Anyone have Medigap G instead of the Advantage plans?

[metoo21]

We would prefer to have Medigap G instead of any of the Advantage plans. Does anyone in The Villages have G? Is there an issue using it? We would just prefer to select our on doctors and facilities.

[billethkid]

If it is standard medicare plus a supplement then usually everything is covered....pick your own doctors/hospitals/no referrals required to go to specialists.
Some might say it costs more....all I know is we have not had to reach in our pocket for ANY procedures.....very major surgeries over the years.....100% covered.

[metoo21]

Thanks. However, everything I've read about the villages and medicare plans seem to indicate an Advantage Plan is preferred by medical professionals and facilities in The Villages. Just need to make sure "G" is also accepted.

[Mrprez]

Thanks. However, everything I've read about the villages and medicare plans seem to indicate an Advantage Plan is preferred by medical professionals and facilities in The Villages. Just need to make sure "G" is also accepted.

No. The Villages Health only accepts Medicare Advantage plans. Now, there may be doctors in The Villages not associated with TVH that accept those plans but you’d have to go and ask each one specifically.

[vintageogauge]

You can use the G plan supplement anywhere except The Villages Health System primary care doctors. I have my primary outside of the system but use their specialists. The premiums are higher but as billethkid stated, you don't have to pay for anything after your small deductible is covered and you can be treated anywhere you like. I'm pretty sure that you can't go to Moffit for treatment if you have United Health Care and are part of The Villages health and a lot of times you cannot see a doctor, they set you up with a PA or nurse practitioner.

[bagboy]

Thanks. However, everything I've read about the villages and medicare plans seem to indicate an Advantage Plan is preferred by medical professionals and facilities in The Villages. Just need to make sure "G" is also accepted.

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

My humble opinion is for you to contact SHINE and get their advice and recommendations. I think you may be confusing medical professionals in the area with those connected with The Villages Healthcare.

[metoo21]

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

My humble opinion is for you to contact SHINE and get their advice and recommendations. I think you may be confusing medical professionals in the area with those connected with The Villages Healthcare.

What does The Villages Healthcare mean? Is that the clinics? Hospitals?

[bagboy]

What does The Villages Healthcare mean? Is that the clinics? Hospitals?

Google The Villages Health or The Villages Healthcare. And again, SHINE can answer many of your questions.

[champion6]

We would prefer to have Medigap G instead of any of the Advantage plans. Does anyone in The Villages have G? Is there an issue using it? We would just prefer to select our on doctors and facilities.

What does The Villages Healthcare mean? Is that the clinics? Hospitals?The Villages Health is a group of clinics with primary care docs. They require specific Advantage plans for patients over age 65.

The hospitals in The Villages and Leesburg are owned by UFHealth. They accept Medicare and many more HMO & PPO insurance plans.

Attached is a list I created with primary care groups in/around The Villages. As far as I know, on this list The Villages Health is the only group that requires specific Advantage plans.

[LuvtheVillages]

We would prefer to have Medigap G instead of any of the Advantage plans. Does anyone in The Villages have G? Is there an issue using it? We would just prefer to select our on doctors and facilities.

There are many many doctors and clinics throughout The Villages, and also just outside The Villages, that accept Medigap policies. You will not have trouble finding care.

The Villages Health is just one of those many clinics, and it is the only one that does not accept Medigap.

[Northwoods]

You can use the G plan supplement anywhere except The Villages Health System primary care doctors. I have my primary outside of the system but use their specialists. The premiums are higher but as billethkid stated, you don't have to pay for anything after your small deductible is covered and you can be treated anywhere you like. I'm pretty sure that you can't go to Moffit for treatment if you have United Health Care and are part of The Villages health and a lot of times you cannot see a doctor, they set you up with a PA or nurse practitioner.

