Talk of The Villages Florida

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-   Medical and Health Discussion (https://www.talkofthevillages.com/forums/medical-health-discussion-94/)
-   -   Medicare Advantage Plans (https://www.talkofthevillages.com/forums/medical-health-discussion-94/medicare-advantage-plans-346572/)

RPDaly 01-08-2024 03:42 PM

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Jayhawk 01-08-2024 03:43 PM

Quote:

Originally Posted by Justputt (Post 2289175)
That's not the case. We have Advantage plans say no to what Medicare would say yes to all to often.


Someone is not being honest with you.

https://www.medicare.gov/sites/defau...8-07/11474.pdf

What do Medicare Advantage Plans cover?

Medicare Advantage Plans must cover all of the services that Original Medicare covers
except hospice care

Dusty_Star 01-08-2024 04:09 PM

Quote:

Originally Posted by Jayhawk (Post 2289192)
Someone is not being honest with you.

Medicare Advantage Plans must cover all of the services that Original Medicare covers
except hospice care

& what they SHOULD & what they DO, are sometimes two very different things. Abuses often enough that Congress has started paying attention.

Bipartisan anger aimed at Medicare Advantage care denials

'''It was stunning''': Bipartisan anger aimed at Medicare Advantage care denials - POLITICO

gatorbill1 01-08-2024 04:14 PM

Quote:

Originally Posted by Justputt (Post 2289179)
A lot of guesswork in these posts. The best thing is to sit down with someone that does this for a living. Rusty Nelson did a YouTube chat with someone that specializes in this near TV. There are a lot of if/and/but to what is best. IMO, if you are at TV fulltime, an Advantage Plan (limiting your referring physicians to local) may be a better bet, since they also cover eye, dental, gym, hearing aids. However, if you are a snowbird, your local Advantage Plan isn't going to cover you in-network in PA, MI, CO, etc. Also, Medicare doesn't require you to get a referral to a specialist, whereas Advantage plans do. Most patients we treat with Advantage Plans require preauthorization, when Medicare doesn't, and sometimes what the Advantage Plan authorizes isn't in the best interest of the patient, e.g. accelerated treatments so the plan doesn't have to pay for as many. You really should consult a specialist in these insurance products because they are very dependent on what you need.

UHC Advantage does not require referral for specialist. And Advantage plans must pay for anything Medicare pays for. That is facts.

upstate 01-13-2024 09:47 AM

We have traditional Medicare with a supplemental plan. No referrals are needed and we can choose our doctors and hospitals. Is it cheap, no, but for us it’s worth it. I should note, we are seasonal residents.

kingofbeer 01-13-2024 11:02 AM

Quote:

Originally Posted by upstate (Post 2290679)
We have traditional Medicare with a supplemental plan. No referrals are needed and we can choose our doctors and hospitals. Is it cheap, no, but for us it’s worth it. I should note, we are seasonal residents.

I am going with a Medicare advantage plan because I want to use the Villages Health primary doctors. They do not accept traditional Medicare or supplement. Only select Medicare Advantage plans.

MX rider 01-14-2024 01:17 PM

Quote:

Originally Posted by GoRedSox! (Post 2288732)
For those who spend time in two different states, doesn't United Healthcare Medicare Advantage have a national provider network and you are covered under the in-network benefits in both states?

Yes. We both have AARP UHC Advantage. Our policies are from Indiana but we can use their huge network anywhere we go. We did a ton of research, even talked with people on UHC and chose this plan. Works well for us.

MX rider 01-14-2024 01:20 PM

Quote:

Originally Posted by Justputt (Post 2289179)
A lot of guesswork in these posts. The best thing is to sit down with someone that does this for a living. Rusty Nelson did a YouTube chat with someone that specializes in this near TV. There are a lot of if/and/but to what is best. IMO, if you are at TV fulltime, an Advantage Plan (limiting your referring physicians to local) may be a better bet, since they also cover eye, dental, gym, hearing aids. However, if you are a snowbird, your local Advantage Plan isn't going to cover you in-network in PA, MI, CO, etc. Also, Medicare doesn't require you to get a referral to a specialist, whereas Advantage plans do. Most patients we treat with Advantage Plans require preauthorization, when Medicare doesn't, and sometimes what the Advantage Plan authorizes isn't in the best interest of the patient, e.g. accelerated treatments so the plan doesn't have to pay for as many. You really should consult a specialist in these insurance products because they are very dependent on what you need.

UHC Advantage is totally portable. They have a nationwide network you can use anywhere. We know, we've used it.

OrangeBlossomBaby 01-14-2024 08:33 PM

Quote:

Originally Posted by kingofbeer (Post 2290705)
I am going with a Medicare advantage plan because I want to use the Villages Health primary doctors. They do not accept traditional Medicare or supplement. Only select Medicare Advantage plans.

This is another important consideration. My doctors are with the Villages Health. My PCP, audiologist, OB/Gyn. They're basically across the street from me, and I've been with them since we moved in 4 years ago. Assuming each of those specific doctors are still working for TVH, I might not have any choice but to select Advantage, when I'm eligible for Medicare in 3 years. Unless I'm willing to get all new doctors.

I love having everything I need on a single campus only 10 minutes away by golf cart, AND right next door to the hospital, cancer center, the MRI/mammography center - would really prefer to keep it that way as long as possible.

RICH1 01-15-2024 06:44 AM

i'll stick with my Original Medicare and my F PLAN ...Now is not the time to Get Frugal...


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