Florida Blue HMO vs United Health Advantage Plans

[rhood]

We switched this year to Florida Blue HMO From United Health and so far it has been good, with only a small copay to our optometrist, but we are considering going back to United. We’ve had no other out of pocket expenses.
I am looking at knee replacement in the future. Does anyone have an opinion of which plan would have the best coverage for this surgery?
Thanks

[Keefelane66]

I have UHC Plan F (paid by Employer retirement) over the last 3 years $0 out of pocket for Hospital stay/procedures Abdominal stint placement

[Joeint]

I have UHC Plan F (paid by Employer retirement) over the last 3 years $0 out of pocket for Hospital stay/procedures Abdominal stint placement

UHC Plan F is a Supplement the OP is asking about Advantage Plans, apples, and oranges. A supplement is 100% better, there are no networks, no referalls or approvals, go to any Dr. or hospital the monthly premium is more with a Supplement. The out-of-pocket is more with an Advantage Plan. The OP may not qualify for a Supplement due to preexisting conditions. Pick your plan carefully you only get one chance to get a Supplement with a guaranteed issue. Be sure to ask about the trial period when you sign up.

[Hardlyworking]

UHC Plan F is a Supplement the OP is asking about Advantage Plans, apples, and oranges. A supplement is 100% better, there are no networks, no referalls or approvals, go to any Dr. or hospital the monthly premium is more with a Supplement. The out-of-pocket is more with an Advantage Plan. The OP may not qualify for a Supplement due to preexisting conditions. Pick your plan carefully you only get one chance to get a Supplement with a guaranteed issue. Be sure to ask about the trial period when you sign up.

How much are your monthly premiums? My maximum OOP is $2500 and so far this year have spent less than $100 in co-pays.

[Joeint]

How much are your monthly premiums? My maximum OOP is $2500 and so far this year have spent less than $100 in co-pays.

My monthly premium is $58, I can go to any Dr. or hospital that accepts Medicare with the decision being made by my Dr. and myself with no approval by an insurance company. Advantage Plans are great until there not!!!

[gatorbill1]

My monthly premium is $58, I can go to any Dr. or hospital that accepts Medicare with the decision being made by my Dr. and myself with no approval by an insurance company. Advantage Plans are great until there not!!!

UHC Advantage plan has no referral needed for specialists - you make your own decision, do not need your doctor's referral. Even though most doctors will give you the referral when asked for, it is quicker if not needed. That is why we have UHC advantage plan. NO monthly extra premium. Only Medicare takeout from Social Security.

[Hardlyworking]

My monthly premium is $58, I can go to any Dr. or hospital that accepts Medicare with the decision being made by my Dr. and myself with no approval by an insurance company. Advantage Plans are great until there not!!!

Wow, the average premium for Plan F in Florida is $213. You got a great deal.

[biker1]

Generally, Plan G is a better deal than Plan F. The only difference is that Plan F includes the Part B deductible of approximately $200. For our area, the premium difference is greater than $200 so Plan G is a better deal. For many people, Plan N will be an even better deal.


Wow, the average premium for Plan F in Florida is $213. You got a great deal.

[rhood]

I should have known not to post a question here. Lots of responses, but not an answer to be seen.

[Badger 2006]

We switched this year to Florida Blue HMO From United Health and so far it has been good, with only a small copay to our optometrist, but we are considering going back to United. We’ve had no other out of pocket expenses.
I am looking at knee replacement in the future. Does anyone have an opinion of which plan would have the best coverage for this surgery?
Thanks

Here is an actual answer to your question. We have the Florida Blue Advantage PPO plan. Our monthly premium is $0. We’ve have a $10 copay for our physicians, and a $47 copay for specialists with no referral needed. My wife has had 2 hips replaced (Dr Locker), a knee replacement (Dr Duke), and successful cancer surgery (Moffitt/Tampa). Since we don’t have UH I cannot compare but with Forida Blue there is a daily hospital charge (around $300) for the first 4 days then all is covered. For hip and knee replacement only one night in hospital. With both UH and Fl BL plans you will get a much better selection of Specialists with a PPO vs HMO. Dr Duke (Ocala) and Dr Locker (Ocala) are highly recommended on TOTV.

