[gomoho]

I am shocked Moffit is not included - thought that was part of The Villages! Don't quite understand the concept of making this the healthiest hometown and not giving us access to the best hospitals. Of course I still don't understand why they eliminated silver sneakers either - thought exercise was an important part of staying healthy. Do they speak with forked tongue???

[casita37]

I didn't see much "advantage" to the UHC Advantage plan. They do include your part D drug plan, which is a $40 per month savings and have a small dental coverage, but it's just so limiting in doctors, facilities, etc. Two main issues for us is that Shands is not included (my husband has a doctor at Shands) and once you sign up for an advantage plan, it is more difficult to then switch over to a supplemental plan. It's not impossible, but you have to have some special permission....not sure what is involved in getting that. Fact is, we are all likely to need more medical care as we age, and those co-pays and limited options could be a problem.

If you are healthy and on the younger side of our medicare years, the UHC advantage plan is probably a good deal. For anyone with health issues, it seems to me the supplemental policy is the only way to go.

We will pay about $200 more per month (supplement plus part D), but we willl no longer have co-pays, plus we will have the added "insurance" for anything else major, or even minor, that might come along. I have a very thick folder of medical co pay receipts for my husband, and he hasn't even really been sick. A minor out-patient surgery, regular visits to the dermatologist, his specialist he visits about 4 times per year. Every little procedure creates several co-pay bills from doctors and labs, etc. It adds up quickly.

Also, to clear up what might have been misunderstood from a couple of previous posts. The Villages Health system will accept supplemental insurance and other insurance policies, as well as regular medicare, but....the ONLY ADVANTAGE plan they will accept is UHC-The Villages. If you have your advantage plan through another company like BCBS or Humana, etc., it's not accepted at TV. If you have a supplemental plan through another company, it is accepted. There may be exceptions they don't take, so best to check with them.

[jimmy D]

Originally Posted by gerryann

I believe you are incorrect. HMO requires referral. PPO does not require referral, except for a few exceptions and procedures.

avista is correct no referrals . only hmo that does not have referrals

[jazzeoneaj]

Yes, the Medical Advantage plans..are great ..one stop shop...but remember you get what you pay for.

Shand, Moffit and the others that have been listed do not have this plan available to honor should you need treatment if you are really sick, dying or whatever.

There is a window I believe to 'bow out' of the Advantage plans..only for a month..then you are stuck until reenrollment time which is usually in October.

Fortunately, I am pretty healthy and may try the HMO and HOPE that something changes for next year's plan. I hope Moffit Center here will take on patients under the Advantage Plans since they promoted themselves so. Doesn't seem fair, does it to put the bait out there and then reel it in saying 'we don't want you'.

I haven't signed up yet with Advantage Plan..just doing my homework like many others. I can't really afford the PPO Medical ADV. Plan with the option of going out of network and paying a huge coinsurance right now.

Keep the information coming and good luck.

[cinepuxon]

If your Medicare Advantage plan is ending you then have a 'guaranteed issue right' to go back to Original Medicare and pick up a Medigap policy ie., supplement. The rate the insurance company can charge you will only be based on your age and not on any existing medical condition. Medigap Plan F (most coverage) can be under $200/month and you will never see a co-pay. You will also need a Plan D which can be as low as $12/month with no co-pays for tier 1 and tier 2 generics by mail order. See a SHINE counselor at The Villages rec centers during the open enrollment season. 1-800-963 5337.

[jimmy D]

Originally Posted by nyclicker

For those of you that had Preferred Care Partners which is no longer available which plans are you considering for 2014?

Just a short note. If you are picking your med adv program because it has a rebate, be careful. Lots of plans that continued with rebates are now out of business. With proper planning a rebate is unnecessary unless you need the $ to live on and if you do obviously you did not plan well for the future

[dstege]

Originally Posted by gerryann

I believe you are incorrect. HMO requires referral. PPO does not require referral, except for a few exceptions and procedures.

I sell the new UHC The Villages Medicare Complete and it does NOT require a referral

[DDoug]

I decided to go with Humana advantage plan PPO no rebate but looks better than being stuck with UHC. obamacare comes to mind with UHC. Not a good thing My opinion

[gomoho]

Originally Posted by jimmy D

Just a short note. If you are picking your med adv program because it has a rebate, be careful. Lots of plans that continued with rebates are now out of business. With proper planning a rebate is unnecessary unless you need the $ to live on and if you do obviously you did not plan well for the future

Have to disagree - had PCP for 2013 and was able to have an additional $1200 in my pocket for the year (better mine than the governments). They no longer offer plans in this area, but not a big deal. Will switch to another plan the also offers a rebate (once again, better in my pocket than the governments). I understand the rebates will probably be gone for 2015, but in the meantime I have $2000 I wouldn't have had otherwise.

