[SharonW]

Ardith “Chere” Johnson at 352-746-0048
Independent agent who represents many companies.
Many factors in deciding right plan. Do you travel. Do you stay in Florida year round or go to another state part of year? Specialist like cancer care, heart doctors, kidney specialist, etc. An independent agent who represents many companies will help you make right decision.

[Bridget Staunton]

Thanks to all the posts advising others because I have questions too, great neighborhood

[FromDC]

A year before we signed up for Medicare, I attended many SHINE monthly meetings at Manatee Rec Center and also had a few one on one sessions with a SHINE rep. Very informative!

We signed up for original Medicare and the AARP UnitedHealthcare Plan F and have never regretted it.

As a new perk with UnitedHealthcare, as January 2020, we can use MVP Fitness for free through their Renew Active program. I have told many MVP members about this and they switched their paid account to FREE when they found out it. Just ask at the fitness desk. Sorry, don't know if Blue Cross qualifies. It's not just Advantage Plan members that get a free membership!

[Coley]

Originally Posted by kathyspear

I am currently insured through my husband's employer. Because it is a small company (30 - 40 employees?) my coverage is pricey. Also, like most people with private insurance, my deductible has quadrupled in the last few years. I have been reluctant to switch to Medicare but am currently investigating my options.

It looks as if I can save $200-300 per month on my premiums if I sign up for regular Medicare, a Plan G supplement, and a drug plan. In addition, if I am understanding what I read about Medi-gap plans, I will save several thousand dollars in annual out-of-pocket costs if I dump hubby's coverage.

Assuming that is correct (and please correct me if it is not!), my primary concern is: Will I have trouble finding doctors who accept my new coverage? Right now I can go to any doctor I want. If he/she is out of network I pay a larger percentage but I can still see that doctor.

I gather I will need to find another primary care dr if I make the switch because I have been seeing someone with TVHS. I have no attachment to that person, though, and have no problem with going elsewhere. BUT I'm terrified that something BAD will happen, everyone will say, "Oh, you MUST see Dr. So-and-So, he is the expert on that problem!" But Dr. So-and-So won't take Medicare patients.

Advice? Comments?

Thanks in advance.

kathy

There are 2 types of medicare--Regular medicare and medicare advantage. With regular medicare and supplemental plans you can see any doctor that accepts medicare anywhere in the USA. Medicare advantage limits the doctors you can see to the ones in their system. Medicare advantage is much less expensive. If you choose medicare advantage and decide later to go back to regular medicare-they can underwrite your risk and could refuse to take you. One example would be if you got cancer and decided to go back to regular medicare so you could see a specific Dr who is not part of the Advantage program-they could refuse to accept you. Once your in regular medicare they can not cancel your coverage. Medicare advantage can not cancel your coverage either.
The real difference is the price of your premiums. Many take medicare advantage because it's a lot cheaper and their doctors are in the network so why not.
All medicare supplement plans(F,G,N,etc etc) differ in price only. The law states that plan F's benefits from one carrier cannot be any different from another carrier. Same with all the other plans(G,N etc etc). So one should shop price for the medicare supplemental plans that go with regular medicare.
Good luck with your decision.

[Marshaw]

We came from MN. We have united healthy care advantage. Our primary I'd the united health system. For specialties any doctor who takes Medicare is good. When traveling they have a passport for that purpose. The premium is 0. No copay for primary, 40 for specialist. It has optum for meds. Depending on which tier it's free. It's not through AARP which is good. Call shandy at focus pointe ins in lady lake. She is great to help you through.

[KRM0614]

I’d stay away from united healthcare, TV hospital Leesburg too go to Mayo. If you have good doctors up north keep them down here it’s a mediocre system

[jsd412]

I have been on Humana Advantage Plan for over 3 years. When I turned 65 and went on this plan I was in the middle of cancer treatment and reconstruction. I never had any issues finding GOOD doctors. I've been here in TV for little over a year and stayed Humana Gold Plus Advantage Plan. It covers GOOD doctors here locally as well as my specialists up at UF/Shands in Gainesville.

Do your homework. Check with your doctors if they take the different plans. Also, go on Nextdoor and ask people their experience with those plans.

