Where do you go for Medicare advice?

[DruannB]

We are moving to The Villages on Nov. 3. We're actually here now. I'm turning 65 in January and need to sign up for a Medicare plan. I know I saw on a previous post somewhere you could go in The Villages for advice on how to choose a plan. Can someone steer me in the right direction? Thanks.

[bagboy]

SHINE - Home (https://www.floridashine.org/)

[villagetinker]

We are moving to The Villages on Nov. 3. We're actually here now. I'm turning 65 in January and need to sign up for a Medicare plan. I know I saw on a previous post somewhere you could go in The Villages for advice on how to choose a plan. Can someone steer me in the right direction? Thanks.

Be aware IF you want to be part of the Villages Health System, they only accept 3 or 4 ADVANTAGE plans. We were in the Villages health for a while and really liked it, then they stopped the grandfathering of the Medicare (and supplemental) patients. We found the supplemental plans had too many limitations, so we left Villages health. As noted above SHINE is an excellent source of information.

[FenneyGuy]

Health Insurance - Medicare - Blue Cross-Blue Shield - The Villages - Mid-Florida Agencies (https://www.midfloridaagencies.com/)

Make an appointment with Samantha Gump. They market Florida Blue.

[biker1]

Sort of. The Villages Health Care System (the PCP facilities) only accept UHC Medicare Advantage and Florida Blue Medicare Advantage. I believe there are two options with each plan: an HMO and a PPO. There are UHC and Florida Blue representative at some of the PCP facilities that you can talk to.

Be aware IF you want to be part of the Villages Health System, they only accept 3 or 4 ADVANTAGE plans. We were in the Villages health for a while and really liked it, then they stopped the grandfathering of the Medicare (and supplemental) patients. We found the supplemental plans had too many limitations, so we left Villages health. As noted above SHINE is an excellent source of information.

[biker1]

I do not know the reasons why The Villages Healthcare System (the PCPs) only accepts UHC Medicare Advantage Plans and Florida Blue Medicare Advantage Plans once you become eligible for Medicare. They give you a choice of two companies, not one. Before Medicare age, they accept most insurances. I was a patient with them for a number of years but had to leave once I turned 65 and opted to go with Medicare and a Supplemental Plan. I was very satisfied with The Villages Healthcare system and would have stayed if it was possible. Their company, their rules, and, fortunately, there are other PCPs in the area. The Villages Health Care System was, however, very convenient and well run - always taken on time and visits were never rushed.

People should be very skeptical of any doctor/hospital or healthcare system that ONLY accepts Medicare Advantage. There is no reason for this other than they are somehow benefiting from forcing their patients to one company.

Medicare is accepted at 99.9% of all doctors and hospitals in the U.S. Therefore, you have to question the motives of an institution that requires someone to pick their Medicare Advantage Plan of choice.

Most of the time it's the opposite....a provider will only take Medicare and not Medicare Advantage because billing for them is so much more complicated.

Medicare Advantage and Medicare is billed differently. With Medicare...they bill Medicare, Medicare pays it's portion and then sends the balance on to the Medicare Supplement carrier. There are very strict rules on how quick the turn around needs to be for Medicare Supplement carriers. That is why most doctors don't even know who a good Medicare Supplement company is because they never have to deal with it or worry about it. Unlike Medicare Advantage.

We have reached a new low in healthcare when a heathcare system/ hospital tells you that must take their suggested Medicare Advantage plan or else.

United Healthcare has been in the news a lot lately and lots of law suits. Here is an article about it...
Report says UnitedHealth Group was top recipient of questionable Medicare payments - StarTribune.com (https://www.startribune.com/report-says-unitedhealth-group-was-top-recipient-of-questionable-medicare-payments/600108138/)

It would be much easier for them to also accept Medicare and give their patients freedom to choose. It makes you wonder how much they are making from the Medicare Advantage Plan.

Here is a recent article I did comparing Medicare Advantage vs Medicare Supplement Plans. The differences they don't mention in all the commercials...

What is the difference between Medicare Supplement and Medicare Advantage? - Summit Medigap Medicare Supplement Insurance (https://summitmedigap.com/what-is-the-difference-between-medicare-supplement-and-medicare-advantage-2/)

[retiredguy123]

I do not know the reasons why The Villages Healthcare System (the PCPs) only accepts UHC Medicare Advantage Plans and Florida Blue Medicare Advantage Plans once you become eligible for Medicare. They give you a choice of two companies, not one. Before Medicare age, they accept most insurances. I was a patient with them for a number of years but had to leave once I turned 65 and opted to go with Medicare and a Supplemental Plan. I was very satisfied with The Villages Healthcare system and would have stayed if it was possible. Their company, their rules, and, fortunately, there are other PCPs in the area. The Villages Health Care System was, however, very convenient and well run - always taken on time and visits were never rushed.
I think they limit their patients to a few Medicare advantage plans because they want to provide a health care system that is convenient and available to Village residents. If they accepted original Medicare patients, they could become overwhelmed by non-Village residents, making it more difficult to serve the Village residents who they want to serve. Also, original Medicare patients with a supplement pay no co-pays, which increases their tendency to overuse the system, thereby making it less available to the Medicare advantage patients. It makes sense to me.

[Babubhat]

Ambulance and ER visit was only 90 bucks with United Health. The price was right. No complaints. Bills were over 7k

[craigrmorrison]

We are moving to The Villages on Nov. 3. We're actually here now. I'm turning 65 in January and need to sign up for a Medicare plan. I know I saw on a previous post somewhere you could go in The Villages for advice on how to choose a plan. Can someone steer me in the right direction? Thanks.

I usually consult with Craig Morrison

[retiredguy123]

[QUOTE=Summit Medigap;2023436]People should be very skeptical of any doctor/hospital or healthcare system that ONLY accepts Medicare Advantage. There is no reason for this other than they are somehow benefiting from forcing their patients to one company.

It's called The Villages Healthcare system because they want to serve Villages residents. If they accepted original Medicare patients, they would probably become overwhelmed by a lot of non-Villages residents from the surrounding areas, and they couldn't refuse service. If that happened, the system would no longer be attractive to Villagers.

[biker1]

The Villages Health Care System, IIRC, did accept traditional Medicare, originally. They made the change to accepting only Medicare Advantage, initially the UHC flavor and then the added the Florida Blue flavor, a few years ago (perhaps 5 years?). They also continue to accept most insurance for folks under 65, regardless of where you live. Something clearly changed in their thinking. Perhaps they were, as you suggested, trying to limit the number of patients. They did lose patients when they went to Medicare Advantage only. There are also possible financial reasons. Regardless of the reason, for me it is unfortunate as I was quite satisfied and regretted having to find another PCP.


[QUOTE=Summit Medigap;2023436]People should be very skeptical of any doctor/hospital or healthcare system that ONLY accepts Medicare Advantage. There is no reason for this other than they are somehow benefiting from forcing their patients to one company.

It's called The Villages Healthcare system because they want to serve Villages residents. If they accepted original Medicare patients, they would probably become overwhelmed by a lot of non-Villages residents from the surrounding areas, and they couldn't refuse service. If that happened, the system would no longer be attractive to Villagers.