It's not always a matter of NEEDING the money, but sometimes it's a matter of managing your money to your benefit rather than someone else's. This is all based on the assumption the plan is something that works for you.

[2BNTV]

Originally Posted by casita37

I didn't see much "advantage" to the UHC Advantage plan. They do include your part D drug plan, which is a $40 per month savings and have a small dental coverage, but it's just so limiting in doctors, facilities, etc. Two main issues for us is that Shands is not included (my husband has a doctor at Shands) and once you sign up for an advantage plan, it is more difficult to then switch over to a supplemental plan. It's not impossible, but you have to have some special permission....not sure what is involved in getting that. Fact is, we are all likely to need more medical care as we age, and those co-pays and limited options could be a problem.

If you are healthy and on the younger side of our medicare years, the UHC advantage plan is probably a good deal. For anyone with health issues, it seems to me the supplemental policy is the only way to go.

We will pay about $200 more per month (supplement plus part D), but we willl no longer have co-pays, plus we will have the added "insurance" for anything else major, or even minor, that might come along. I have a very thick folder of medical co pay receipts for my husband, and he hasn't even really been sick. A minor out-patient surgery, regular visits to the dermatologist, his specialist he visits about 4 times per year. Every little procedure creates several co-pay bills from doctors and labs, etc. It adds up quickly.

Also, to clear up what might have been misunderstood from a couple of previous posts. The Villages Health system will accept supplemental insurance and other insurance policies, as well as regular medicare, but....the ONLY ADVANTAGE plan they will accept is UHC-The Villages. If you have your advantage plan through another company like BCBS or Humana, etc., it's not accepted at TV. If you have a supplemental plan through another company, it is accepted. There may be exceptions they don't take, so best to check with them.

Excellent post with correct info.

Originally Posted by cinepuxon

If your Medicare Advantage plan is ending you then have a 'guaranteed issue right' to go back to Original Medicare and pick up a Medigap policy ie., supplement. The rate the insurance company can charge you will only be based on your age and not on any existing medical condition. Medigap Plan F (most coverage) can be under $200/month and you will never see a co-pay. You will also need a Plan D which can be as low as $12/month with no co-pays for tier 1 and tier 2 generics by mail order. See a SHINE counselor at The Villages rec centers during the open enrollment season. 1-800-963 5337.

According to the Shine couselor I saw today. You have 12 months to switch to original Medicare with a supplement, if you have been on a Medical Advantage program for several years.

In addition, you have to be careful if you have previous problems as you only get one bite at the apple. You can be rejected, so do your homework.

[gerryann]

Originally Posted by gomoho

Have to disagree - had PCP for 2013 and was able to have an additional $1200 in my pocket for the year (better mine than the governments). They no longer offer plans in this area, but not a big deal. Will switch to another plan the also offers a rebate (once again, better in my pocket than the governments). I understand the rebates will probably be gone for 2015, but in the meantime I have $2000 I wouldn't have had otherwise.

It's not always a matter of NEEDING the money, but sometimes it's a matter of managing your money to your benefit rather than someone else's. This is all based on the assumption the plan is something that works for you.

Which advantage plan will be giving the rebate...and what is the amount of the rebate for 2014? I need to do more research.....thanks

[gomoho]

PUP is offering $90 for 2014. The few others offering rebates are only doing so on a special needs basis.

[rpensabene]

Not The Villages HMO. It definitely does not require referrals.

[juneroses]

For those who are still undecided as to which Medicare Plan to choose for 2014, I highly recommend contacting Donna Stegmeier, a Villages resident, who is also a representative for many of the plans available to us.

I'd done my homework and knew which plan my husband and I wanted. We made an appointment with Donna to make our decision official. Instead of just signing us up and going on her way, however, she made a suggestion for a different plan for one of us because of an existing medical condition. That plan also saved us money.

She then pointed out some subtle differences in plans for the other of us, which led to a better choice.

It ended up that neither of the plans we've officially signed onto are the plan that I had thought we would chose.

I'm grateful to Donna for her knowledge of the various plans nuances and her guidance in choosing ones that were best for us individually.

If you'd appreciate the same type of individual attention, consider giving her a call at 352-350-7135. There's no cost to you.

June

P.S. I realize this sounds like an ad, but I promise this is TOTALLY unsolicited. I'm just so doggone pleased with Donna's input that I want to spread the word. She has NOT promised to weed my garden or do ironing in exchange. However, Donna, if you're reading this, you do know my address, so if you see a weed…

[katyk]

Hi: I too am considering PUP because of the Medicare premium return. but the agent I spoke with said that there was a possibility they will not be covering Sumter and Marion counties come February so that could put some people at risk of not having a plan any longer. Has anyone else heard anything about Pup in that respect?