This pertains to The Villages Health. I Agree... I don't think United Healthcare Advantage includes Moffit, but Florida Blue Advantage does include Moffit (and Shands).
If you need to see a medical professional immediately (the same day), you might see a PA or nurse practitioner. You might also see your Primary Physician. It depends on availability. But if you've scheduled an annual (or biannual) physical, you will almost always see your primary care physician... and it will be either a 30 min. or 60 min appointment.

[Eg_cruz]

We would prefer to have Medigap G instead of any of the Advantage plans. Does anyone in The Villages have G? Is there an issue using it? We would just prefer to select our on doctors and facilities.
The only thing is the The Village Health Care only takes advantage plans…….but I personally don’t see that as a downside. Other then that Plan G and N are great plans.

[bowlingal]

I have traditional medicare and UHC as a supplement. My premiums are less than $200 per month and EVERYTHING is covered. No referrals. no co-pays, no deductibles. I can go to any doctor, hospital anywhere in the US. Yes, I can't use the Villages Healthcare for primary doctors, but I can for specialists. My total yearly payout is less than $2400. I bet your deductible, co-pays are more than that. Why wouldn't you get traditional medicare? make no sense to me.

[Mrprez]

I have traditional medicare and UHC as a supplement. My premiums are less than $200 per month and EVERYTHING is covered. No referrals. no co-pays, no deductibles. I can go to any doctor, hospital anywhere in the US. Yes, I can't use the Villages Healthcare for primary doctors, but I can for specialists. My total yearly payout is less than $2400. I bet your deductible, co-pays are more than that. Why wouldn't you get traditional medicare? make no sense to me.

Really? I paid out $183 last year on copays. Makes lots of sense to me.

[villageuser]

I have Plan F, which is similar to Plan G, but without the deductible. My parents have it too, as well as my husband, who has many health issues. We have had NO problem getting any medical attention here in the Villages and it sure is nice not having to worry about who is in the plan or not, and whether coverage will be changed mid-year, as can happen with any advantage plan.

[BrianL99]

It's really a very simple equation.

If you want control of your Healthcare, stick with a Medicare Supplemental Plan.

If need to save a few bucks and are willing to compromise your healthcare to do that, get a Medicare Advantage Plan.

[Oneiric]

In response to your question, if you want to select your physicians and facilities, you would do better avoiding Advantage plans and The Villages system, which is essentially an HMO. If you never need a doctor, HMO's are fine. If you want the best physicians available, God help you.

[rsmurano]

If you can get plan G, plan N, plan X, get any of them because they are Cadillac plans vs. an advantage plan, according to a Medicare insurance broker. I can go to any doctor that is covered under Medicare, even to a villages health specialist. My deductible is < $200. I also have a prescription supplement that costs $15 a month.
Most advantage plans have high deductibles and you probably will pay a copay and if it’s a specialist, it’s around $65. Plan G, no copays.
Since the supplement plans are much better, the biggest restriction is that after your initial welcome to Medicare at 65, they don’t have to accept you. So if you have an advantage plan now and get cancer or afib and you want to get a plan G, they will probably refuse you. Once you are in a plan G, you will always be in.
1 more thing, you can get a plan G from any state it doesn’t have to be from a florida insurance company. I save over $60 a month by keeping my out of state plan

[rsmurano]

If you can get plan G, plan N, plan X, get any of them because they are Cadillac plans vs. an advantage plan, according to a Medicare insurance broker. I can go to any doctor that is covered under Medicare, even to a villages health specialist. My deductible is < $200. I also have a prescription supplement that costs $15 a month.
Most advantage plans have high deductibles and you probably will pay a copay and if it’s a specialist, it’s around $65. Plan G, no copays.
Since the supplement plans are much better, the biggest restriction is that after your initial welcome to Medicare at 65, they don’t have to accept you. So if you have an advantage plan now and get cancer or afib and you want to get a plan G, they will probably refuse you. Once you are in a plan G, you will always be in.
1 more thing, you can get a plan G from any state it doesn’t have to be from a florida insurance company. I save over $60 a month by keeping my out of state plan

[msilagy]

That is an excellent choice plan G. Choosing your own DR's and hospitals is very important If you need to go to the top hospital/Dr's in the country for a severe illness you can. Don't listen to the hype about advantage plans. Yes they may be more inexpensive but not the best choice if you want freedom of choice yourself. I have had plan G for 7 years - the only money outlay is the medicare deductible. All else has been paid for.

