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-   -   Medicare Advantage Plans (https://www.talkofthevillages.com/forums/medical-health-discussion-94/medicare-advantage-plans-279391/)

rustyp 12-09-2018 03:04 PM

Quote:

Originally Posted by capecoralbill (Post 1606170)
The trouble is, when you are sick, or in the middle of a crisis , I would not exactly be in the mood to contact United Healthcare, getting forms for the doctor to fill out, and then start petitioning Doctors and waiting 3 days to get an approval for a doctor 50 miles closer . As far as finding out WHO is the network or not , I found it daunting, trying to navigate the United Healthcare website to scroll to the right plan, county, City, for the condition I needed. and even if you do locate one , they have a disclaimer that says their online list might not be up to date. I went back to the Medicare with a supplement , it's not cheap though , it costs me $ 207 per month

Not even close to my experience. When traveling between TV and New York a 2 minute phone call before I leave switches me onto the NY network which then puts me in network there and vice versa. No referrals need for any specialists. Again did this really happen to you or are you relating to something you heard or read about here ?

Dan9871 12-09-2018 05:43 PM

Quote:

Originally Posted by capecoralbill (Post 1606170)
The trouble is, when you are sick, or in the middle of a crisis , I would not exactly be in the mood to contact United Healthcare, getting forms for the doctor to fill out, and then start petitioning Doctors and waiting 3 days to get an approval for a doctor 50 miles closer . As far as finding out WHO is the network or not , I found it daunting, trying to navigate the United Healthcare website to scroll to the right plan, county, City, for the condition I needed. and even if you do locate one , they have a disclaimer that says their online list might not be up to date. I went back to the Medicare with a supplement , it's not cheap though , it costs me $ 207 per month

This is an over the top description of how UHC Advantage works. We've had a number of major medical crises and UHC Advantage handled them all very well.

Getting a prescription for a prothesis filled is not a crisis.

gatorbill1 12-09-2018 05:53 PM

another thumbs up for uhc

queasy27 12-09-2018 07:46 PM

OP, I definitely agree with the advice to contact a potential doctor's office directly to confirm that they accept your insurance rather than relying on a published list or even calling the insurance company's help line. The online lists are very unreliable.

While I was researching Medicare, I also made the mistake of speaking to an insurance agent I thought was independent but who works for UH. The entire process was very confusing for me, even after talking to SHINE.

I went with UH Advantage/Villages Health strictly on price; it was about $200/month less than the Medicare supplements I looked at. It has been a bit of a struggle to find specialists here who accept my WellMed UHC plan, but that's partially on me because I wanted to stay with my primary care doctor and don't use the Villages Health system itself.

I've had one instance of UH denying authorization for an MRI and me having to argue about it with them. That happens more frequently with Advantage plans than it does with original Medicare.

Choosing health care involves a bit of predicting the future with regard to what one's health care needs might be.

Best wishes to you.

manaboutown 12-09-2018 09:49 PM

Half of the doctors graduated at the bottom half of their medical school classes. I want to be able to choose my doctor, preferably one who went to an excellent medical school in the good old USA and graduated near the top of his class. I also may need one in any one of four states. Thus I choose Medicare plus the UHC supplement.

Dan9871 12-09-2018 09:57 PM

Quote:

Originally Posted by queasy27 (Post 1606284)
I've had one instance of UH denying authorization for an MRI and me having to argue about it with them. That happens more frequently with Advantage plans than it does with original Medicare.

.

When my wife was on regular Medicare she had a couple of echo tests denied because it they were too soon after the previous one. The same thing happened once after she transitioned to Advantage.

So I don't think test denials have anything to do with Advantage vs. regular. Advantage has to run under the same rules as regular Medicare and CMS, that runs Medicare, sets the rules for when and how often tests can be done.

shmoo1 12-10-2018 04:37 AM

The best recommendation is to speak with a licensed insurance broker that represents many plans.

They can discuss the pros and cons, listen to your concerns and help you make an informed choice.