[Hardlyworking]

We switched this year to Florida Blue HMO From United Health and so far it has been good, with only a small copay to our optometrist, but we are considering going back to United. We’ve had no other out of pocket expenses.
I am looking at knee replacement in the future. Does anyone have an opinion of which plan would have the best coverage for this surgery?
Thanks

I compared the two and there are minor differences between them. Maximum out of pocket is better with Florida Blue as are the amounts paid for hospital stays. There’s few other differences but minor stuff. Call SHINE and have them explain things to you. They do not charge for this service.

[Rwirish]

Have you UHC and have been very satisfied. Difficult to beat a Medicare Advantage Plan.

[WindyCityzen]

We switched this year to Florida Blue HMO From United Health and so far it has been good, with only a small copay to our optometrist, but we are considering going back to United. We’ve had no other out of pocket expenses.
I am looking at knee replacement in the future. Does anyone have an opinion of which plan would have the best coverage for this surgery?
Thanks

Only in the US do you have to play this ridiculous medicine-for-profit shell game. It won’t happen in my lifetime but the single-payer system is what all the other first -world nations have for healthcare. Just sayin.

[josephkb]

Go back to United healthcare. Dr. Duke Dr. Nguyen are not covered under Florida blue. And they are two of the best for Nails.

[mkjelenbaas]

We switched this year to Florida Blue HMO From United Health and so far it has been good, with only a small copay to our optometrist, but we are considering going back to United. We’ve had no other out of pocket expenses.
I am looking at knee replacement in the future. Does anyone have an opinion of which plan would have the best coverage for this surgery?
Thanks
What did the insurance companies say when you called them?

[Haggar]

I should have known not to post a question here. Lots of responses, but not an answer to be seen.

The State of Florida has an agency - SHINE - that assists seniors in determining which insurance best suits them. Contact them.

There were fifty six different plans last I looked available. PPO's and HMO's. You can try the selection yourself (which I look at every year) through Social Security.gov or got to SHINE.

[jrandall]

My monthly premium is $58, I can go to any Dr. or hospital that accepts Medicare with the decision being made by my Dr. and myself with no approval by an insurance company. Advantage Plans are great until there not!!!

Which Insurer do you have your supplement with?

[jrandall]

UHC Advantage plan has no referral needed for specialists - you make your own decision, do not need your doctor's referral. Even though most doctors will give you the referral when asked for, it is quicker if not needed. That is why we have UHC advantage plan. NO monthly extra premium. Only Medicare takeout from Social Security.

Florida Blue’s PPO Advantage Plan works the same as well.

[Joeint]

UHC Advantage plan has no referral needed for specialists - you make your own decision, do not need your doctor's referral. Even though most doctors will give you the referral when asked for, it is quicker if not needed. That is why we have UHC advantage plan. NO monthly extra premium. Only Medicare takeout from Social Security.

While you don't need a referral you do need the insurance company's approval. I had a friend whose Dr. prescribed a hip replacement. The insurance company said he would need to have one year of PT before they would approve the hip replacement. If you want to go to John Hopkins or the Mayo Clinic or anywhere else you have that choice with a supplement. Insurance companies are in business to make money spending it on your health care cost them money. Delay, denied, limit choices, Advantage Plans are good as long as you are relatively healthy, good luck with The Villages Hospital's two-star rating.

[Captmagic]

I am a licensed agent and sell UHC and Fla Blue among other plans. I would be happy to help you compare the two policies. Please provide me with your contact info.

Mike

[Joeint]

Which Insurer do you have your supplement with?

I have a High Deductible G Plan (HDG) through United American a top-rated company. Medicare pays 80% I am responsible for the other 20% until I reach the deductible of $2040 then it works like a regular G Plan. My broker is Yvonne Tepsick 202.439.2530 she works with many plans and will help you make the best choice for you.

office call $200
medicare $160
me $40

[bp243]

I should have known not to post a question here. Lots of responses, but not an answer to be seen.

Maybe listen to your gut next time!

[Joeint]

I should have known not to post a question here. Lots of responses, but not an answer to be seen.

If you're looking for someone to tell you what to do get married.

[mimiray]

Interesting, I have the Florida Blue HMO and Dr. Vuong Nguyen is in the plan.

