Talk of The Villages Florida

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-   Medical and Health Discussion (https://www.talkofthevillages.com/forums/medical-health-discussion-94/)
-   -   It appears that Florida Blue 2025 Advantage plans are Out of Network at Moffitt !! (https://www.talkofthevillages.com/forums/medical-health-discussion-94/appears-florida-blue-2025-advantage-plans-out-network-moffitt-353846/)

kendi 10-19-2024 08:33 AM

Quote:

Originally Posted by OrangeBlossomBaby (Post 2380319)
I wish I could afford supplemental plans. Paying extra on top of the Part A that gets deducted from my social security check won't be an option.

That’s a shame. I’m assuming you checked to see if you qualify for one of the extra help options offered by the government

will1546 10-19-2024 08:35 AM

Talk FLBu and Moffitt

kendi 10-19-2024 08:37 AM

Quote:

Originally Posted by JRcorvette (Post 2380501)
That is the main problem with all Advantage Plans where you have to stay In Network. If you really get sick you might be out of luck. Medicare plus a good supplement is much better but yes more expensive. What’s your health worth?

So true. I know someone who was “out of luck” and she paid the price with her life.

MX rider 10-19-2024 08:39 AM

Quote:

Originally Posted by will1546 (Post 2380534)
Talk FLBu and Moffitt

We are talking Florida Blue. It's open enrollment time. If Moffitt is a deal breaker for them, there's other options besides that plan. Some are very good options.

kendi 10-19-2024 08:41 AM

Quote:

Originally Posted by G.R.I.T.S. (Post 2380513)
PPO Advantage plans don’t require referrals.

But they require approvals. So you are still at the mercy of the insurance company. Went through that with my mother.

It’s just a way to full you to make the plan seem more desirable.

kendi 10-19-2024 08:50 AM

Quote:

Originally Posted by Michael 61 (Post 2380514)
What has me skittish about Advantage plans, are those who say “you’ll love it until you don’t”. Younger, healthier people absolutely love their advantage plans and all the “freebies” that come with it. I’m trying to make and educated decision, not just looking at the present, but 20 years from now when I’m in my 80s with the possibility of deteriorating health, illnesses, disease, etc. Would I want advantage or traditional Medicare at that point? Would I have to be concerned year-to-year that any of my medical providers could opt out of the insurance plan I’m currently on?

I’ve been under “managed care” most of my working life, and still am, since I’m not Medicare age yet. Having to get referrals for specialists has been difficult and trying at times (I don’t like it). Also, I have had diagnostic treatments and tests recommended by my doctor denied by my insurance carrier. I’m going to SHINE in 2025 to continue to do my homework on this important decision, so I am ready before turning 65. It’s important to not just look at the current condition of one’s health, but look 20-30 years into the future.

That’s very wise. Especially since once you are locked into a plan it can be difficult to change. Especially if you develop a serious condition.

Don’t forget to check premium increases. Some increase with age, others don’t.

MX rider 10-19-2024 08:51 AM

Quote:

Originally Posted by kendi (Post 2380540)
But they require approvals. So you are still at the mercy of the insurance company. Went through that with my mother.

It’s just a way to full you to make the plan seem more desirable.

That has not been our experience. Painting with a broad brush is not a good idea. Some plans are much better than others. And some plans continue to get better.

gmdds 10-19-2024 09:13 AM

Quote:

Originally Posted by MX rider (Post 2380493)
We're on AARP UHC Advantage HMO/PPO in Indiana and really like it. We do not need referals and they have a very large nationwide network. And no, they don't deny 70% of what doctors order. That's fake news.

Since we just moved here we signed up for the The Villages UHC Advantage plan for 2025 after much research.
As with many things in life, some plans are better than others. Moffitt and Advent Health in Orlando are both in our network and very highly rated.

We also love the wellness benefits, vision and dental, we use them all.

There's no one size fits all as many of "medicare experts" here try to claim. Choice is good.
We chose MA because we thought it was the best fit for us, plain and simple. And I would guess that many of the over 50% of new enrollees that choose MA plans did the same and didn't just do it for cost.

And please stop with the "I don't want an insurance company in charge of my healthcare" crap. Almost all of us that had employer provided health insurance had it thru a for profit company. This is not new! I was with Sysco for many years and I was happy with my insurance overall.

I would never tell someone which to go with. That's a very specific, personal decision. I'm just here giving our experience with MA and the how and why we chose it, and trying to debunk some of the false statements.

Btw, SHINE said this was a very good option for us.

All that said, do the research. The information is out there and easy to find. Also talk to people on the plan if you can. We did

You are incorrect….UHC Advantage plans are not accepted at Moffitt for 2024, and they aren’t for 2025 either. The reason for posting this in the first place was to let everyone know that Florida Blue Advantage plans were accepted at Moffitt in 2024, but won’t be in 2025.

