Talk of The Villages Florida

Talk of The Villages Florida (https://www.talkofthevillages.com/forums/)
-   Medical and Health Discussion (https://www.talkofthevillages.com/forums/medical-health-discussion-94/)
-   -   Medicare Advantage (https://www.talkofthevillages.com/forums/medical-health-discussion-94/medicare-advantage-339546/)

kayakerlee 03-05-2023 08:18 AM

there is SO LITTLE information in that statement "Go to The Village Hospital and get educated really fast", as to be useless to someone who has not read the past history. I won't elaborate here, as it requires a small book for a glimpse of the past stories, some even factual.

Michael 61 03-05-2023 08:28 AM

Not Medicare age yet, but researching and doing homework in advance of turning 65 in a few years. My take is “advantage is great until it isn’t’. The supplement monthly premiums are reasonable in my opinion, and the flexibility of doctors, and not fearing a procedure will be denied makes it a no-brainer for me. Currently I am in a PPO and hate it. My doctor insists I need injections for spinal degeneration that is causing pain. Insurance company says no - wants me in a very expensive (at my cost) physical therapy regiment for a year first. These things are common when an insurance adjuster, and not a doctor is guiding your healthcare.

Roron123 03-05-2023 08:34 AM

Aetna has Advantage plans here check with them and United Health care have advantage plans also Good Luck

sowtime444 03-05-2023 09:13 AM

Go to a Villages Health site near you and take a tour. If you like the facility, most sites also have an on-site insurance specialist that you can make an appointment with and will talk you through the options.

There are five advantage plans that Villages Health takes, and there are 9 Villages Health sites for your PCP, lab work, and other small things outside of emergencies and specialists. See Health care Providers - The Villages Health for details.

The five plans that Villages Health takes are:
AARP
Humana
FloridaBlue (Blue Cross)
United Villages Advantage
United Villages Focus

United Villages Advantage was the first available, then they added the others. United Villages Focus is brand new this year. There are slightly less doctors in network with Focus. ("Focus" plan's Provider Directory is only 752 pages long, vs 790 pages for the United Villages Advantage plan). You might not want Focus if you go back and forth to Connecticut I believe - someone told me that United Villages Advantage is better for being covered by any United doctor country-wide.

We recently dropped FloridaBlue for my father-in-law because the Skilled Nursing Facility near him only took the United plans, and dental coverage was poor. He is now with Focus.

You mentioned $45 per quarter at CVS.

The "Focus" plan is $230/quarter, and not just CVS but multiple places including Walmart!! AND a $500/year pre-paid card for glasses and dental work.
The regular United Villages Advantage is $75/quarter and no additional pre-paid card for vision/dental.

However, with Focus you need referrals for specialists, but this is not a big deal. My father-in-law writes an quick note on the Patient Portal saying "I would like an appointment with a urologist" and they schedule him one.

Medicare.gov is good for researching and comparing all plans available in your new zip code. The site will tell you how much money you will pay with each plan, given your specific medications. Once you decide on a few plans, I would advise downloading the "Evidence of Coverage" document for the ones you are comparing, and make a line-by-line comparison.

Stu from NYC 03-05-2023 09:19 AM

We have a Humana gold plan which we are happy with.

Best bet go visit Shine for very unbiased info.

Tvflguy 03-05-2023 09:23 AM

Quote:

Originally Posted by skyking (Post 2194518)
Freedom Medicare Advantage. Zero premium. Covers everything. Dental, vision, medical and pharmacy. Plus you receive $50 each month toward over the counter medications and vitamins.

I spent entire career in health care in Ohio. We never had anything that compares.

++++ re Freedom. Have it for 7 years now. Zero issues. Great benefits and huge savings. Never let me down. Excellent phone service with any questions. They are headquarter in FL. At least check them out.

gatorbill1 03-05-2023 09:24 AM

UHC Advantage has been great - no need for a referral for a specialist. I have never had anything turned down as far as tests or procedures, and there have been a lot of those.

kendi 03-05-2023 09:40 AM

Quote:

Originally Posted by skyking (Post 2194518)
Freedom Medicare Advantage. Zero premium. Covers everything. Dental, vision, medical and pharmacy. Plus you receive $50 each month toward over the counter medications and vitamins.