Good Luck!

Originally Posted by kathyspear

I am currently insured through my husband's employer. Because it is a small company (30 - 40 employees?) my coverage is pricey. Also, like most people with private insurance, my deductible has quadrupled in the last few years. I have been reluctant to switch to Medicare but am currently investigating my options.

It looks as if I can save $200-300 per month on my premiums if I sign up for regular Medicare, a Plan G supplement, and a drug plan. In addition, if I am understanding what I read about Medi-gap plans, I will save several thousand dollars in annual out-of-pocket costs if I dump hubby's coverage.

Assuming that is correct (and please correct me if it is not!), my primary concern is: Will I have trouble finding doctors who accept my new coverage? Right now I can go to any doctor I want. If he/she is out of network I pay a larger percentage but I can still see that doctor.

I gather I will need to find another primary care dr if I make the switch because I have been seeing someone with TVHS. I have no attachment to that person, though, and have no problem with going elsewhere. BUT I'm terrified that something BAD will happen, everyone will say, "Oh, you MUST see Dr. So-and-So, he is the expert on that problem!" But Dr. So-and-So won't take Medicare patients.

Advice? Comments?

Thanks in advance.

kathy

[KMcgee]

I am 66 and have Medicare plus AARP United Health Care as my supplemental Insurance plan ( F ). I have not had any problems with doctors accepting my Insurance and other than the monthly premiums for Medicare & AARP I have not had any out of pocket expenses ( Note this excludes Prescriptions which would be covered under Medicare Part ( D ). I believe that no matter what Part ( D ) Plan / Provider you choose you will have a monthly premium and some out of pocket expense for your medications. If you do not use many medications and are not on any specialty Medications the expense should be minimal. However if you are on alot of medications and any specialty medications you will likely have some significant out of pocket expense. Medicare provides an online tool to help estimate your annual medication expense. You should familiarize yourself with how Medicare Part ( D ) works and compare it against the coverage you are receiving from your Husbands plan and consider this in your decision making process. While you will not be able to use the Villages health for your primary care provider you can continue to use them for any Specialist that you may be seeing ( unless they changed this for 2021 ). Also I would like to clarify that Mayo Clinic does accept Medicare patients. However they do not accept Medicare assignment which means they will not accept the Medicare approved amount ( which is the amount medicare will pay your provider for a specific service / procedure ). Medicare allows Doctors / Hospitals that do not accept Medicare assignment to charge an additional 15% over the Medicare approved amount. Medicare Medigap Plan ( F ) covers this additional expense should you use a provider that does not accept Medicare assignment. Note for 2021 plan ( F ) is not being offerred to New Medicare clients so you should look at each of the
Medicare medigap plans ( A, B, C, D, G, K, L, M & N ) to see which one provides the level of coverage you desire. Again you can look at this online at Medicare.gov. Medicare is confusing and I would suggest that you speak with someone from SHINE to insure you have a full understanding prior to making any changes Finally here are some of the items and services Medicare doesn't cover:

Long-term care (also called custodial care )
Most dental care
Eye exams related to prescribing glasses
Dentures
Cosmetic surgery
Acupuncture
Hearing aids and exams for fitting them
Routine foot care

[Carla B]

Another thing, Kathy, since you didn't buy a Medigap plan when you turned 65, you may have to pay a penalty through slightly higher premiums for your Medigap Plan. That happened to us. We had insurance secondary to Medicare through his employment when we turned 65. It became very expensive and there were big balances to pay due to our living outside the network area. We never knew how much we'd end up owing, so even with the higher premium we had to pay for Medigap we felt it was worth it.

Somewhat of a negative, the premiums for Medigap with AARP were stable the first few years but now I'm dreading the annual letter raising the rates.

[massachusettskid]

Kathy my wife and I .moved here in June. My wife is 62 so I got a plan for her though Florida Blue.

I had Medicare plan F but I found a doctor who was virtual. I switched to The Village Health system and got United Health Care Advantage Plan 0 monthly payment very low deductible prescription,vision and dental.