[spinner1001]

We would prefer to have Medigap G instead of any of the Advantage plans. Does anyone in The Villages have G? Is there an issue using it? We would just prefer to select our on doctors and facilities.

If you are already in a Medicare Advantage plan, you may have limitations in flipping over to a Medicare Supplement plan (e.g., Plan G) depending on personal circumstances. The devil is in the details.

SHINE, a Program run by a State of Florida agency, is a good way to educate yourself with unbiased insights.

[mkjelenbaas]

We would prefer to have Medigap G instead of any of the Advantage plans. Does anyone in The Villages have G? Is there an issue using it? We would just prefer to select our on doctors and facilities.
Don’t have one - thanks for asking.

[Joanne19335]

If it is standard medicare plus a supplement then usually everything is covered....pick your own doctors/hospitals/no referrals required to go to specialists.
Some might say it costs more....all I know is we have not had to reach in our pocket for ANY procedures.....very major surgeries over the years.....100% covered.

Agree 100%. I have Aetna Medigap Plan N. Premiums are reasonable and everything is covered. I would never have an advantage plan.

[TNLAKEPANDA]

Yes we have the G plan and it’s great. You pay a monthly premium but there is no out of pocket or limitations or deductibles.

[JoannMH]

I have AARP plan G and have had no problems finding doctors within the villages. I worked for several years as an RN for a Medicare Advantage plan and everyone I worked with agreed that we would never get an advantage plan. We spent so much of our time helping our patients search for in network doctors and helping them understand their bills and what their financial responsibility was. It was confusing for us and very confusing for our patients. Plus every year it changed. If you qualify for Medicare Supplement.....I definitely think that is your best choice here in the villages. Also...from experience searching for doctors for my patients...I found that frequently the best doctors, specialists and hospitals did not accept an advantage plan.

[toeser]

I have traditional medicare and UHC as a supplement. My premiums are less than $200 per month and EVERYTHING is covered. No referrals. no co-pays, no deductibles. I can go to any doctor, hospital anywhere in the US. Yes, I can't use the Villages Healthcare for primary doctors, but I can for specialists. My total yearly payout is less than $2400. I bet your deductible, co-pays are more than that. Why wouldn't you get traditional medicare? make no sense to me.

Must be nice. I have Medicare plus the AARP UHC Supplement F + drug insurance. My premiums are $22,000 per year for my wife and I. That includes the portion for Medicare taken from my SS.

[Rhonda West]

I just went through this with changing my mom over to straight Medicare with a supplement.

The Advantage Plan she had for years served her well UNTIL SHE GOT SICK! The dirty secret is that if you end up in rehab or need longer care than the ADVANTAGE plan has in their FINE print you are up a tree! My mom had a traumatic injury breaking her femur around an existing hip replacement. Her UHC Advantage plan issued a NOMNC - which is a termination of rehab coverage after 2 weeks! Short story is I learned that even though the Medicare guideline says you have 100 days in a rehab or nursing facility - UHC Advantage gives you 20 days and then they start sending you these notices!! We had to file appeals 6 different times to keep her in rehab without us having to be self pay. I can't even tell you what a pain in the @#$% this was!

I spoke with MANY medical professionals, facility professionals, social workers, nurses, and therapists and they ALL said there is NO advantage to an ADVANTAGE PLAN because Medicare gives them the power to dictate your coverage. With straight Medicare and a supplement Medicare allows the FACILITY that is treating you to determine when you are safe to go home within that 100 days!! What a novel idea!!

I disenrolled my mom from the Advantage Plan and enrolled her in supplement F with straight Medicare. "F" is the GOLDEN TICKET and is not available to all Medicare eligible individuals. With this combo we have received NO MORE "ousting notices" for my mom. She received 3 of those notices in the first 45 days she was in rehab before I made the switch back to straight Medicare and supplement F.