[Burgy]

I paid $200 to West Marion Hospital, and 4 $40 copays for pre and post op doctor visits for my hip replacement. With UHC of the Villages Advantage Plan. I went home same day and had intermittent home health and therapy visits for 2 weeks, all covered. I was very pleased

[gatorbill1]

While you don't need a referral you do need the insurance company's approval. I had a friend whose Dr. prescribed a hip replacement. The insurance company said he would need to have one year of PT before they would approve the hip replacement. If you want to go to John Hopkins or the Mayo Clinic or anywhere else you have that choice with a supplement. Insurance companies are in business to make money spending it on your health care cost them money. Delay, denied, limit choices, Advantage Plans are good as long as you are relatively healthy, good luck with The Villages Hospital's two-star rating.

UHC has never denied any request I needed, which unfortunately has been too many.

[macawlaw]

Not in Florida, but dealt with PPO/HMO/Medicare with both of my parents.

Get out of the HMO. The requirements and limitations are odious if you need more than routine care.

My dad chose the HMO one year without checking with anyone. He had been on the PPO plan. It upset his whole medical routine. We are in Ohio. I wanted to take him to the Cleveland Clinic for an issue, but the HMO would not approve it. The HMO had ridiculous rules to follow before they would approve care - and many of his regular doctors were not in the HMO. For example, he needed a knee replacement that was planned, changed plans, and then the PPO said that he had to have a bunch of therapy before he could have the surgery. Plus, they didn't cover his ortho. I got him changed back into the PPO the next year. He could have his hospital and doctors of choice. The difference in price was certainly worth it.

FWIW, and something else to think about, the choice of hospital turned out to be incredibly important at the end of dad's life. I did not know it when we changed back to the PPO, but our hospital of choice referred end-of-life patients to a wonderful hospice facility, if that was their wish. The hospital required by the HMO kept the patients and said they were in hospice by having a nurse stop by a few times a week. I am incredibly grateful that dad had the care and comfort of the hospice facility.

[mimiray]

Not in Florida, but dealt with PPO/HMO/Medicare with both of my parents.

Get out of the HMO. The requirements and limitations are odious if you need more than routine care.

My dad chose the HMO one year without checking with anyone. He had been on the PPO plan. It upset his whole medical routine. We are in Ohio. I wanted to take him to the Cleveland Clinic for an issue, but the HMO would not approve it. The HMO had ridiculous rules to follow before they would approve care - and many of his regular doctors were not in the HMO. For example, he needed a knee replacement that was planned, changed plans, and then the PPO said that he had to have a bunch of therapy before he could have the surgery. Plus, they didn't cover his ortho. I got him changed back into the PPO the next year. He could have his hospital and doctors of choice. The difference in price was certainly worth it.

FWIW, and something else to think about, the choice of hospital turned out to be incredibly important at the end of dad's life. I did not know it when we changed back to the PPO, but our hospital of choice referred end-of-life patients to a wonderful hospice facility, if that was their wish. The hospital required by the HMO kept the patients and said they were in hospice by having a nurse stop by a few times a week. I am incredibly grateful that dad had the care and comfort of the hospice facility.



I decided on Florida Blue because as a cancer survivor Moffitt was very important to me.

[golfing eagles]

Only in the US do you have to play this ridiculous medicine-for-profit shell game. It won’t happen in my lifetime but the single-payer system is what all the other first -world nations have for healthcare. Just sayin.

And they get what they pay for. Again, Luxemburg is ranked #1 (usually by a socialist committee of the WHO) for health care in the world. I would like to invite everyone with a serious health issue to bypass NY and Boston and flock to Luxemburg. You'll probably die, unnecessarily, but you will have evaded the "ridiculous medicine for profit shell game". Good luck with that, RIP

[jump4]

Now why do agents receive a high commission for selling Advantage health insurance plans? Think about it! As someone else said, better to make an appointment to speak with an unbiased FL SHINE representative.

I am a licensed agent and sell UHC and Fla Blue among other plans. I would be happy to help you compare the two policies. Please provide me with your contact info.

Mike

[Hardlyworking]

Now why do agents receive a high commission for selling Advantage health insurance plans? Think about it! As someone else said, better to make an appointment to speak with an unbiased FL SHINE representative.

He probably sells supplemental plans. Big bucks there.

[Badger 2006]

Go back to United healthcare. Dr. Duke Dr. Nguyen are not covered under Florida blue. And they are two of the best for Nails.

Dr Duke covered Under Florida Blue Advantage PPO.