Anyone have ChampVA and regular Medicare? Did you see a necessity to change to an advantage plan along with your champ VA?

Champ VA is a no cost benefit for me, but so far have not had to use Medicare or ChampVA to figure out if I should switch to an Advantage Plan. Thoughts, advice from those who have experience with both

Not all Advantage plans are like the government plans as seen on television
 

Some Advantage plans are perks for government employees. I have an Advantage PPO because I worked for the County for many years. I see who I want, where I want.

Medicare vs Advantage
 

I find it rediculous that The Villages allows health care entities to enter TV and not take straight Medicare patients. That should be one of the requirements to be able to offer health care in a retirement community. Yes, I understand that the advantage plans offer higher reimbursements and the health care practitioners make more money but that should not be allowed here in TV. If money is your only goal in practicing medicine, go elsewhere.

I could be wrong, but as I understand it, the 10 percent per year penalty for delaying Medicare Part B only applies to the basic minimum Medicare premium, not to the much higher IRMAA premium. Because of IRMAA, my Medicare premium would be almost as much as the $5,000 Blue Cross catastrophic annual limit. So, it makes no sense for me to pay Medicare premiums that are as much as the maximum out-of-pocket cost that I could incur with the Blue Cross plan. I would be basically paying money for no additional coverage. That is why I don't have Medicare Part B.

Hopefully someone knows way more about this, than I.

Per the Medicare Database, UF Health The Villages Hospital (NPI #1275902124, NPI #1912317538, NPI #1275902124) has NOT opted out of accepting Medicare.

Which leads me to believe the exclusion of non-Advantage plan patients, isn't really an exclusion of Medicare patients, but a refusal to accept their supplemental insurance.

I'm curious if anyone can enlighten me.

Not true. The Villages Hospital accepts original Medicare and the supplemental insurance. Supplemental insurance pays the 20 percent coinsurance that is associated with original Medicare Part B, and the hospital coinsurance associated with Medicare Part A. So, if you go to the Villages Hospital and you have original Medicare and a supplement, you will be covered in full.

The Villages Health system does not accept original Medicare for their primary care providers. They only accept the United Health advantage plan and a few other advantage plans. So, if you only have original Medicare and the associated supplemental insurance, you cannot use the primary care doctors who work at the Villages Health care facilities. This has nothing to do with the Villages Hospital.

The Villages Healthcare System (NPI# 1699012922) has not opted out of Medicare.

Opt out search results | Medicare

It is true that the Villages Healthcare system has not opted out of Medicare. Medicare advantage plans ARE part of Medicare. They are referred to as Medicare Part C. Original Medicare is referred to as Part B and Part D, which is the drug plan. Part C combines Part B and Part D into one, comprehensive plan. But, they are both Medicare plans and they receive Federal funding.

What you are looking at is a list of providers who have opted out of all Medicare plans. Those providers have chosen to not accept any Federal Medicare money. They do it so they can charge whatever they want to charge for their services and they accept no Federal funding.

Its a financial decision only. True story from CoachK's hospital: Large Intl mfg in the city switched their pensioners health care insurance to UHC Advantage. UHC came around to negotiation, and told the hospital that since UHC had a large population of patients, they wanted to pay lower reimbursement rates than Medicare The entire hospital system dropped UHC Advantage contract and all the retires lost their insurance coverage with their PCPs. (currently unknown is if the negotiations have since arrived at a different reimbursement rate or not) insurance rates are all negotiated with carriers, and Medicare is the lowest rate provide. Without govt reimbursements, hospitals can't survive only on Medicare, so there must be a mix of private and medicare patients to cover total costs of the hospital, and pay their bond holders / rent building owners the market rates as well.

So hmmm, what did the hospital do? They created their own Medicare Advantage plan for local residents

Its all about the money if you want the hospital to afford providing quality medical care, as many of you have posted about, most have to have more than Medicare or you get the the pulse check only.

Pick wisely the class of 58

Since 2006, the role of Medicare Advantage, the private plan alternative to traditional Medicare, has steadily grown. In 2022, more than 28 million people are enrolled in a Medicare Advantage plan, accounting for nearly half or 48 percent of the eligible Medicare population.

50% Medicare eligible select Medicare Advantage Plans and that percentage is growing yearly. According to some posters that is a lot of people making a huge mistake ! :a20: