[tuccillo]

Nobody is forcing anyone to go with a Medicare Advantage Plan.

Originally Posted by KRMACK55

If you live here full time those days are over. Villages likes to force feed United healthcare under the guise that your 147- part B will go to them then you will have deductibles to meet but it operates like an HMO - you will have to purchase dental and drug separately. If you had health ins in another state where you could choose who to go without a referral those days are gone. There is a crisis of not enough staff nurses and doctors.

[Heyitsrick]

Originally Posted by cindyfeh

I do. As you get older, you can change plans. Your decision is not written in stone. As for now, it is cost effective to be on Plan N.

Be careful with that. If someone opts for a Medicare Advantage (aka MA) plan, the options to "change plans" as you get older to a traditional supplemental plan are quite limited. You have the first year you're on an MA plan to decide whether you want to stay on it. If you renew your MA going forward, you're pretty much stuck ** on MA plans going forward.

What's the problem with that? Well, it depends upon the MA plan, of course, but many of these MA plans are offered because of low or NO premiums, plus the prescription drug plan as part of the MA. Some have free gym membership, some have some limited dental coverage and hearing aid coverage. BUT, become an in-patient in a hospital? You could end up with HUGE premiums for the first few days as an in-patient.

How do I know this? Some doctor's office in TV told my Mom that she needed a particular MA plan to continue seeing the doctor she was seeing. She ultimately had three different in-patient hospital stays one year. That was 9 days of NO coverage (first 3 days of in-patient not covered) for these hospital stays - thousands of dollars in charges that we had to essentially beg the hospital to dismiss out of monetary hardship for Mom.

Bottom line - as mentioned earlier, you don't get something for nothing. "Healthy" seniors love MA plans - until they're not so healthy. It's the restrictions on switching from an MA plan to a supplemental plan that really bite.

To be clear, it's not that you can't switch to a supplemental plan after being on an MA plan for more than the first year. It's that you don't get the underwriting pass that seniors going on a supplemental plan normally get. In other words, the supplemental insurance company will want to assess your current health, and force you to get a physical to ascertain what condition you're in. They can deny supplemental coverage to you, OR make you pay a ton of money.

We got lucky with Mom - her MA plan was a "regional" TV MA plan. One "out" for people wanting to switch away from MA back to guaranteed acceptance Medicare supplemental plans - e.g. plans "G" or "F", etc. - was that if your MA plan is regional and you move outside that region, you can still get guaranteed acceptance back in a traditional supplemental plan; no physical exam required, for example. She moved out of TV to Crystal River. Her TV doctors did not cover that region, so she was able to get back on supplemental Plan G, thankfully. You might not be so lucky if you go with an MA plan and then need much more intensive healthcare coverage while you get older.

Here's a snippet about the risk of going MA:

Avoiding the Medigap Gap

One risk of switching from original Medicare to a Medicare Advantage plan is that when you leave you may not be eligible for the same Medigap policy you had before you shifted to Medicare Advantage.

When you return to regular Medicare, you have the right to go back to the same Medigap policy you had before you joined the Medicare Advantage plan, if the same insurance company you had before still sells it. If the policy is no longer available, you have a guaranteed right to buy a Medigap policy designated A, B, C, F, K or L that is sold in your state by any insurance company as long as you had Medicare Advantage for less than a year. In these circumstances the insurers cannot refuse you coverage as long as you apply for the Medigap policy no later than 63 days after coverage from your Medicare Advantage plan terminates. The insurance company is required to by law to sell or offer you a Medigap policy even if you have health problems (called "pre-existing conditions"). If you had Medicaid Advantage for a year or more or wait longer than 63 days, you can apply but you aren’t guaranteed of acceptance.

Entering and Leaving Medicare Advantage Plans

I'm sure someone here will say something to the effect of "I have full in-patient coverage on my MA plan!" or words to that effect. Just make sure you read all of the plan's policies before signing on so you don't find yourself in a money hole later.

