[rustyp]

Originally Posted by JohnN

We have been living in The Villages for 17 years now and using UHC The VIllages Advantage Plan.
In 2024, I had FOUR serious cardiovascular surgeries with a total of 9 stents. Plus all of the other hospital time, MRI, CT, rehab, etc. UHC preauthorized quickly whenever needed with no trouble. Total 2024 provider billing was in excess of $250K, my share of which was $1,500. The docs literally saved my life and UHC did what they were supposed to do.

Prior to that adventure, in the other years, again no problems with UHC. We did have o learn our way around The Villages Health System and other providers, but that's likely the same anywhere these days. A lot of people knock the advantage plan and say "wait til you have something serious happen." Well, I did and it worked out great. Best wishes.

Originally Posted by Aces4

Great? How about 8 surgeries in four years, 6 of them major, rehab and no pre-auth and NO money out of pocket and none of the surgeries in The Villages.

I don't get lt. John N spent $1500 for major issues. You spent $0 except for approx $200/month supplemental for 4 years = $9600. Bonus - both of you are still on the top side of the grass.

[JohnN]

Originally Posted by Rainger99

What hospital did you go to?

Leesburg Regional Hospital, my cardiologist was top-tier and associated with Orlando Health. The hospital wasn't at all "fun" but they did their job pretty well.

I have been to the Villlages Hospital ER some years back, not a good experience but that was a long time ago. If given a choice, I'd pick Leesburg.

[JohnN]

Originally Posted by Aces4

Great? How about 8 surgeries in four years, 6 of them major, rehab and no pre-auth and NO money out of pocket and none of the surgeries in The Villages.

Nope, I don't want any more surgeries! LOL I'm glad we're both here though.

[Aces4]

Originally Posted by rustyp

I don't get lt. John N spent $1500 for major issues. You spent $0 except for approx $200/month supplemental for 4 years = $9600. Bonus - both of you are still on the top side of the grass.

We got to chose top notch facilities, providers, therapists and didn't have to jump through approval hoops from private insurance companies. Perhaps you missed an early thread from another poster in which a surgeon indicated his patient was refused TKR care even though the x-ray showed bone on bone.

Why do you think Drs and medical centers are beginning to drop patients with advantage medicare? Private insurance companies on the back side controlling expenses to enhance their profits are the answer. If original Medicare is eliminated and everyone is pushed into the private insurance companies advantage program, you'll really see Drs dropping advantage Medicare patients.

[Rainger99]

Originally Posted by biker1

I believe it is only 4 states. I grew up in one and wouldn't consider moving back there or to the other 3. I guess that qualifies as "many" ;-)

Four states (CT, MA, ME, NY) require either continuous or annual guaranteed issue protections for Medigap for all beneficiaries ages 65 and older, regardless of medical history.

[BrianL99]

Originally Posted by Rainger99

Four states (CT, MA, ME, NY) require either continuous or annual guaranteed issue protections for Medigap for all beneficiaries ages 65 and older, regardless of medical history.

Are you forgetting about California, Idaho, Illinois, Nevada, and Oregon ?

[MX rider]

Originally Posted by Aces4

Great? How about 8 surgeries in four years, 6 of them major, rehab and no pre-auth and NO money out of pocket and none of the surgeries in The Villages.

You paid plenty out of pocket. How much have you spent over the years on a supplimatal plan? You may want to add it up so you know the true cost.

Nothing is totally free! Advantage plans have their place, but aren't for everyone. As I said earlier, choice is a good thing.

[Aces4]

Originally Posted by MX rider

You paid plenty out of pocket. How much have you spent over the years on a supplimatal plan? You may want to add it up so you know the true cost.

Nothing is totally free! Advantage plans have their place, but aren't for everyone. As I said earlier, choice is a good thing.

Unfortunately, we've had far more expenses than we have ever paid in. We're good with our original Medicare and our supplemental plan.

[MX rider]

Originally Posted by Aces4

Unfortunately, we've had far more expenses than we have ever paid in. We're good with our original Medicare and our supplemental plan.

My point remains, you paid a lot out of pocket over they years. Saying you paid nothing simply isn't true.

MA plans are a great option for many of us, as is medicare for others. There's no right or wrong.

[Aces4]

Originally Posted by MX rider

My point remains, you paid a lot out of pocket over they years. Saying you paid nothing simply isn't true.

MA plans are a great option for many of us, as is medicare for others. There's no right or wrong.

One of the surgeries I listed was an 8 hour, complicated, new surgical procedure. A study was developed and the surgery created great success for an ongoing problem. It also provided needed information for others undergoing such an extensive surgery.

Try to fly that past advantage Medicare coverage.

[Blueblaze]

Originally Posted by Aces4

One of the surgeries I listed was an 8 hour, complicated, new surgical procedure. A study was developed and the surgery created great success for an ongoing problem. It also provided needed information for others undergoing such an extensive surgery.

Try to fly that past advantage Medicare coverage.

Why would any hospital or doctor refuse a dollar just because it comes from an Advantage PPO?

Yes, an out-of-network doctor might charge more than the plan is willing to pay, and you might get stuck with the balance. But that could happen with ANY insurance plan, including a medigap policy. At least with my MA plan, I'm saving $8000/year in premiums. I happen to think it's worth the bet that if the worst happens and I wind up stuck with a 6-figure medical bill some day, at least I'll have the $160K I saved over 20 years to use before I have to dip into my savings. But on the other hand, there's at least an even chance that will never happen -- and I pocket $160K.