I would suggest you contact the villages Shine representative who is an independent person to advise on health care issues. Good luck

Bob

Originally Posted by Pommom91

I have Traditional Medicare with a blue cross supplement. I can go to any doctor in any state in the US if they participate in Medicare. I think the Villages Health care PCP’s are missing out by not accepting Medicare.

The Villages entered a contract with UHC so the PCP's have no choice.

Originally Posted by HappyRetired

Plan F for supplemental insurance is no longer offered. If you have it, don't change. There are Advantage plans that are PPO (you can pick your doctor), not part of an HMO. However, some doctors don't take those plans. Add in costs of dental and eye care if they are not covered by supplemental. Some Advantage plans include some (limited) benefits. You must have drug coverage even if you don't use it or there is a penalty to pick up later. SHINE should be able to help. Also, set up an online account at Medicare.gov for lots of information on plans and Medicare in general. Do the same for Social Security because there are lots of questions answered there.

I received an email from Medicare about checking out supplemental plans & clicked on a link after reading these posts. It directed me to UHC. I was born in 1953 but have been on disability since Dec 2000 & Medicare since Dec 2001. After I entered my info, all the plans showed up. I guess since I was already on Medicare when I turned 65, that has allowed me the ability to enroll in Plan F, etc. The monthly charge for Plan F, the most popular, is $202, Plan G--$177(?). It said the charge might change once I applied. I already have UHC for Part D coverage. In fact, I used to work for UHC in Ohio as a precertification nurse for outpt surgeries & skilled home care visits. What UHC Advantage Plan salespeople don't tell you is that the medical director of that office location can deny custodial care (mostly bathing) if patient is receiving skilled care even though Medicare pays for it if the patient is receiving skilled care (RN/PT/OT/ST) because it is THEIR plan. I used to sit one aisle over from these people & wanted to yell to the person on the phone "Don't do it!!!" Of course, this was in 1999 but I doubt if they have changed. Advantage plans sound great but are only good for people who are in good health.

[beccaboo**]

It was wonderful to see so many individuals take the time to respond to this important issue. After reviewing the responses, I would just like to add a few points of clarification:
1. You will not be penalized when you go onto Medicare Part B and buy your supplement, as you indicated you were under full coverage with your spouse's plan. This is considered creditable coverage and you do not then pay a penalty.
2. As was indicated, to select your Medicare Part D plan, the federal government does offer assistance. Go to the website, www.medicare.gov[/url], enter your data and sort results by cost of premium+ medication costs. Since this is a very individualized result, based upon your personal circumstances, do not just pick a company by a personal recommendation, as it may not be the most cost effective for you.
3. Review your Medicare Part D on an annual basis, during the open enrollment, which runs October 15th through December 7th. This is important because plans can change annually, new options can enter the market, providers can alter formularies and co-pays, premiums and out of pocket maximums can be adjusted annually.
4. When you select your Medicare Supplement, you will most likely remain with it ongoing, as you would generally be out of your Guaranteed Issue period ( the 6 months after you elect Medicare Part B) and changes can be more difficult to make.
5. Due to the MACRA (Medicare Access and CHIP Reauthorization Act) of 2015, Supplemental Plans C and F are not now available to newly eligible Medicare recipients. However, if you were eligible for Medicare prior to December 31, 2019, even if you were not yet enrolled in Medicare, you can still purchase a Plan C or F, as you are grandfathered into those programs.
6. While using an insurance broker may be a valuable tool for you in this process, you might want to ask how many companies they are able to broker with for your coverage, in comparison to you searching on the open market.
All the best in your search process.

[gail swanson]

You always give great info!

[jjombrello]

Had an AARP Medicare supplement plan with a drug plan for several years. Worked well both in Florida and elsewhere. Last year switched to an AARP Medicare Advantage Plan 2 (Regional PPO). Very happy with it. NO Premium. Have been able to go back to TVH system and can go to doctors out of state who accept this type of coverage. Out-of- network doctors and specialists may charge a higher fee but these are not prohibitive. With not paying any premium, the additional costs, if any, are affordable. Also comes with a drug plan that is equal to what I had before, again with no premium. When I signed up I specifically asked about coverage when travelling and was assured by UHC that this plan did cover when on the road.