[chuckandbernice]

I've been with Optimum and Freedom Health, same company, since 2011 and could not be happier. I am type 2 diabetic, testing supplies free, tier 1 drugs free, paying $120 of my Medicare premium monthly, free dental cleanings twice a year, my major neck surgery was $100,000 and I paid $174, shoulder surgery $56,000, I paid $200. No copays for Dr visits, free labs and x-rays. $75 worth of items monthly on their web site. My wife $100 pay-down and $50 free from their web site, she is healthy. But some do not like an HMO.

[Roron123]

I myself prefer Medicare (as I can choose any Dr and go to them at any time without a referral) and for my supplemental I have United Health Care who cover the 20% co-pay! I pay $21 a month for my drug plan. BUT if you want a plan which includes a drug plan then you may want an Medicare Advantage Plan which is an all in one plan but check to see if your Dr is in the one you choose! Also you may need a referral from your primary dr to go elsewhere depending on which plan!!

[Marine1974]

Check out plan G with Blue Cross or United Healthcare which will accommodate your needs . Good luck , turning 65 is a good thing with supplemental healthcare coverage .

[Spalumbos62]

[QUOTE=cindyfeh;1975590]

Originally Posted by cindyfeh

I do. As you get older, you can change plans. Your decision is not written in stone. As for now, it is cost effective to be on Plan N if you are healthy.

You can change your plan every year. I went with uhc advantage, a ppo.
This works for me while in NY and FL. Definitely go talk to shine, and remember premium is not the only variable here.
Are you a diabetic, hospital stays, take allot of meds, deductible size.
And once you figure it out....well there is really no perfect answer. But as you said, you are starting soon....if you totally choose wrong-you can change between Oct and Dec.
Good luck
Don't forget 148.50 will come out of your SS monthly check to cover part B...if you don't collect yet, that needs to be covered somehow.
Ps....you are not still working are you? That's another ball of wax.

[Annie66]

If you are a retired military veteran, Tricare for Life is the gold standard. In the past 8 years, my wife and I haven't paid an extra penny that Medicare did not cover.

[cindyfeh]

Originally Posted by Heyitsrick

Be careful with that. If someone opts for a Medicare Advantage (aka MA) plan, the options to "change plans" as you get older to a traditional supplemental plan are quite limited. You have the first year you're on an MA plan to decide whether you want to stay on it. If you renew your MA going forward, you're pretty much stuck ** on MA plans going forward.

What's the problem with that? Well, it depends upon the MA plan, of course, but many of these MA plans are offered because of low or NO premiums, plus the prescription drug plan as part of the MA. Some have free gym membership, some have some limited dental coverage and hearing aid coverage. BUT, become an in-patient in a hospital? You could end up with HUGE premiums for the first few days as an in-patient.

How do I know this? Some doctor's office in TV told my Mom that she needed a particular MA plan to continue seeing the doctor she was seeing. She ultimately had three different in-patient hospital stays one year. That was 9 days of NO coverage (first 3 days of in-patient not covered) for these hospital stays - thousands of dollars in charges that we had to essentially beg the hospital to dismiss out of monetary hardship for Mom.

Bottom line - as mentioned earlier, you don't get something for nothing. "Healthy" seniors love MA plans - until they're not so healthy. It's the restrictions on switching from an MA plan to a supplemental plan that really bite.

To be clear, it's not that you can't switch to a supplemental plan after being on an MA plan for more than the first year. It's that you don't get the underwriting pass that seniors going on a supplemental plan normally get. In other words, the supplemental insurance company will want to assess your current health, and force you to get a physical to ascertain what condition you're in. They can deny supplemental coverage to you, OR make you pay a ton of money.

We got lucky with Mom - her MA plan was a "regional" TV MA plan. One "out" for people wanting to switch away from MA back to guaranteed acceptance Medicare supplemental plans - e.g. plans "G" or "F", etc. - was that if your MA plan is regional and you move outside that region, you can still get guaranteed acceptance back in a traditional supplemental plan; no physical exam required, for example. She moved out of TV to Crystal River. Her TV doctors did not cover that region, so she was able to get back on supplemental Plan G, thankfully. You might not be so lucky if you go with an MA plan and then need much more intensive healthcare coverage while you get older.