Insurance is a bet, anyway you look at it. I don't disparage anyone for seeing the odds differently or having a different risk tolerance than I do. I think the only reason someone would do that is because they're insecure about the choice they've made.

[Aces4]

Originally Posted by Blueblaze

Why would any hospital or doctor refuse a dollar just because it comes from an Advantage PPO?

Yes, an out-of-network doctor might charge more than the plan is willing to pay, and you might get stuck with the balance. But that could happen with ANY insurance plan, including a medigap policy. At least with my MA plan, I'm saving $8000/year in premiums. I happen to think it's worth the bet that if the worst happens and I wind up stuck with a 6-figure medical bill some day, at least I'll have the $160K I saved over 20 years to use before I have to dip into my savings. But on the other hand, there's at least an even chance that will never happen -- and I pocket $160K.

Insurance is a bet, anyway you look at it. I don't disparage anyone for seeing the odds differently or having a different risk tolerance than I do. I think the only reason someone would do that is because they're insecure about the choice they've made.

As I said earlier, I believe one's view of the advantage medicare plan is myopic. One is only guaranteed their advantage medicare coverage and costs today, once they convert every senior to private insurance who's only goal is high profits and low care, one will understand what they have in 20 years.

I believe there is no way advantage medicare would have approved and totally paid for the advanced surgical services I mentioned earlier.

[MX rider]

Originally Posted by Aces4

As I said earlier, I believe one's view of the advantage medicare plan is myopic. One is only guaranteed their advantage medicare coverage and costs today, once they convert every senior to private insurance who's only goal is high profits and low care, one will understand what they have in 20 years.



I believe there is no way advantage medicare would have approved and totally paid for the advanced surgical services I mentioned earlier.

Key phrase in your statement: "I believe". In truth you're just guessing.

Inferring people on MA plans aren't making a smart decision, didn't do their research, and only are looking at cost is insulting, and for many people you couldn't be more wrong!
You seem to have a really hard time accepting that many of us like our MA plans.

We chose UHC MA because we think its the best fit for us.
Whats best for you isn't whats best for everyone, even though you think so..

[BigDawgInLakeDenham]

There is so much false information and opions on this issue presened here that it proves there are many people that don't know what they are talking about but will remain passionate about their opinion based on their limited experiences. Everyone needs to educate themselves through researching all of their opinions THEMSELVES!!! It's about you and your personal needs. No one here knows your personal health information and no one knows your travel plans...etc. Maybe you are 80 and maybe you are 45 on SSDI with Medicare but mostly healthy.....nobody here knows and that is why you need to choose the best you can afford. Should you pay for an insurance company that will send you to your cancer center of choice but you have no cancer history and no risk factors....only you can decide that. Just Please don't base your needs on everything you've read here and talk to your Doctors and Insurance advisors. As a retired RN I have a greater understanding of how it all works. If I like my current Doctors and I am changing insurance I call my doctors' offices and ask to talk to the billing person. I tell them my situation and I ask what insurances they accept and which one is the best payor to assist in my informed decision.....in addition to talking to my Doctor, insurance advisors, and my own research. I know it's much harder for folks that haven't worked in the health industry and everything seems like a different language...but it's not hard to do your own research. One thing is for sure, after a career in the ER, I've never ever seen someone denied a life saving procedure....insurance or not. Oh....Medigap insurance is from the same insurance companies that offer Advantage plans. And stop saying MA instead of Medicare Advantage because every Healthcare practitioner knows MA means Medicaid. Do you qualify for Medical Assistance? If you do then how can you afford your bills here in the Villages. Stop confusing the issue with MA please

[MX rider]

Originally Posted by BigDawgInLakeDenham

There is so much false information and opions on this issue presened here that it proves there are many people that don't know what they are talking about but will remain passionate about their opinion based on their limited experiences. Everyone needs to educate themselves through researching all of their opinions THEMSELVES!!! It's about you and your personal needs. No one here knows your personal health information and no one knows your travel plans...etc. Maybe you are 80 and maybe you are 45 on SSDI with Medicare but mostly healthy.....nobody here knows and that is why you need to choose the best you can afford. Should you pay for an insurance company that will send you to your cancer center of choice but you have no cancer history and no risk factors....only you can decide that. Just Please don't base your needs on everything you've read here and talk to your Doctors and Insurance advisors. As a retired RN I have a greater understanding of how it all works. If I like my current Doctors and I am changing insurance I call my doctors' offices and ask to talk to the billing person. I tell them my situation and I ask what insurances they accept and which one is the best payor to assist in my informed decision.....in addition to talking to my Doctor, insurance advisors, and my own research. I know it's much harder for folks that haven't worked in the health industry and everything seems like a different language...but it's not hard to do your own research. One thing is for sure, after a career in the ER, I've never ever seen someone denied a life saving procedure....insurance or not. Oh....Medigap insurance is from the same insurance companies that offer Advantage plans. And stop saying MA instead of Medicare Advantage because every Healthcare practitioner knows MA means Medicaid. Do you qualify for Medical Assistance? If you do then how can you afford your bills here in the Villages. Stop confusing the issue with MA please

Thats what I've been saying as well. Do your research, talk to SHINE, check the ratings and providers, and make an educated decision. We even talked to people on UHC. Having more than one option is a good thing.

But I disagree on this, if you're responding to a post titled "Medicare Advantage plans", and using MA plans as an abbreviation, it isn't confusing anyone. imo