Accepted, meaning In Network.

Karmanng 10-19-2024 09:14 AM

Quote:

Originally Posted by gmdds (Post 2380308)
If you saw the ad in The Daily Sun, on 10/16, by Florida Blue, comparing Advantage plans, be very careful, as it is comparing their 2024 plan. I have found out that Florida Blue has chosen not to renew their contract with Moffitt for 2025. Apparently Moffitt wanted to renew, but Florida Blue didn’t.

It seems pretty deceptive, as the ad came out one day into the enrollment period, but in smaller print states that it is comparing 2024 plans.

YES LOTS of advantage plans will not be with lots of hospitals and Doctors moving forward thats why its best to stay with the original plan and a supp Its been blasted all over utube on medicare explanations...............MY agent never even recommended a advantage plan to me at all..........No way Advantage get the name? yup they take advantage of the situation...........every year they have changes and it happened to my folks thats why i vowed never to go that route.....

Karmanng 10-19-2024 09:15 AM

Quote:

Originally Posted by OrangeBlossomBaby (Post 2380319)
I wish I could afford supplemental plans. Paying extra on top of the Part A that gets deducted from my social security check won't be an option.

YOU pay something just for having that advatnage plan later down the road there are hidden fees late in life with it...........You can pick a supp plan that is for your budget I did that..........Plan N you dont need plan G and pay more monthly lots of other options you should look into

Karmanng 10-19-2024 09:16 AM

Quote:

Originally Posted by MX rider (Post 2380545)
That has not been our experience. Painting with a broad brush is not a good idea. Some plans are much better than others. And some plans continue to get better.

YUP you are correct they control your health NOT you like with regulare medicare and a supp

Karmanng 10-19-2024 09:19 AM

Quote:

Originally Posted by kendi (Post 2380544)
That’s very wise. Especially since once you are locked into a plan it can be difficult to change. Especially if you develop a serious condition.

Don’t forget to check premium increases. Some increase with age, others don’t.

Well looks like you need a regualr medicare plan and a supp.........I did lots of investigating and from what you mentioned that would be the way t go with yourself no need to go to SHINE just go in utube many on there very knowledgeable to learn from I only had a agent to help pick the right supp I chose AARP just turned 65 this year.....havent had a chance to see how it all works out yet.......

MX rider 10-19-2024 09:38 AM

Quote:

Originally Posted by gmdds (Post 2380552)
You are incorrect….UHC Advantage plans are not accepted at Moffitt for 2024, and they aren’t for 2025 either. The reason for posting this in the first place was to let everyone know that Florida Blue Advantage plans were accepted at Moffitt in 2024, but won’t be in 2025.

Accepted, meaning In Network.

Oops my bad! You're correct. I went back and edited my post.
I got them mixed up with Shands in Gainesville. They're in our network along with Advent Health in Orlando. Both are very highly rated so we feel confortable with our choice.

MX rider 10-19-2024 09:52 AM

Quote:

Originally Posted by Karmanng (Post 2380555)
YUP you are correct they control your health NOT you like with regulare medicare and a supp

I'm glad you enlightening me about the plan I'm actually on and have used, as has my wife.
I guess you're more knowledgable about our plan than we are. Just another keyboard "medicare expert'.

Please stop telling us why we shouldn't like our plan and inferring we went into this blindly. We made a very educated choice that was right for us, and we're happy with it.

Unlike many here, I'm not telling anyone what they "should do", except to do the research and have an open mind. And letting people know there are options, and what works for us.

Aces4 10-19-2024 10:02 AM

Quote:

Originally Posted by MX rider (Post 2380563)
Oops my bad! You're correct.
I got them mixed up with Shands in Gainesville. They're in our network along with Advent Health in Orlando. Both are very higly rated so we feel confortable with our choice.

Medical centers are moving away from Medicare Advantage primarily due to issues with low reimbursement rates, excessive administrative burdens like prior authorization denials, delayed payments from insurers, and strict clinical guidelines that limit their ability to provide optimal care, making it financially challenging to participate in these plans.

From Becker's hospital review:

Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers.

In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.

"Medicare Advantage provides health coverage to more than half of the nation's older adults, but some hospitals and health systems are opting to end their contracts with MA plans over administrative challenges.

Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers."


Remember, it's easy to move to Medicare Advantage but it's getting regular Medicare coverage which is difficult when you want to change to better coverage. People can be very blind when a few goodies are dangled in front of their eyes. They can't see the ogre in the background.

The government is working constantly to cut Medicare costs and services for the elderly. Even under regular Medicare coverage they have instituted "value based programs" to insureds claiming "Our value-based programs are important because they’re helping us move toward paying providers based on the quality, rather than the quantity of care they give patients". Which translates to fewer services to save money, IMHO.

Seniors pay close attention, this pertains to all of us.


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