Here's a snippet about the risk of going MA:



Entering and Leaving Medicare Advantage Plans

I'm sure someone here will say something to the effect of "I have full in-patient coverage on my MA plan!" or words to that effect. Just make sure you read all of the plan's policies before signing on so you don't find yourself in a money hole later.

.
Yes, sorry. I should have been mire specific. Being able to change from G to N etc. is on the United Health Plan with an AARP supplement. Changing from an Advantage Plan to a Medigap/ Supplement Plan, you would incur underwriters that can refuse to take you or raise your premiums if in poor health.

[PugMom]

Originally Posted by tombpot

Don’t get an advantage plan

i hear everyone say that, but we love ours. we have no deductable, low co-pays & i had no charge for my latest spinal fusion. i can get everything done for so much less. if i need to see a specialist outside the villages, that's ok, too-my dr sets it up & i'm on my way.

[boatorgolf]

Shine is the answer to picking your insurance ! What is good FOR YOU!

[rogerk]

Check with SHINE, ( Serving Health Insurance Needs of Elderly). It is a terrible name, but it is run by the state and volunteers in The Villages are very helpful. Look in the phone book or look at the VHA web site for their contact information.

Be sure you understand the benefits and pitfalls of Advantage plans. There are both! I believe that if you start with an Advantage Plan you can't go back to a traditional Medicare plan, but I'm not sure of that.

Good luck and welcome to all the beuof officially becoming a SENIOR Citizen!😉

[mrkorn12@aol.com]

Keep it simple: Medicare Parts A and B. You can go to any Doctor or Hospital. Part A premium is $0. Part B standard premium is $148.50 per month. It will be more if your AGI exceeds certain thresholds. You need a Medicare Part D for your prescription medicine. If you do not take "serious" medicine-- take the Humana Part D Plan for $17.20 per month. There are several preferred pharmacies including Walmart, Sam's Club, etc. They also offer 90 days supplies by Mail Order-- very convenient, and less costly. To back-up Medicare Parts A and B, take a Medical Supplement Plan (also known as Medigap Plan). I recommend TransAmerica Life Insurance company. They have the lowest premium in Florida. You can see this on the State of Florida Medigap Insurance Company Website. It costs even less if you auto-pay quarterly by Credit Card. If you belong to an Affinity organization-- for the first year only-- the ongoing premium will be a few dollars a month less. When you call them-- they will review all of this with you. Take plan G, it is the most comprehensive, and will cover any Deductibles, Co-Pays and much more. The cost at age 65-- probably about $160 per month. Remember-- all Medigap Plan Letters are standardized by Federal Law-- only the monthly premium varies by Insurance company. If the above is too costly-- start cutting from the above. Of course, all of this is just my humble opinion. SHINE is a good source of information too.

[rmeston]

Thank you for posting that link to SHINEs educational site. It really helped me learn a lot!

[lennythenet]

Originally Posted by tuccillo

I am guessing you have UHC, via AARP, Plan F. If you live in Sumter County you can save yourself money by switching to Plan G ( no underwriting required). The Part B deductible (about $200) is covered by Plan F and not Plan G but the Plan G premiums are about $360 less. All other aspects are identical.

We have to do the same in 2022. We spend a few months in Ohio every year. Do you know if UHC-AARP covers medical expenses there as well? I have heard you have to call and request a travel passport and then it is limited to which doctors you can see?

[tuccillo]

It is best to call UHC/AARP, or a broker that represents them, for the fine print. In general, with Medicare and a Supplemental plan, you can pretty much see anyone who accepts Medicare.

Originally Posted by lennythenet

We have to do the same in 2022. We spend a few months in Ohio every year. Do you know if UHC-AARP covers medical expenses there as well? I have heard you have to call and request a travel passport and then it is limited to which doctors you can see?