EVERY professional I spoke with told me they DO NOT recommend Advantage Plans for their aged relatives - that says a lot to me.

BTW - Moffit, SHANDS and Mayo Clinic ALL accept Advantage Plans - I know this first hand. Still easier to have straight Medicare with supplement.

[metoo21]

1 more thing, you can get a plan G from any state it doesn’t have to be from a florida insurance company. I save over $60 a month by keeping my out of state plan

So, are you a permanent resident of Florida? Have another home out of state? We would be permanent residents of FL with no other home. plan G in our current home state will be cheaper than in FL.

[Jerseyborn]

The Villages Health is a group of clinics with primary care docs. They require specific Advantage plans for patients over age 65.

The hospitals in The Villages and Leesburg are owned by UFHealth. They accept Medicare and many more HMO & PPO insurance plans.

Attached is a list I created with primary care groups in/around The Villages. As far as I know, on this list The Villages Health is the only group that requires specific Advantage plans.

Thank you for sharing!

[Lsepanske@aol.com]

I have Plan G for last 3 years.....minimum deductible, highly recommend it. Had Plan F, expensive, no deductible.
Had Advantage Plans, cost me more in deductibles, limited in doctors, hospitals, etc.

[JwizChick]

I have Traditional Medicare, Plan F (no longer available, but grandfathered in). Years ago, when The Villages switched to United Health Care and I was kicked out of The Villages Health, I asked a specialist I see for a referral to another Primary Care Physician. He was glad I wasn’t switching to Medicare Advantage. To quote him, “Please don’t switch to Advantage. They dictate what tests I can order for my patients. I have a patient right now that needs an MRI and they won’t let me order it for her.”

So Medicare Advantage is more than which doctors you see, it’s also about what tests and procedures you can have. To me, that means a disAdvantage!

[allsport]

We would prefer to have Medigap G instead of any of the Advantage plans. Does anyone in The Villages have G? Is there an issue using it? We would just prefer to select our on doctors and facilities.

DO NOT give up G for any advantage plan. The advantage plan gets rewarded for keeping you from care. The Village system is less than stellar. I had to go to their specialty clinic and they charged my insurance for a procedure I never had and they charged me for a well woman visit. I fought for 3 months to get it fixed. They also tried to make me pay in advance for an injection and charge me an actual visit for a shot. If I had not been a healthcare professional, I might never have figured out what they did.

[loufromnewjersey]

I have plan F and everything is covered with a $20 copay.
One example: my friend and I both had kidney stones the same year, went to the same urologist and had the same procedure. He has the advantage plan and his out of pocket cost was $800 vs my $20. The advantage plans work until you get sick.

[Mrprez]

I have plan F and everything is covered with a $20 copay.
One example: my friend and I both had kidney stones the same year, went to the same urologist and had the same procedure. He has the advantage plan and his out of pocket cost was $800 vs my $20. The advantage plans work until you get sick.

Wrong. He is $1600 ahead of you. He also has a maximum out of pocket each year.

[condomom22]

Doctors/medical facilities that accept Medicare accept all Medigap (Supplemental) plans. Plenty of doctors accept Medicare in and around The Villages. And with Medicare + a Medigap plan you do not need referrals and are not restricted in using only physicians/hospitals/other medical facilities that are in your Advantage Plan. I have Medicare + Medigap Plan G and all I have had to pay for medical services is the annual Medicare Part B deductible. The Villages Health system requires one to be in certain Advantage Plans for using one of their primary care physicians; however, specialty doctors with The Villages Health do accept Medicare.

[Mrprez]

Doctors/medical facilities that accept Medicare accept all Medigap (Supplemental) plans. Plenty of doctors accept Medicare in and around The Villages. And with Medicare + a Medigap plan you do not need referrals and are not restricted in using only physicians/hospitals/other medical facilities that are in your Advantage Plan. I have Medicare + Medigap Plan G and all I have had to pay for medical services is the annual Medicare Part B deductible. The Villages Health system requires one to be in certain Advantage Plans for using one of their primary care physicians; however, specialty doctors with The Villages Health do accept Medicare.

