Talk of The Villages Florida

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-   -   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/)

gmdds 10-19-2024 10:17 AM

Quote:

Originally Posted by MX rider (Post 2380563)
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.

No problem…and you weren’t totally incorrect…if you have a UHC PPO Advantage plan, you could go to Moffitt…the difference being that you would be out of network vs. in network, and thus have a much higher out of pocket.

kendi 10-19-2024 10:34 AM

Quote:

Originally Posted by Karmanng (Post 2380557)
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.......

I think your reply was referring to someone else’s comment.

kendi 10-19-2024 10:36 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, lots of options. Takes a lot a time and research.

MX rider 10-19-2024 11:14 AM

Quote:

Originally Posted by Aces4 (Post 2380567)
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.

Again, you're painting with a broad brush. All MA plans are not the same, and many people I know personally did it the exact same way as us. They did lots of research and made an educated decision. MA plans aren't going away. And the good ones will be around for a long time. Imo.

Aces4 10-19-2024 11:23 AM

Quote:

Originally Posted by MX rider (Post 2380589)
Again, you're painting with a broad brush. All MA plans are not the same, and many people I know personally did it the exact same way as us. They did lots of research and made an educated decision. MA plans aren't going away. And the good ones will be around for a long time. Imo.

A broad brush... facts are a broad brush? Unfortunately, your opinion won't keep your plan outline and coverages intact. I say ride that pony til it drops, one can always walk uphill from there, lol.

MX rider 10-19-2024 01:30 PM

Quote:

Originally Posted by Aces4 (Post 2380594)
A broad brush... facts are a broad brush? Unfortunately, your opinion won't keep your plan outline and coverages intact. I say ride that pony til it drops, one can always walk uphill from there, lol.

Can't worry about something that may never happen. As of now, there are plenty of quality doctors, hospitals, specialists and medical groups that take UHC.

In reality, you actually have no more idea about what plans will be around in 2,5, or 10 years from now than anyone else. We live in a ever changing world, so the best we can do is hang on and enjoy the ride.
We're happy with our choice and it's working well for us, as well as many others. As I said earlier. SHINE also told us it was a very good option.

MA plans will change no doubt, hopefully for the better. They have to or people won't use them. But medicare will change even more as we go along.

We also use the wellness benefits, vision and dental. We get $2500 per person of dental. And we also get free gym membership to a super nice modern gym, which would cost us $1000 a year. My wife takes 2 classes there everyday. Boot camp, yoga, stretching, cardio and strength training. We take our fitness seriously. These added benefits are valuable to us

Assuming everyone who chooses an MA plan is getting duped and didn't make an educated decison is just flat wrong!

But we can agree to disagree on this.

Aces4 10-19-2024 01:57 PM

Quote:

Originally Posted by MX rider (Post 2380615)
Can't worry about something that may never happen. As of now, there are plenty of quality doctors, hospitals, specialists and medical groups that take UHC.

In reality, you actually have no more idea about what plans will be around in 2,5, or 10 years from now than anyone else. We live in a ever changing world, so the best we can do is hang on and enjoy the ride.
We're happy with our choice and it's working well for us, as well as many others. As I said earlier. SHINE also told us it was a very good option.

MA plans will change no doubt, hopefully for the better. They have to or people won't use them. But medicare will change even more as we go along.

We also use the wellness benefits, vision and dental. We get $2500 per person of dental. And we also get free gym membership to a super nice modern gym, which would cost us $1000 a year. My wife takes 2 classes there everyday. Boot camp, yoga, stretching, cardio and strength training. We take our fitness seriously. These added benefits are valuable to us

Assuming everyone who chooses an MA plan is getting duped and didn't make an educated decison is just flat wrong!

But we can agree to disagree on this.

Giddyup!:0000000000luvmyhors

Arlington2 10-19-2024 04:50 PM

Worldwide Coverage
 
Traditional Medicare and medigap programs have zero coverage outside the U.S. UHC advantage provides worldwide coverage.

