Gainesville (wanted the best Dr.) and wife had one at Advent in Orlando (again the best Dr, recommended by our MD) no issues, all hospitals here accept it as payment in full,

By "payment in full", I assumed he meant that the hospitals accepted his Medicare Advantage Insurance as payment in full (i.e. no additional cost). I don't believe this has anything to do with his premiums.

Payment in full is just that, I paid only my copay which hospital was $250.00
With my plan Hospital copay is $250, Specialist is $35, regular MD. Is $5, THAT IS ALL PROVIDING YOUR HOSPITAL IS A HUMANA APPROVED FACILITY (all hospitals here in The Villages, Leesburg, Ocala or Gainesville are approved)

jojo
11-18-2020, 09:00 AM
My mother had HUMANA which I think was a PPO. Worked fine for doctors but was disastrous for rehab. They only approved the absolutely worst two facilities in The Villages. I could write a book about her stay.

Quixote
11-18-2020, 09:30 AM
Message accidentally erased; will repost.

Quixote
11-18-2020, 09:57 AM
Are you saying that you had zero cost for the surgeries or you had zero cost because you had hit your out-of-pocket maximum prior to the surgery? The reason I ask is that Medicare Advantage Plans typically have pretty high out-of-pocket maximums (say around $6K).

We have both unfortunately have had the need for extensive medical care. With original Medicare and United HealthCare (not to be confused with a United HealthCare Advantage plan), ALL our medical costs are covered IN FULL—no deductibles, no co-pays, no out-of-pocket costs. ZERO.

However, we are paying premiums for this coverage. In addition, we pay for Medicare Part D Prescription Drug coverage, as it’s a great program—for the insurance and pharmaceutical drug industries—not especially for many (most?j seniors. For those with high prescription drug costs, check out the GoodRx app and pharmacy checker . com.

A we’ve heard too many horror stories of seniors who in good health switched to an Advantage plan because it APPEARED to be a,good deal. However, once the inevitable health problems showed up, they discovered (1) how much was NOT covered, and (2) the virtual impossibility of switching back.

All we can suggest is to exercise due diligence. As pointed out by another poster, you get what you pay for....

Quixote
11-18-2020, 10:02 AM
We have both unfortunately have had the need for extensive medical care. With original Medicare and United HealthCare (not to be confused with a United HealthCare Advantage plan), ALL our medical costs are covered IN FULL—no deductibles, no co-pays, no out-of-pocket costs. ZERO.

However, we are paying premiums for this coverage. In addition, we pay for Medicare Part D Prescription Drug coverage, as it’s a great program—for the insurance and pharmaceutical drug industries—not especially for many (most?j seniors. For those with high prescription drug costs, check out the GoodRx app and pharmacy checker . com.

We’ve heard too many horror stories of seniors who in good health switched to an Advantage plan because it APPEARED to be a,good deal. However, once the inevitable health problems showed up, they discovered (1) how much was NOT covered, and (2) the virtual impossibility of switching back.

All we can suggest is to exercise due diligence. As pointed out by another poster, you get what you pay for....

I have no idea why my post is repeating as a quote. I must have done something wrong, sorry.

newgirl
11-18-2020, 12:30 PM
I have had it since day 1 and never any issues at all. I have a disability and love it only costs $10. to see a specialist.

kimgarwel12@gmail.com
11-18-2020, 01:40 PM
We have Humana Choice PPO and yesterday I was refused an appt to get established with a primary Dr because she recently stopped taking patients with Humana Choice, but still takes Humana Advantage. My insurance agent says legally she can't deny services if she accepts Medicare at all. He's checking into this for us, but it definitely has me concerned!

retiredguy123
11-18-2020, 02:23 PM
We have Humana Choice PPO and yesterday I was refused an appt to get established with a primary Dr because she recently stopped taking patients with Humana Choice, but still takes Humana Advantage. My insurance agent says legally she can't deny services if she accepts Medicare at all. He's checking into this for us, but it definitely has me concerned!
Your insurance agent is wrong.

Stu from NYC
11-18-2020, 03:30 PM
We have Humana Choice PPO and yesterday I was refused an appt to get established with a primary Dr because she recently stopped taking patients with Humana Choice, but still takes Humana Advantage. My insurance agent says legally she can't deny services if she accepts Medicare at all. He's checking into this for us, but it definitely has me concerned!

When we moved here the DR recommended to us would not take the Humana plan we had been taking but would accept Humana Gold. We do have to get referrals thru our Doc but very happy with the suggested referrals.

And $ 10 co pay for specialists is very welcome. You might want to consider going to this.

Still no idea why Humana would close their office here.

BAT777
11-19-2020, 03:06 PM
Which one pays for CT scans and other tests? We just had to pay 85 dollars for a scan. We have United Healthcare the Villages plan but seem to be paying quite a bit in addition to the monthly. :(

Mrprez
11-19-2020, 03:55 PM
My wife was in the hospital for two nights. Total charges billed was just under $16,000 which was covered 100% by Medicare and FEPBlue. Some of the charges were outrageous! $3884 for the X-ray tech to do a CT scan? He made more than the doctor who saw her in the ER.