Are you telling me you have no monthly premium? Plus, your Part B premium?

[DrHitch]

Medicare "Advantage" plans are a waste of money (in my humble opinion) because the dental and vision part of those plans are not worth the premiums. Better to self-pay.

Get regular Medicare with a part F or G supplemental. Then look for one that has "Silver Sneakers" to join a fitness place (eg Planet Fitness for free).

Those Advantage plans are all "private" and will steer you towards their own set of doctors and service providers and are very limited in travel especially outside the USA.... Plus somebody has to pay for all of their advertising Guess who??

[rustyp]

I have plan F and everything is covered with a $20 copay.
One example: my friend and I both had kidney stones the same year, went to the same urologist and had the same procedure. He has the advantage plan and his out of pocket cost was $800 vs my $20. The advantage plans work until you get sick.

Wrong. He is $1600 ahead of you. He also has a maximum out of pocket each year.

Oh silly me I forgot the $200 month premium in the analysis.
I call this kind of logic Casino mathematics.

[cindyfeh]

If you are still n good health, you may consider “N”. The monthly premiums are less even with the copays. You can always change to “G” when you health issues increase.

[Mrprez]

Oh silly me I forgot the $200 month premium in the analysis.
I call this kind of logic Casino mathematics.

Don’t forget about the Part D premium as well. Topping $400 a month even if you aren’t sick.

[Mrprez]

Medicare "Advantage" plans are a waste of money (in my humble opinion) because the dental and vision part of those plans are not worth the premiums. Better to self-pay.

Get regular Medicare with a part F or G supplemental. Then look for one that has "Silver Sneakers" to join a fitness place (eg Planet Fitness for free).

Those Advantage plans are all "private" and will steer you towards their own set of doctors and service providers and are very limited in travel especially outside the USA.... Plus somebody has to pay for all of their advertising Guess who??

I don’t pay any premiums. I have emergency world wide coverage. I don’t use the vision as I need to have my eyes checby an ophthalmologist. The hearing coverage is fine. My hearing aids were free and include 3 years of batteries. I want to be in a network, I like one stop shopping. Last thing I want to spend time on is looking for a doctor.

[Mrprez]

If you are still n good health, you may consider “N”. The monthly premiums are less even with the copays. You can always change to “G” when you health issues increase.

And if you aren’t in good health you will never get one of these plans. They only want healthy people covered.

[larcha]

It is the clinics only. The hospitals accept all insurances including Medicare supplement plans.

[Mrprez]

It is the clinics only. The hospitals accept all insurances including Medicare supplement plans.

As do the specialists. Only primary care physician requires a Medicare Advantage plan.

[Jack58033]

We would prefer to have Medigap G instead of any of the Advantage plans. Does anyone in The Villages have G? Is there an issue using it? We would just prefer to select our on doctors and facilities.
If you have the advantage plan but want to see the best doctor in the country. You would be out of network right?

[dougawhite]

I have traditional medicare and UHC as a supplement. My total yearly payout is less than $2400. I bet your deductible, co-pays are more than that. Why wouldn't you get traditional medicare? make no sense to me.

Most Advantage plans have a max yearly out-of-pocket around $3,000. You never pay more than that max amount for your healthcare in the year. So you ALWAYS pay $2,400 per year for your supplement. In an Advantage plan you sometimes pay the full max amount per year (~$3,000) but NEVER more than that; and most years you pay a lot less than that for total healthcare.
PLUS, with Advantage you'll get $1,000 per ear for hearing aid coverage, dental cleanings are covered, covered eye exam, several hundred dollars discount off your glasses. AND all your prescription drugs, no need for Part D...
Now does it make sense?