Aces4 10-19-2024 06:49 PM

Quote:

Originally Posted by Arlington2 (Post 2380654)
Traditional Medicare and medigap programs have zero coverage outside the U.S. UHC advantage provides worldwide coverage.


Yes, you can add coverage for treatment outside the United States with a Medicare Supplement Insurance (Medigap) policy:
Coverage
Most Medigap policies cover some emergency care abroad, usually with a $250 annual deductible, a 20% copay, and a lifetime limit of $50,000. Coverage is typically limited to the first 60 days of your trip.


Medicare Advantage plans may offer some coverage for foreign travel, but it's usually limited:
Emergency care
Medicare Advantage plans cover emergency care anywhere in the U.S. They may also cover emergency care outside the U.S. in certain situations, such as:
If you're traveling between Alaska and another U.S. state and the closest hospital that can treat you is in Canada
If you're on a cruise ship in U.S. territorial waters
If you're in the U.S. when a medical emergency occurs and the foreign hospital is closer than the nearest U.S. hospital
Non-emergency care
Medicare Advantage plans may cover non-emergency inpatient services in a foreign hospital if it's closer to your residence than the nearest U.S. hospital.
Routine care
Medicare Advantage plans may not cover routine health care beyond your plans service area.

Just the facts...

TVTVTV 10-19-2024 08:40 PM

Quote:

Originally Posted by MX rider (Post 2380615)
Can't worry about something that may never happen. As of now, there are plenty of quality doctors, hospitals, specialists and medical groups that take UHC.

In reality, you actually have no more idea about what plans will be around in 2,5, or 10 years from now than anyone else. We live in a ever changing world, so the best we can do is hang on and enjoy the ride.
We're happy with our choice and it's working well for us, as well as many others. As I said earlier. SHINE also told us it was a very good option.

MA plans will change no doubt, hopefully for the better. They have to or people won't use them. But medicare will change even more as we go along.

We also use the wellness benefits, vision and dental. We get $2500 per person of dental. And we also get free gym membership to a super nice modern gym, which would cost us $1000 a year. My wife takes 2 classes there everyday. Boot camp, yoga, stretching, cardio and strength training. We take our fitness seriously. These added benefits are valuable to us

Assuming everyone who chooses an MA plan is getting duped and didn't make an educated decison is just flat wrong!

But we can agree to disagree on this.

How does dental work with UHC? I know you get $2500 annually for in network dental care. Can you tell me some of the main dental companies in your network plan? Like Aspen? Or the others I've heard around here famous for up-selling? The dental care MA plans includes concerns me.

Rainger99 10-20-2024 04:23 AM

Quote:

Originally Posted by Buckeyephan (Post 2380516)
Since SS checks are direct deposit, people are unaware that they are making a monthly payment.

Is there anyone who is unaware that you are paying for part B?

jojo 10-20-2024 05:46 AM

In my experience with my mother and now neighbors who are aging, those with Advantage plans may be OK with doctors but it's almost impossible to get into quality skilled nursing if you need that. My mother had Humana PPO and we had no issues until she began to be hospitalized more her last couple years and would need skilled nursing. Humana would approve only 2 places and they were the worst. It was an absolute nightmare. This is the case with my neighbors also. I know of 3 cases in which they were given very limited choices for skilled nursing with an Advantage plan. When we needed skilled nursing for my husband and they knew we had a supplement plant, all options were given immediately.

DPWM21 10-20-2024 05:49 AM

While in Portugal this year, emergency room visit and tests free.

Four prescriptions including two anti-biotics were $30.00 US.

Why?

westernrider75 10-20-2024 05:54 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.

We just went to a Florida Blue presentation a week ago and that question was asked about Moffitt. The answer was yes, Moffitt is considered in network for 2025.

JoannMH 10-20-2024 06:30 AM

For several years I worked as an RN health coach for a large health insurance company that provided advantage plans. It is a a company that is in TV. Instead of helping members with health issues… most of our time was spent helping members search for doctors, explaining co-pays, listening to their frustrations about their coverage. Most of my RN co-workers all agreed we would never have an advantage plan when we were on Medicare. I have Medicare supplement and so glad I made that decision.


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