I spent entire career in health care in Ohio. We never had anything that compares.

Question is, will this plan cover you outside of the area. If not this is not a good plan for many. I haven’t seen any advantage plans yet that do.

MSGirl 03-05-2023 09:46 AM

Quote:

Originally Posted by bowlingal (Post 2194475)
comingfromct...go see a SHINE ( Servicing Health Insurance Needs of Elders) representative at a several rec centers ( Eisenhower, Lake Miona for example). They are medicare specialists ( NOT insurance people). THEY will guide you to the plan best for you. The advantage plan is good as long as you are healthy. BUT, who knows how long that will be? I can go to any doc, no co-pay, no deductible, no referral ANYWHERE in the country....YOU cannot.

False information. With UHC, you can go to any dr in the country that accepts Medicare and UHC. Medicare Advantage plans have an out of pocket cap. There are Medicare advantage plans in the villages that do not require pre authorization! And you get Part D included, dental, OTC drugs and gym membership.
Traditional Medicare-pay at the front end
Medicare Advantage-pay at the back end

Hardlyworking 03-05-2023 09:50 AM

Quote:

Originally Posted by kendi (Post 2194595)
Question is, will this plan cover you outside of the area. If not this is not a good plan for many. I haven’t seen any advantage plans yet that do.

Florida Blue has worldwide emergency coverage. If you don’t know about something, you really shouldn’t be spreading misinformation.

rustyp 03-05-2023 10:20 AM

Quote:

Originally Posted by Michael 61 (Post 2194548)
Not Medicare age yet, but researching and doing homework in advance of turning 65 in a few years. My take is “advantage is great until it isn’t’. The supplement monthly premiums are reasonable in my opinion, and the flexibility of doctors, and not fearing a procedure will be denied makes it a no-brainer for me. Currently I am in a PPO and hate it. My doctor insists I need injections for spinal degeneration that is causing pain. Insurance company says no - wants me in a very expensive (at my cost) physical therapy regiment for a year first. These things are common when an insurance adjuster, and not a doctor is guiding your healthcare.

If you were on Medicare with a supplement would the injections be carte blanche ?

MSGirl 03-05-2023 10:57 AM

Quote:

Originally Posted by Michael 61 (Post 2194548)
Not Medicare age yet, but researching and doing homework in advance of turning 65 in a few years. My take is “advantage is great until it isn’t’. The supplement monthly premiums are reasonable in my opinion, and the flexibility of doctors, and not fearing a procedure will be denied makes it a no-brainer for me. Currently I am in a PPO and hate it. My doctor insists I need injections for spinal degeneration that is causing pain. Insurance company says no - wants me in a very expensive (at my cost) physical therapy regiment for a year first. These things are common when an insurance adjuster, and not a doctor is guiding your healthcare.

Then wait until you get Medicare. Whether it’s traditional Medicare or an Advantage plan, Medicare becomes your primary and dictates what is acceptable and what is not!

Pgcacace 03-05-2023 11:03 AM

We chose UHC Adv. Villages plan.There is an office at LSL for all your questions. There are non village Drs. on the plan. $75 quarterly non RX credit. Just show your ins. card. $2,000 allowance for dental. We are very pleased w the plan. No referrals needed.

Pgcacace 03-05-2023 11:06 AM

We are from CT. Welcome to the Villages.😊

PugMom 03-05-2023 11:17 AM

Quote:

Originally Posted by Marcojb (Post 2194476)
Why are you losing Aetna? I have Aenta Massachusetts PPO and have had no issues.

Aetna has been in a steady downward spiral for almost a decade. while we still lived in Ct., the major office building in the industrial park off 72 in Cromwell was shut down, leaving many jobless. the office in Hartford was cutting back to bare essentials, & 1 of my buddies was forced to work from home. i'm surprised it's still standing, lol. @ 1 time it was the best coverage a person could get, i loved it-but the economy caught up with them & this is what we have now


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