[dblwyr]

The initial post makes it clear that the poster should contact SHINE or similar help to explain Medicare Plans. Supplemental plans, such as the poster mentioned—plan G—is not available to enrollees in Advantage Plans. Rather, they are supplemental to original Medicare Plans and based on the one selected offer various benefits to help with uncovered costs under original Medicare Plans. Advantage Plans, known as Medicare Part C, are administered by contractors under arrangement via the Medicare Agency.

[Oneiric]

For info go on "Medicare On Video" on YouTube and watch "Why I Would Never Choose Medicare Advantage" before you make any decisions. Be Smart!

[jojo]

I had a similar issue with my mother. She was fine with an Advantage plan until she needed rehab after a hospital visit. They would only approve two godawful places nearby in The Villages. It was a nightmare. We have Plan G and it is the best.

[Mrprez]

I had a similar issue with my mother. She was fine with an Advantage plan until she needed rehab after a hospital visit. They would only approve two godawful places nearby in The Villages. It was a nightmare. We have Plan G and it is the best.

What happened to your mother? How did you resolve the nightmare?

[Mrprez]

DO NOT give up G for any advantage plan. The advantage plan gets rewarded for keeping you from care. The Village system is less than stellar. I had to go to their specialty clinic and they charged my insurance for a procedure I never had and they charged me for a well woman visit. I fought for 3 months to get it fixed. They also tried to make me pay in advance for an injection and charge me an actual visit for a shot. If I had not been a healthcare professional, I might never have figured out what they did.

I don’t doubt what happened to you and you are right. If you can get a Medigap policy and you can afford the premium then go for it. If you are on Medigap now you probably shouldn’t switch to MA. Medigap plans are very hard to get on if you are sick. You have to pass a medical exam before they will approve you.

[jojo]

I thought I hit reply. I'm responding to a previous poster who asked what happened to my mother.

Fortunately she was only in for two weeks and then was released home. She was 105 at the time. They lost her hearing aids the first night she was there and it went downhill from there. I spent as much time as I could at the facility and enlisted friends to be with her. She passed away at 106 and was walking on her own and using the computer the week she died. Her heart just gave out.

[Mrprez]

I thought I hit reply. I'm responding to a previous poster who asked what happened to my mother.

Fortunately she was only in for two weeks and then was released home. She was 105 at the time. They lost her hearing aids the first night she was there and it went downhill from there. I spent as much time as I could at the facility and enlisted friends to be with her. She passed away at 106 and was walking on her own and using the computer the week she died. Her heart just gave out.

Woah! 105? That’s amazing. And using a computer. I’ll bet she had some stories to tell.

[Rhonda West]

So, are you a permanent resident of Florida? Have another home out of state? We would be permanent residents of FL with no other home. plan G in our current home state will be cheaper than in FL.

Resident of Florida. Secured the supplement "F" through Banker's Life - I can provide you with the agents contact info - supplement is $309 p/mo.

[metoo21]

So, those with G, who is the insurer? United Healtcare, Cigna, ???

[crydzanich]

Moffitt took my United Healthcare for my cancer surgery in 2017. No problems.

[bassfish]

Ive had it for yrs. Cost higher in Fl., about $200 per mo for retired person over 65. It covers all but Medicare deductible, around $200. Free to go to any dr except The Villages Health primary Dr. But can go to The Villages Specialty dr’s they accept Medicare. I go to 2 specialty dr.’s from Villages Health.

[craigrmorrison]

If it is standard medicare plus a supplement then usually everything is covered....pick your own doctors/hospitals/no referrals required to go to specialists.
Some might say it costs more....all I know is we have not had to reach in our pocket for ANY procedures.....very major surgeries over the years.....100% covered.
A few of items to consider:

The Villages Health (Primary Care) would not be accessible

You are best served in purchasing a prescription drug (Part D) plan as MediGap (aka supplements) do not cover your prescriptions outside of a hospitalization.

There is no dental, hearing or vision benefits with a MediGap policy.

For more information, visit
www.800GoMeducare.com