Talk of The Villages Florida

Talk of The Villages Florida (https://www.talkofthevillages.com/forums/)
-   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/)

rustyp 10-20-2024 05:25 PM

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.

What is with the infatuation of Moffit ? Can someone provide the statistics of success over other institutions. Better yet when I reach the point of needing such an institution over another what is the percent of survival and for how long ? You all act like these institutions don't talk to each other and one has the privilege of holding the golden wand.

Blueblaze 10-20-2024 05:48 PM

Quote:

Originally Posted by biker1 (Post 2380748)
Any concern about requiring or not requiring a referral is a bit of a mystery to me. The only provider I directly make appointments with is my PCP (annual visits to the dermatologist notwithstanding). If I have an issue, I talk it over with her and she provides the referral to a specialist. I look upon her as the conductor of my health care. Now, there can be issues of which provider is referred. I have Medicare with a Supplemental Plan so she can refer me to anyone who accepts Medicare but I am not trying to schedule visits to anyone without talking to her first.

Well, that's an easy one to answer. I didn't need to ask my PCP's permission (or route him $300 of my insurer's money) when I needed to see a urologist for a prostate problem that I knew the PCP could do nothing about. Heck, my PCP refuses to even do prostate exams, or for that matter, the skin cancer screening that I've had to pay a dermatologist for every year since I moved to Florida. Would you waste time scheduling your PCP if you suddenly noticed a mole turn threatening, if you didn't have to? I wouldn't.

Two years, ago, I was due for my 5 year treadmill stress test, that my Texas doctor used to do in his office, as part of my physical, when it was due. Here, I had to pay a cardiologist. So I certainly would not waste time talking to my primary if I thought I actually had a heart problem. And I certainly didn't waste time consulting my PCP before I saw a podiatrist for my plantar faciistus last year.

Referrals are generally a complete waste of time and money, but if I want one, I'm free to get one with my PPO. It's just my call instead of the doctor.

Dusty_Star 10-20-2024 06:15 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.


Completely untrue. Please check your facts. I'll give you a hint: It depends on which medigap plan you choose.

KathyW 10-20-2024 06:17 PM

Quote:

Originally Posted by rustyp (Post 2380806)
What is with the infatuation of Moffit ? Can someone provide the statistics of success over other institutions. Better yet when I reach the point of needing such an institution over another what is the percent of survival and for how long ? You all act like these institutions don't talk to each other and one has the privilege of holding the golden wand.

Moffitt is one of the top ten Cancer Centers in the U.S. The head of Moffitt was the #2 man at MD Anderson (which is rated #1). If I had cancer, I would want the best. Look at the rankings for Florida Cancer Specialists. (Use to be below the 200s).

KathyW 10-20-2024 06:21 PM

Quote:

Originally Posted by rustyp (Post 2380806)
What is with the infatuation of Moffit ? Can someone provide the statistics of success over other institutions. Better yet when I reach the point of needing such an institution over another what is the percent of survival and for how long ? You all act like these institutions don't talk to each other and one has the privilege of holding the golden wand.

Do a search on MA plans be Supplements on this site - a lot of members who are doctors said their offices had several employees at their medical practice that only "argued with MA plans...".
Ask your specialists what they think of MA plans.

biker1 10-20-2024 06:31 PM

Dermatologist are different, as I already indicated. Once you have a relationship with a specialist for ongoing care you certainly don’t need to go through your PCP. I assumed this was fairly obvious. The only other piece of information you have communicated is that you need to find a better PCP. Also, all of my interactions with my PCP do not involve a $300 office visit as I have asked her about issues over their portal and received advice on who to see. I am pretty sure my PCP know more about health care than I do and it would be stupid not to take advantage of her knowledge.

Quote:

Originally Posted by Blueblaze (Post 2380810)
Well, that's an easy one to answer. I didn't need to ask my PCP's permission (or route him $300 of my insurer's money) when I needed to see a urologist for a prostate problem that I knew the PCP could do nothing about. Heck, my PCP refuses to even do prostate exams, or for that matter, the skin cancer screening that I've had to pay a dermatologist for every year since I moved to Florida. Would you waste time scheduling your PCP if you suddenly noticed a mole turn threatening, if you didn't have to? I wouldn't.

Two years, ago, I was due for my 5 year treadmill stress test, that my Texas doctor used to do in his office, as part of my physical, when it was due. Here, I had to pay a cardiologist. So I certainly would not waste time talking to my primary if I thought I actually had a heart problem. And I certainly didn't waste time consulting my PCP before I saw a podiatrist for my plantar faciistus last year.

Referrals are generally a complete waste of time and money, but if I want one, I'm free to get one with my PPO. It's just my call instead of the doctor.


Arlington2 10-20-2024 07:33 PM

Quote:

Originally Posted by KathyW (Post 2380818)
Moffitt is one of the top ten Cancer Centers in the U.S. The head of Moffitt was the #2 man at MD Anderson (which is rated #1). If I had cancer, I would want the best. Look at the rankings for Florida Cancer Specialists. (Use to be below the 200s).

Good luck getting an appointment with the head of Moffitt. You will instead get a staff doctor. Who knows what their credentials are.

frostola 10-21-2024 04:28 AM

I recently had surgery at Moffitt, when I booked my appointment I had no idea which doctor I was going to have an appointment with. When we arrived I was shocked to learn my doctor was the head of the department. When I asked my PCP if she personally referred me to this doctor she replied “no, I just referred you to Moffitt”.

