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/)

KatieRN 10-22-2024 04:34 PM

Quote:

Originally Posted by jojo (Post 2380697)
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.

I agree with you. I am a nurse and worked the last couple of years in case management. im the one who helps place people in nursing homes. i cant tell you the number of times i had to send the sweetest and nicest patients to an absolute crap hole of a nursing home. All because of the crummy Medicare advantage plan they had. Yes Humana was one of the worst. I would never have an advantage plan based on my experience with them.

Rainger99 10-22-2024 08:50 PM

Quote:

Originally Posted by KatieRN (Post 2381187)
I agree with you. I am a nurse and worked the last couple of years in case management. im the one who helps place people in nursing homes. i cant tell you the number of times i had to send the sweetest and nicest patients to an absolute crap hole of a nursing home. All because of the crummy Medicare advantage plan they had. Yes Humana was one of the worst. I would never have an advantage plan based on my experience with them.

bv

I thought Medicare didn’t pay for nursing homes.

And if they do, what are the nursing homes that advantage pays for if you live in the villages?

And what is the closest decent nursing home that we could get with original Medicare?

MichaelAllsup 10-24-2024 07:16 AM

Humana has a new PPO option that's available in The Villages Health. Moffitt is in-network plus there is no Rx deductible and only $4900 max-out-of-pocket. I work for Humana and will be conducting seminars every Friday untill December 6th, minus Nov 29th, at 3pm at The Villages Health Creekside.

gmdds 10-24-2024 09:11 AM

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 summarized.

Mrprez 10-24-2024 11:08 AM

Quote:

Originally Posted by MichaelAllsup (Post 2381536)
Humana has a new PPO option that's available in The Villages Health. Moffitt is in-network plus there is no Rx deductible and only $4900 max-out-of-pocket. I work for Humana and will be conducting seminars every Friday untill December 6th, minus Nov 29th, at 3pm at The Villages Health Creekside.

I looked at that plan but when I add my Villages Health doctor it doesn’t show her in network. Her name is Lauren Hana, can you check?

Rainger99 10-24-2024 02:02 PM

Quote:

Originally Posted by MichaelAllsup (Post 2381536)
Humana has a new PPO option that's available in The Villages Health. Moffitt is in-network plus there is no Rx deductible and only $4900 max-out-of-pocket. I work for Humana and will be conducting seminars every Friday untill December 6th, minus Nov 29th, at 3pm at The Villages Health Creekside.

The Villages Health Creekside
1050 Old Camp Rd., Bldg. 100
The Villages, FL 32162

MichaelAllsup 10-24-2024 06:01 PM

Quote:

Originally Posted by Mrprez (Post 2381615)
I looked at that plan but when I add my Villages Health doctor it doesn’t show her in network. Her name is Lauren Hana, can you check?

The PPO plan we have available at TVH is the H5216-074. The online physician finder tool doesn't show the TVH doctors for the Medicare PPO network as the other plans are not available there, but I can assure you that plan has all TVH doctors in-network. I will be going over plan benefits every Friday at 3pm at TVH Creekside. 1050 Old Camp Rd

herbaru 11-04-2024 09:43 PM

Seems there has been a change
 
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.

Gmdds, I went to Moffitts website when you first posted this and it did say as of January 2025 they will no longer be in network with Florida Blue but I just checked again and that line has been removed.
As of 11/4/24 this is from Moffitts website Medicare Coverage Cancer | Moffitt

The Moffitt Cancer Center and Moffitt Medical Group are contracted, participating providers for Florida Blue's Medicare HMO and PPO plans. Moffitt is not in-network with Blue Cross Blue Shield's Medicare Preferred HMO plan.
Moffitt Cancer Center is not contracted or participating with "Advantage 65", which is a Medicare Select supplement. Patients with Advantage 65 can come to Moffitt with their Original Medicare primary insurance but their Advantage 65 supplement will not pay its supplemental portion. Patients can call BCBS to switch to a traditional Medicare supplement (BCBS uses the name CompCoverage).

RICH1 11-05-2024 06:03 AM

Quote:

Originally Posted by Aces4 (Post 2380373)
We personally don't "crapshook" anything and are very aware with aging, health becomes more tenuous and not better. $400. a month is $4,800. a year and do you realize one tiny little medical issue can chew that savings up and spit it out very quickly? Penny wise, pound foolish but people need to choose what makes them happy.

Exactly .... My Supplement is an " F" plan ... it's in the cards that we will get sick.

Bitsee 11-05-2024 07:06 AM

Well said...It all boils down to how much do you value your life and peace of mind ?

There is positively nothing for free in this life and you will definitely pay if you discover a spot on your lung , God forbide , or something similar...

I compare those DIS-Advantage plans out there like the infamous roofing scams we are all aware of here in Florida...Free for now until the insurance company says otherwise.


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