SHINE is good also but they cannot discuss specific plans, they aren’t appointed by specific company’s. Only brokers are.

They have to take an annual test with each company they represent to know all the specifics

larcha 12-10-2018 05:53 AM

Medicare Advantage (MA) takes the place of regular Medicare. If you want to keep your current doctor and they are not a provider under your MA plan, your plan won't pay. I have a UHC supplemental plan and can see whatever doctor I want to see who accepts traditional Medicare. The best advice is to call SHINE. They are unbiased and can explain both systems.

Rwirish 12-10-2018 06:11 AM

Have been 100% satisfied with the United Healthcare Medicare Advantage plan.

People always complain about their healthcare coverage regardless of their plan.

banjobob 12-10-2018 06:40 AM

I opted for United Health Advantage through the Villages the only drawback has been dentists , some do not participate , I keep my own Doctors and pay 82.00 per month and receive no deductible medications , no copay on Doctor visit except specialist and 15 for them had a pacemaker installed no cost very satisfied with my program.

bonrich 12-10-2018 07:18 AM

My wife and I are snowbirds and wanted a plan that can travel to different States. We have Medicare as our primary and UHC/AARP as our secondary. Under AARP we have two different tiers since one of us requires more health care than the other. As long as the Dr. accepts Medicare we are covered in any State. Also, for our Part D coverage we have Silver Script for one of us and Express Script for the other. Chose these two based on our RX's and what tiers they were in.

Dan9871 12-10-2018 08:46 AM

Quote:

Originally Posted by larcha (Post 1606357)
If you want to keep your current doctor and they are not a provider under your MA plan, your plan won't pay. .

Some MA plans won't pay out of network providers and some will.

HelenLCSW 12-10-2018 08:47 AM

Quote:

Originally Posted by coffeebean (Post 1605975)
In January, I have to make a decision as to which medicare advantage plan to go with due to my husband's retirement and therefore I will transition to post medicare. My husband and I have been reading reviews for United Health Care and Humana. My head is ready to explode after reading the awful reviews of both of these plans.

I don't plan on using The Villages Health Care system as of now because the current Doctors that I see are not in their system. I just want to use this plan for my doctors that I have been going to since I have moved to The Villages.


The common "theme" of the reviews is that people verify with the insurance company that their provider is in network. Come time for the bill to be paid, both plans claim the providers were "out of network" and will not pay the claim.

What has your experience been with either United Health Care Medicare Advantage plan or Humana Medicare Advantage plan?


Many doctors do not take advantage plans --They are HMO’s or PPOs. I have had straight Medicare with United as Medigap plan and have never had a problem getting any doctor I want in any state that I want.

OhioBuckeye 12-10-2018 09:28 AM

The comments are interesting. We decided to stay with our original Ins. that I started with when I retired with 11 yrs. ago. A couple of comments answered the question that I was always wondering about, is it hard to find a Dr. in network to get us less pay out of pocket. We didn't take any of these, we stayed with our original Ins. PPA, only because we never go to the Dr. for anything. The Dr. I have, who's a really good Dr. does have us come back every 3 months, WHY. He wants us to come back & do blood work checks, am I going to die in that short of a time, NO, these 3 month check up's are always the same, he always says, everything looks good, come back in 3 months. I know people that have lots of medical issues & they go back to their Dr. every 6 months to a yr. So what good will switching to Advantage or any of the other Ins. do us any good, so are these really great deals they want us to go on? Interesting article!

genobambino 12-10-2018 10:28 AM

Dan9871 is right on with his description. We have UHC thru the Villages Health and consider it is the best one going anywhere around here. I have always had a advantage plan since I started on Medicare 11 years ago with no payment and no problems. I just had spinal fusion surgery and the bill was about $325,000, I paid maybe 12 or $1400 out of pocket. We have friends that have advantage plans with other companies that give you back 60 or $70 of your part B back as an incentive to sign up, but they go thru hell getting refferals and wait times, we don't have any of that with Villages Health. There very professional, no referrals, no BS.


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