Mrprez
11-19-2020, 04:03 PM
Which one pays for CT scans and other tests? We just had to pay 85 dollars for a scan. We have United Healthcare the Villages plan but seem to be paying quite a bit in addition to the monthly. :(

According to the webpage, CT copays are $85 for your plan. I would get off that plan as it is not rated very highly.

2021 UnitedHealthcare The Villages Medicare Advantage (HMO) H1045-025 By UnitedHealthcare. (https://www.medicarehelp.org/2021-medicare-advantage/ma/unitedhealthcare-the-villages-medicare-advantage-hmo-H1045-025)

TSO/ISPF
11-19-2020, 07:33 PM
Yes, the Medicare Part B varies with income but the poster seemed to indicate that $144.80 was the amount he would be paying.
The max income for a married couple filing jointly is 176K a year. If your making more than that after retirement taxable, more power to you and what the heck are you doing in a low rent retirement community? Just kidding. They call it irma(income related monthly adjustments)! In 2021 the
max adjustment makes part b 504.90 a month for income over 750K. It also raises your cost for Part
D.

retiredguy123
11-19-2020, 07:51 PM
The max income for a married couple filing jointly is 176K a year. If your making more than that after retirement taxable, more power to you and what the heck are you doing in a low rent retirement community? Just kidding. They call it irma(income related monthly adjustments)! In 2021 the
max adjustment makes part b 504.90 a month for income over 750K. It also raises your cost for Part
D.
I understand the concept of progressive tax rates based on income. But, Medicare Part B is a product that has different prices for the same thing based on income. It's like buying a television at Best Buy and paying more because you have a higher income. I don't think many people would accept that idea.

Northwoods
11-19-2020, 09:29 PM
You can choose any doctor except The Villages Health System Primary Care Doctors. I too have the supplement and found it a little hard finding a primary other than Premier which I will not go back to for any reason. This is a perfect location for a few good younger primary doctors to open a business.

Unfortunately, I think this is a lousy place for young primary care doctors to open a business...
Most of their billing is Medicare, which pays less than traditional insurance.
If they want to see professional sports or culture, they have to drive to either Orlando or Tampa. Or... they live in Orlando or Tampa and drive over an hour to get to work each day.
The selection of good restaurants and shopping is poor.
If they have children, they can't send them to the Charter School.
They'll have a hard time finding competent workers.

Why do you think The Villages Health pays their primary physicians a salary and caps the number of patients they have? They have to attract physicians to a retirement community. I know of at least 1 physician in TVH who stays here because he is so impressed with the Charter School.

TSO/ISPF
11-19-2020, 09:45 PM
I’ve heard too many unfortunate stories of persons who switched from regular Medicare Parts A, B, and D to an Advantage plan we’re shocked to discover when there was a serious issue just how limited—and limiting—Advantage plans are. As a result, at least until original Medicare is done away with, that is what I am sticking with, along with a Medicare Supplement.

I just watched a really good video on Medicare choices.

🔥2021 Medicare Plans CAUTION - Urgent Updates - YouTube (https://www.youtube.com/watch?v=g5EXR0K4BLU)

rustyp
11-20-2020, 07:10 AM
I just watched a really good video on Medicare choices.

🔥2021 Medicare Plans CAUTION - Urgent Updates - YouTube (https://www.youtube.com/watch?v=g5EXR0K4BLU)

I watched. Very biased toward supplement plans. Look at footage around 16 minute mark. He is explaining most advantage plans pay 80% of chemotherapy. He explains how expensive this could get. AND then in almost a whisper he says up to OOP (out of pocket) cost which for most advantage plans is somewhere between $3000 - $7000 per year.

Also so much talk about Doctors not in network. We have United Healthcare PPO (The Villages Healthcare plan). They have a published list by state what docs and facilities take the plan. Unfortunately we used the plan heavily this year and mostly out of Florida. We have bills from over 50 docs and facilities. 100% was in network even the ambulance. The plan has a $5900 OOP stop and that is what we paid and our share indeed did stop.

I like another poster here suggest you go to SHINE (an independent organization) for help selecting a type of plan that fits you and even more important a non biased education on the facts.

TSO/ISPF
11-20-2020, 07:20 AM
I watched. Very biased toward supplement plans. Look at footage around 16 minute mark. He is explaining most advantage plans pay 80% of chemotherapy. He explains how expensive this could get. AND then in almost a whisper he says up to OOP (out of pocket) cost which for most advantage plans is somewhere between $3000 - $7000 per year.

Also so much talk about Doctors not in network. We have United Healthcare PPO (The Villages Healthcare plan). They have a published list by state what docs and facilities take the plan. Unfortunately we used the plan heavily this year and mostly out of Florida. We have bills from over 50 docs and facilities. 100% was in network even the ambulance. The plan has a $5900 OOP stop and that is what we paid and our share indeed did stop.