Plinker 10-21-2024 09:52 AM

Quote:

Originally Posted by Arlington2 (Post 2380835)
Good luck getting an appointment with the head of Moffitt. You will instead get a staff doctor. Who knows what their credentials are.

If you go to Moffitt’s website you will find the credentials of their staff. In addition to being board certified, many have a PhD and their research has been published. I have a relative in The Villages who was diagnosed with cancer and I went with her for every appointment including treatment.
Impressive is a gross understatement of the facility and their staff.
Your statements are false and baseless.

MX rider 10-21-2024 12:23 PM

Quote:

Originally Posted by Plinker (Post 2380944)
If you go to Moffitt’s website you will find the credentials of their staff. In addition to being board certified, many have a PhD and their research has been published. I have a relative in The Villages who was diagnosed with cancer and I went with her for every appointment including treatment.
Impressive is a gross understatement of the facility and their staff.
Your statements are false and baseless.

Moffitt is very good. But so is Advent Health Cancer Center in Orlando, top 4% nationally. They're in our UHC network, so we feel like we have a great place to go if we ever need it.

mrf6969 10-21-2024 01:00 PM

There is ABSOLUTLEY NOTHING more important than one's health. For us we choose when we went on Medicare the supplement over Med Advantage. By comparison to friends and what doctors tell us, we hear we are very healthy. Sometimes we wonder if we are crazy paying over $400.00 a month for the supplement plan. We also hear about people that are healthy one day and then have a major health issue the next. None of us know what is around the corner when it comes to our health. We all have friends and neighbors and family that are blindsided by a serious all the sudden health issue.
For us it was not worth the gamble to depend on the Med Advantage plan deficiencies. So, for us, our health was not worth gambling on.

MX rider 10-21-2024 02:04 PM

Quote:

Originally Posted by mrf6969 (Post 2380980)
There is ABSOLUTLEY NOTHING more important than one's health. For us we choose when we went on Medicare the supplement over Med Advantage. By comparison to friends and what doctors tell us, we hear we are very healthy. Sometimes we wonder if we are crazy paying over $400.00 a month for the supplement plan. We also hear about people that are healthy one day and then have a major health issue the next. None of us know what is around the corner when it comes to our health. We all have friends and neighbors and family that are blindsided by a serious all the sudden health issue.
For us it was not worth the gamble to depend on the Med Advantage plan deficiencies. So, for us, our health was not worth gambling on.

Yep. It's a very important personal decision for sure. But some on here act like if you're on an MA plan and you get sick, you'll get inferior treatment. And that's just not the case. Our plan has a very large network with many good providers. We know people on the plan with major health issues and they were happy with their treatment.

It really just comes down to what works best for us and what makes us comfortable with or choice.

Rainger99 10-21-2024 02:27 PM

This is an email that I received from Moffitt.

Unfortunately we are out of network with all UHC Medicare advantage plans.
Below is the list of in-network Medicare advantage plans that we bill be accepting for 2025.

Aetna Medicare Advantage HMO/PPO
Florida Complete Care HMOSNP
Health First Medicare Advantage HMO/PPO
Humana Medicare Advantage HMO/PPO

MSGirl 10-21-2024 05:43 PM

Quote:

Originally Posted by rsmurano (Post 2380461)
Why anybody would go with an advantage plan is beyond me. They suck you in saying everything is free and covered until you need the service then it’s not. Hospitals now aren’t accepting advantage plans around the country, advantage plan insurance companies refuse almost 70% of the medical procedures that you dr wants you to have, whereas, Medicare has no requirement of getting a procedure approved or not, but it’s the big way that insurance companies save money. Advantage plan problems have been raised to congress to get them fixed. Supplements are the only way to go even if it costs a couple hundred a month extra.

Not all is necessarily true. UHC Medicare advantage has a plan where you can go anywhere in the country that accepts Medicare and UHC. I’ve used it. True we don’t pay a fee every month. We have copays to pay up to a certain amount. We pay at the back end as we need the services. With my plan I don’t need pre-approval as long as the dr takes Medicare. Supplements you pay at the front end and as you age, your monthly premiums increase. It’s a good plan. But there are folks who cannot afford the $175 Medicare B plus the $200+ per month for the supplement. Then there are the Part D prescriptions. So in essence you pay at the front end with Traditional Medicare and back end with Advantage plans.

MX rider 10-21-2024 06:34 PM

Quote:

Originally Posted by MSGirl (Post 2381019)
Not all is necessarily true. UHC Medicare advantage has a plan where you can go anywhere in the country that accepts Medicare and UHC. I’ve used it. True we don’t pay a fee every month. We have copays to pay up to a certain amount. We pay at the back end as we need the services. With my plan I don’t need pre-approval as long as the dr takes Medicare. Supplements you pay at the front end and as you age, your monthly premiums increase. It’s a good plan. But there are folks who cannot afford the $175 Medicare B plus the $200+ per month for the supplement. Then there are the Part D prescriptions. So in essence you pay at the front end with Traditional Medicare and back end with Advantage plans.

Very well said!
That poster is just another uninformed, keyboard medicare expert. Many people on here really know very little about actual MA plans, and especially UHC. You should only comment on what you actually know., not on what you think you know.


All times are GMT -5. The time now is 07:39 AM.

Powered by vBulletin® Version 3.8.11
Copyright ©2000 - 2025, vBulletin Solutions Inc.
Search Engine Optimisation provided by DragonByte SEO v2.0.32 (Pro) - vBulletin Mods & Addons Copyright © 2025 DragonByte Technologies Ltd.