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  #16  
Old 08-31-2011, 07:06 PM
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I can not find any providers on their website that I have ever heard of so I am a bit leary of trying this plan. I also use WalMart and Sams pharmacies because of their availability while traveling and they don't seem to be listed in the network either.
  #17  
Old 09-01-2011, 07:04 AM
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Default Pet Scan

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Originally Posted by VillagesFlorida View Post
Just a thought: The main reason we are switching from the Advantage Plan to the Gold Plan is because of the possibility down the road that we might need chemo drugs. I am a 10-year breast cancer survivor and my husband is now 14 months out from prostate cancer surgery. At this point we are both doing fine. BUT, I started thinking about the "what-ifs" and decided to take a closer look at the coverage for chemo drugs, should we ever need them. The Advantage plan pays 80% of the cost of these drugs where the Gold plan pays 100%. I know that a 20% co-pay, if I stay with the Advantage plan could be a lot of $$$, as these drugs can be very expensive. For us, the peace of mind will outweigh the Medicare Part B premiums that we will start paying again, come January.

I also was a cancer survivor but now back in some heavy duty stuff. Question is do you know how many Pet Scans can are covered in a year?

My insurance (just thru luck) covers all but the hospital just told us how lucky we were since most only cover two or three a year. I'm doing stem cell right now and Pet Scans are taken quite offten.

Thanks and good luck at beating your cancer and hope you never see it again.

aj
  #18  
Old 09-01-2011, 07:54 AM
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Originally Posted by VillagesFlorida View Post
Just a thought: The main reason we are switching from the Advantage Plan to the Gold Plan is because of the possibility down the road that we might need chemo drugs. I am a 10-year breast cancer survivor and my husband is now 14 months out from prostate cancer surgery. At this point we are both doing fine. BUT, I started thinking about the "what-ifs" and decided to take a closer look at the coverage for chemo drugs, should we ever need them. The Advantage plan pays 80% of the cost of these drugs where the Gold plan pays 100%. I know that a 20% co-pay, if I stay with the Advantage plan could be a lot of $$$, as these drugs can be very expensive. For us, the peace of mind will outweigh the Medicare Part B premiums that we will start paying again, come January.
That's a very good point!
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  #19  
Old 09-01-2011, 08:18 AM
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Originally Posted by wendyquat View Post
I can not find any providers on their website that I have ever heard of so I am a bit leary of trying this plan. I also use WalMart and Sams pharmacies because of their availability while traveling and they don't seem to be listed in the network either.
Chain pharmacies in network are: CVS, Publix, Sweetbay, Walgreen's, WalMart, WinnDixie.

A provider my husband likes is Dr Shaktawat AKA Dr Jay. He is board certified internal medicine. Dr Jay is in the Villa Group. Has two offices, one near the hospital and the other on Wedgewood Dr. The group also has their own Urgent Care open 12 hours a day 7 days a week. If you are a patient, the urgent care will have access to all of your records.
Http://www.villamedicalgroup.com

You may want to read the testimonials.
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  #20  
Old 09-01-2011, 08:48 AM
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Originally Posted by ajdeck View Post
I also was a cancer survivor but now back in some heavy duty stuff. Question is do you know how many Pet Scans can are covered in a year?

My insurance (just thru luck) covers all but the hospital just told us how lucky we were since most only cover two or three a year. I'm doing stem cell right now and Pet Scans are taken quite offten.

Thanks and good luck at beating your cancer and hope you never see it again.

aj
I am looking at the Gold book. I don't see any limit on Pet Scans. It does say for Pet Scans you will pay a co payment of:
0 at primary care physicians office
$100 at in network specialists office
$100 at freestanding in network diagnostic and imaging center
$150 copayment at an in network hospital facility as an outpatient

Remember there is a $3400 out of pocket limit with the Gold plan.
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  #21  
Old 09-01-2011, 01:04 PM
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I'm interested in PCP...my healthcare provider currently isn't in the system. I saw him today and asked what was up with this. I was told that they had their paperwork in and were waiting to be accepted. That PCP only takes a certain number of providers in their enlistement period. I don't know if this is true or not...they had told me at the end of last year they'd submitted their paperwork (still waiting) and my chiro. had done the same thing and was already "in" a few months ago. I'm wondering if anyone here can shed some light on this??!!! It's kind of scarey to be already established with someone you trust and like then have to change into the "great un-known"!!
  #22  
Old 09-01-2011, 01:27 PM
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Wendyquat: The website gets outdated very fast as to participating providers. Half the ones I go to are not listed. I calland ask the doctor's offices if they are providers for PCP and most are , more being added each day.
  #23  
Old 09-01-2011, 01:38 PM
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Quote:
Originally Posted by JenAjd View Post
I'm interested in PCP...my healthcare provider currently isn't in the system. I saw him today and asked what was up with this. I was told that they had their paperwork in and were waiting to be accepted. That PCP only takes a certain number of providers in their enlistement period. I don't know if this is true or not...they had told me at the end of last year they'd submitted their paperwork (still waiting) and my chiro. had done the same thing and was already "in" a few months ago. I'm wondering if anyone here can shed some light on this??!!! It's kind of scarey to be already established with someone you trust and like then have to change into the "great un-known"!!
Sometime when you are in Sumter Landing, stop by the Prefferred Care office. They are near the AAA office. Maybe someone can answer your question about your doctor.
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  #24  
Old 09-01-2011, 01:39 PM
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Originally Posted by Avista View Post
I am looking at the Gold book. I don't see any limit on Pet Scans. It does say for Pet Scans you will pay a co payment of:
0 at primary care physicians office
$100 at in network specialists office
$100 at freestanding in network diagnostic and imaging center
$150 copayment at an in network hospital facility as an outpatient

Remember there is a $3400 out of pocket limit with the Gold plan.
Thanks, that is a help for me for sure.

aj
  #25  
Old 09-01-2011, 05:05 PM
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Oh yeah, I forgot about the office in Lake Sumter. They are very helpful, in fact I was in there three times in the past two weeks, they helped solve my problems with the referral process. Can't believe I forgot to mention them !
  #26  
Old 09-01-2011, 05:06 PM
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Sometime when you are in Sumter Landing, stop by the Prefferred Care office. They are near the AAA office. Maybe someone can answer your question about your doctor.
I was there last week and presented the question and the woman I spoke with didn't give me a clear answer. Perhaps I need to go in again and present it again. Thanks for the response!
  #27  
Old 09-01-2011, 10:57 PM
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I'll be sure to check it out before Open Enrollment. Thanks
  #28  
Old 09-24-2011, 12:40 PM
Villages PL Villages PL is offline
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Default Preferred Care Partners is good for me.

It suits me because I'm healthy and it saves me from having to pay the medicare premium and a premium for part D drugs. I only go to the doctor twice per year: Once for a general check up and then for a flu shot.

I've been with them for 3 years and this year everything is within walking distance! The lab is near publix and the doctor's office is on Laural Manor Drive across from the recreation center. It's a time saver.
  #29  
Old 09-24-2011, 12:46 PM
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Default Preferred Care Partners suits me

Deleted duplicate post.

Last edited by Villages PL; 10-03-2011 at 10:37 AM. Reason: Deleted duplicate post.
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