[aldrich]

Hi,

I will become eligible for Medicare coverage in 2019 and searching for the best Medicare Advantage plan for myself. As a single male in good health, I have looked over the UHC plans being pushed by The Villages Health and like the Medicare Complete HMO. However, a search on medicare.com recommends the Aetna Medicare Select Plan, which although similar in many respects, offers Dental, Vision and Hearing benefits not offered by UHC. In patient hospital care copay is also much more generous.

Now, I understand that TV doctors only serve UHC patients, but as I am not tied to any favorite TV doctors at present, I am wondering if the Aetna plan is the better one for me. Thoughts?

[Dan9871]

Originally Posted by aldrich

Hi,

I will become eligible for Medicare coverage in 2019 and
Now, I understand that TV doctors only serve UHC patients, but as I am not tied to any favorite TV doctors at present, I am wondering if the Aetna plan is the better one for me. Thoughts?

You've got to check all the odd's n end's to compare plans.

The Villages Plan includes same day appointments, though not necessarily with your doc', and half hour or longer appointments. Also Villages Health appointments are almost always on time.

In 2019 out of pocket cutoff is at $2500, not $4500 like it was for 2018. But I think the cost of an ambulance ride went up.

If you go into Villages Hospital the hospitalist that manages your care will be from Villages Health, not the hospital. This is a plus because they have direct access to all of you Villages health info and work only with Villages Health patients.

The Villages Health will give you a tour (and explain to you why it is so wonderful) if you ask.

We've been in Villages Health for almost 5 years and like it a lot but we have neighbors who don't care for it or that use other plans or doctors who they like.

We were in an Advantage plan before we moved down to the Villages. It was a good, but no where near as good as Villages Health has been for us.

Anyhow picking a plan, not matter what your health is, and who knows what it will be next week, is no easy task and is such a personal decision I don't think anyone can tell what will be best for you other than you.

[gatorbill1]

UHC has the most doctors available, and you do not need to use TV Health. There are plenty of good doctors and specialists available outside of TV Health. I have never been rushed out of any doctors visit if I had a question to ask them, primary and specialist. Don't buy the story that TV Health has the best doctors. I am sure they have some good doctors, but not better than the ones outside of their group.
Also don't just look at co-pays, if you need a doctor, you want to have choices.

[villagetinker]

OP, I am assuming that you were very careful reviewing traditional supplemental plans versus advantage plans, not just on cost basis. If you have not done this contact SHINE for an impartial review of the plans available. We had advantage plans and were able to go back to supplemental plans and Medicare due to significant lack of specialists that we required in the VHS system. We loved our PC in the VHS system but had to give him up. Make you look at all of the advantages and disadvantages of each type of plan. There have been many discussions on this subject on this site.

[valuemkt]

Villagetinker . Are your specialists in Ocala, Gainesville, Orlando ? or local but out of network .. I have Medigap .. have not made the move down here permanently .. and will most likely keep that even though with my current (blessed) good health i could save money on premiums .. my wife, on the other hand, sees a slew of specialists as well as a concierge primary.. but wont be medicare eligible for a while. thanks

[jnieman]

One thing to check is which hospitals are accepted by your plan. Are you allowed to go to Shands? To me that would be very important. I had understood some advantage plans were only good in most of the states but not all. Just some things to check.

[NotGolfer]

Originally Posted by Dan9871

You've got to check all the odd's n end's to compare plans.

The Villages Plan includes same day appointments, though not necessarily with your doc', and half hour or longer appointments. Also Villages Health appointments are almost always on time.

In 2019 out of pocket cutoff is at $2500, not $4500 like it was for 2018. But I think the cost of an ambulance ride went up.

If you go into Villages Hospital the hospitalist that manages your care will be from Villages Health, not the hospital. This is a plus because they have direct access to all of you Villages health info and work only with Villages Health patients.

The Villages Health will give you a tour (and explain to you why it is so wonderful) if you ask.

We've been in Villages Health for almost 5 years and like it a lot but we have neighbors who don't care for it or that use other plans or doctors who they like.

We were in an Advantage plan before we moved down to the Villages. It was a good, but no where near as good as Villages Health has been for us.

Anyhow picking a plan, not matter what your health is, and who knows what it will be next week, is no easy task and is such a personal decision I don't think anyone can tell what will be best for you other than you.

