Insurance change unaccepted by The Villages Health.

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  #61  
Old 01-13-2023, 06:06 PM
Pairadocs Pairadocs is offline
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Originally Posted by JoMar View Post
Not sure what you mean by affordable?
No sure, I was not the author of that post, but I took "affordable" to mean: a rate similar or same as the rate I was being charged automatically from my monthly pension check. Poster may have been thinking (as I am), if the percentage is much higher than the group rate through TRS, then it might be UN-affordable. Again, that is only my interpretation.
  #62  
Old 01-13-2023, 08:55 PM
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Originally Posted by jump4 View Post
Yes, it is absolutely the fault of The Villages Health primary care to not accept Standard Medicare.
Or is it your "fault" for not subscribing to the Advantage plans they have said are acceptable and welcomed? You make your choices, the providers make theirs. Sometimes they are the same, sometimes not.
  #63  
Old 01-16-2023, 10:55 PM
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Not true. They use to take BCBS PPO
  #64  
Old 01-20-2023, 06:56 PM
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So where are people with Aetna insurance going?
  #65  
Old 01-20-2023, 07:10 PM
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Originally Posted by retiredguy123 View Post
I am a retired Federal employee and I save thousands of dollars by having the standard Blue Cross plan, but do not have Medicare Part B. The Blue Cross plan covers almost everything I need, and it has a low catastrophic limit of $6,000 per year. The Medicare premiums are too high, especially if you are subject to IRMAA.
IRMAA is what ? ?
  #66  
Old 01-20-2023, 07:18 PM
Davonu Davonu is offline
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So where are people with Aetna insurance going?
Back to UHC in our case.
  #67  
Old 01-20-2023, 11:19 PM
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Originally Posted by GaryKoca View Post
Even with standard Medicare, you probably still need some type of supplemental insurance. We have basic Federal Employees Health Benefits, with pretty much covers everything Medicare does not. But you have to be a retired Federal employee to get that insurance.
I have the Federal Employee Insurance too. It's not cheap but it's no problem using here. I'm not in The Villages United Health care tho.
  #68  
Old 01-20-2023, 11:25 PM
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Originally Posted by retiredguy123 View Post
I am a retired Federal employee and I save thousands of dollars by having the standard Blue Cross plan, but do not have Medicare Part B. The Blue Cross plan covers almost everything I need, and it has a low catastrophic limit of $6,000 per year. The Medicare premiums are too high, especially if you are subject to IRMAA.
I though of doing that. I am subject to IRMAA and wish I had the nerve to cut the cord with Medicare Part B. It is VERY expensive and BC/BS covers I think almost everything. What can you tell me about the catastrophic. Is that different from Medicare?
  #69  
Old 01-20-2023, 11:38 PM
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Originally Posted by retiredguy123 View Post
If you are paying $16,800 per year in insurance premiums, I would recommend that you do the math and compare what would happen if you cancel Medicare Part B. Part A is free. I have the FEHB Blue Cross standard plan as my only insurance. The annual catastrophic limit is only $6,000. So, the maximum out of pocket expense for me would be $6,000 (which I can afford if necessary) and everything after that, including drugs, is fully covered. The Medicare Part B benefits are mostly redundant with Blue Cross and almost every provider accepts the Blue Cross. For me, it is a no brainer to not carry Medicare Part B.
But now do you have to pay a yearly deductible plus co-pays? It still might save you money but is that how it works if you use Federal BC/BS as your primary ins?
  #70  
Old 01-21-2023, 12:37 AM
loweglor loweglor is offline
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What I mean by affordable is a plan that is not three times more expensive in the individual market than it is in the commercial market.
  #71  
Old 01-21-2023, 03:49 AM
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Originally Posted by rmd2 View Post
But now do you have to pay a yearly deductible plus co-pays? It still might save you money but is that how it works if you use Federal BC/BS as your primary ins?
I have the Federal Blue Cross Standard plan as my only insurance, and do not have Medicare Part B. Part A is free. None of the providers in the area have rejected my plan. In fact, they seem to like it. I do pay copays and an annual deductible of $350, but all out-of-pocket payments, including drug copays apply to the annual catastrophic limit of $6,000. I could easily afford the catastrophic limit if I ever needed to. But, I am saving thousands of dollars by not paying the Medicare Part B premiums. Do the math for your own situation. Good luck.

Last edited by retiredguy123; 01-21-2023 at 04:06 AM.
  #72  
Old 01-21-2023, 04:00 AM
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Originally Posted by Pairadocs View Post
IRMAA is what ? ?
The IRMAA was enacted in 2003. IRMAA is the "Medicare income-related monthly adjustment amount". It means that your Medicare Part B and Part D monthly premiums are higher if your income exceeds a certain amount. In 2023, the lowest Medicare Part B monthly premium is $164.90, and the highest premium is $560.50, depending on your income.
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