I like another poster here suggest you go to SHINE (an independent organization) for help selecting a type of plan that fits you and even more important a non biased education on the facts.
I worked with a shine rep in the villages. They run the numbers and explain the details but try to
avoid offering too much advice. If you can afford the supplement plans, it's the
way to go IMHO. It's unfortunate they locked up all the Villages health care clinic's primary care doctors.
I don't understand that but there must be a reason. Any guesses? I did see the post about attracting
doctors.

rustyp
11-20-2020, 08:23 AM
I worked with a shine rep in the villages. They run the numbers and explain the details but try to
avoid offering too much advice. If you can afford the supplement plans, it's the
way to go IMHO. It's unfortunate they locked up all the Villages health care clinic's primary care doctors.
I don't understand that but there must be a reason. Any guesses? I did see the post about attracting
doctors.

Looks like three points here
1 - Shine is independent and won't make the decision for you. It's an educational process. That's the beauty of them. If you went to a Ford dealer and asked what car is best for me guess what the response would be.
2 - I do disagree with your statement if you can afford supplemental plan it's the way to go. Maybe perfect plan for you but everybody's circumstance is different. From what drugs one takes to are you a snowbird to who and where you want your primary, etc.
3 - The reason why they locked up all The Villages health care clinics and primary doctors. The doctors work for The Villages. They are paid a salary. The Villages decides what is the best way to run their facility. One would guess one limit the amount of paperwork involved on their part while maximizing their ability to negotiate plan particulars is one motive.

retiredguy123
11-20-2020, 08:40 AM
One thing that is good is that no matter what plan you sign up for, you can always change plans every year if your situation changes.

TSO/ISPF
11-20-2020, 08:46 AM
[QUOTE=rustyp;1863274]Looks like three points here

2 - I do disagree with your statement if you can afford supplemental plan it's the way to go. Maybe perfect plan for you but everybody's circumstance is different. From what drugs one takes to are you a snowbird to who and where you want your primary, etc.


The many part B supplemental plans give you the most freedom to choose which doctors and the part D plans which drug plans based on your needs. The advantage plans limit your choices and make being a snowbird more difficult. After your first year on Medicare, you get
pretty locked into using the advantage plans. The "medical underwriting" aspect of moving from an advantage plan back to original Medicare with supplemental plan scares me.

Mrprez
11-20-2020, 08:50 AM
That should only be an issue if you were in poor health. As long as you don’t have any serious health problems leaving MA for Medigap shouldn’t be an issue.

pcacace
11-20-2020, 10:33 PM
It would be best to call your ins provider to see how many Drs accept your insurance in the zip codes around here. We have UHC Advantage and many, many Drs accept it.

TSO/ISPF
11-21-2020, 11:59 AM
That should only be an issue if you were in poor health. As long as you don’t have any serious health problems leaving MA for Medigap shouldn’t be an issue.
I don't know what the future holds for me health wise. Odds are, if you live long enough you are going to
have issues and once you sign up for advantage plans it can be difficult to move back to Original Medicare at least according to the things I have seen. After the first year on a plan I believe you would have to wait until open enrollment to switch back and if you needed to see a doctor outside your plan, Well that's when you better know your out of pocket Max spend outside the network. That's just my 2 cents.
Everyone is free to make their own decision.

Quixote
11-23-2020, 08:58 PM
Unfortunately, I think this is a lousy place for young primary care doctors to open a business...
Most of their billing is Medicare, which pays less than traditional insurance....

There have been Medicare reimbursement cutbacks; however, practitioners have told me time and again that they are grateful when a patient is covered by Medicare. A physical therapist told me that one private insurance company paid him $2 per session! Is that believable?...

Quixote
11-23-2020, 09:24 PM
[QUOTE=rustyp;1863274].... The many part B supplemental plans give you the most freedom to choose which doctors and the part D plans which drug plans based on your needs. The advantage plans limit your choices and make being a snowbird more difficult. After your first year on Medicare, you get
pretty locked into using the advantage plans. The "medical underwriting" aspect of moving from an advantage plan back to original Medicare with supplemental plan scares me.

I agree completely. I’ve heard hair-raising stories of people desperately trying—at times unsuccessfully—to return to original Medicare when they inevitably developed some medical issue if they lived long enough.


That should only be an issue if you were in poor health. As long as you don’t have any serious health problems leaving MA for Medigap shouldn’t be an issue.

And the reverse—to go from Medicare Advantage back to original Medicare?! Okay, who’s willing to gamble on their health—and possibly their lives?...

debntom
12-02-2020, 05:22 PM
Thanks, helpful you tube video

jblum315
12-02-2020, 06:26 PM
I have had UH plan F for 30 years and it has always met my requirements. One year they talked me into trying an Advantage plan. None of my doctors would accept it. I had to cancel my Plan F in order to get the Advantage thing and it took 4months to get back on it. So look before you leap