I will agree with this OP. We've had the MAP as well since they came here with it. IF you need a specialist...they will refer you either locally or to Ocala (at least that's been our experience). Being a part of it is pretty seamless if you're hospitalized. Best wishes with your choice.

[Dan9871]

Originally Posted by jnieman

One thing to check is which hospitals are accepted by your plan. Are you allowed to go to Shands? To me that would be very important. I had understood some advantage plans were only good in most of the states but not all. Just some things to check.

If you feel that you have to be able to go to any provider you want Advantage is probably not for you. Providers enter and leave the network throughout the year.

This year the Villages Health Plan doesn't include Shands. Note that just because a hospital isn't in network doesn't mean you can't go to it but it would require a special exception and it might not be given.

Also an Advantage plan has to cover all conditions/treatments that regular Medicare does so if you require a treatment that none of the in-network provider can do you can go out of network.

Advantage plans cover emergencies anywhere in the US. Note that neither Advantage nor regular Medicare cover any medical costs outside the US.

[Bay Kid]

I am in Virginia half a year then in TV. 1st year starting medicare in January. Do I plan for TVs or VA.?

[GoodLife]

Originally Posted by Dan9871

If you feel that you have to be able to go to any provider you want Advantage is probably not for you. Providers enter and leave the network throughout the year.

This year the Villages Health Plan doesn't include Shands. Note that just because a hospital isn't in network doesn't mean you can't go to it but it would require a special exception and it might not be given.

Also an Advantage plan has to cover all conditions/treatments that regular Medicare does so if you require a treatment that none of the in-network provider can do you can go out of network.

Advantage plans cover emergencies anywhere in the US. Note that neither Advantage nor regular Medicare cover any medical costs outside the US.

I don't think this is correct. A few years ago I had Aetna medicare advantage, slipped and fell in Mexico and cracked 2 ribs, collapsed a lung. Went to ER at local Mexican hospital where they treated me for 3 days. I had to pay the bill with credit card when checking out, but Aetna reimbursed me with a check for 95% of the bill (over $6000) once I mailed them documentation.


UHC medicare advantage works the same way. Make Sure You're Covered While Traveling | UnitedHealthcare

[perrjojo]

I do not know how it is today but when we moved here 6 years ago there were not many Aetna providers and we switched to a different plan the next year.

[Dan9871]

Originally Posted by GoodLife

I don't think this is correct. A few years ago I had Aetna medicare advantage, slipped and

It depends on your plan. From the Medicare site:

"In general, health care you get while traveling outside the U.S. isn't covered. The 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are considered part of the U.S."

Travel (when you need health care outside the U.S.) | Medicare

However Advantage and supplement plans can include health care while you travel if they want to.

Advantage plans are only required to cover what Medicare covers which means they are not required to cover travel outside the US. Just another detail that gets in the way when you have choose a Medicare supplement/advantage

[rexxfan]

Originally Posted by Dan9871

It depends on your plan. From the Medicare site:

"In general, health care you get while traveling outside the U.S. isn't covered. The 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are considered part of the U.S."

Travel (when you need health care outside the U.S.) | Medicare

However Advantage and supplement plans can include health care while you travel if they want to.

Advantage plans are only required to cover what Medicare covers which means they are not required to cover travel outside the US. Just another detail that gets in the way when you have choose a Medicare supplement/advantage

I am pretty sure that the UHC advantage plans cover emergency care, no matter where you need it (but of course, do your own homework to verify).
--
bc

[GoodLife]

Originally Posted by Dan9871

It depends on your plan. From the Medicare site:

However Advantage and supplement plans can include health care while you travel if they want to.

Your earlier statement was quite different and incorrect. In fact, most medicare advantage plans cover at least treatment in Emergency Rooms during travel. Misguided info is not helpful.

"Note that neither Advantage nor regular Medicare cover any medical costs outside the US"

[Dan9871]

Originally Posted by GoodLife

Your earlier statement was quite different and incorrect. In fact, most medicare advantage plans cover at least treatment in Emergency Rooms during travel. Misguided info is not helpful.

"Note that neither Advantage nor regular Medicare cover any medical costs outside the US"

Right, some plans pay for services worldwide, but Medicare does not and Advantage plans are not required to pay for services outside the US, but some do.

It looks like the 2019 UHC plan does pay worldwide emergency services with a $90 copay. But there doesn't seem to be anything in the 2019 plan about paying for worldwide hospital services.