Talk of The Villages Florida

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-   -   Medicare Advantage Plans in Florida and The Villages? (https://www.talkofthevillages.com/forums/medical-health-discussion-94/medicare-advantage-plans-florida-villages-356071/)

biker1 01-25-2025 07:54 AM

Plan F has an eligibility requirement date of Jan 1, 2020. Someone turning 65 now, will not be eligible.

Quote:

Originally Posted by coleprice (Post 2404265)
When turning 65 and signing up for Medicare, consider a Medicare SUPPLEMENT Plan G or Plan F rather than an Advantage Plan. Medicare Supplement plans cost more, but they are far more comprehensive. Plus, more Doctors accept Supplement Plans and they can save you money if you're hospitalized. For more information, check out medicare school.com or call them at 833-833-3661.


lawgolfer 01-25-2025 08:04 AM

Avoid "Advantage" Plans
 
Quote:

Originally Posted by JWish (Post 2403910)
We just moved to The Villages from another state, and I just started in Medicare in December. All was set up for the other state as original Medicare, as I had researched Medicare extensively and heard lots of negatives about Advantage plans.

We are now working with a local Medicare insurance broker in The Villages, who is telling us that Advantage plans are totally different in Florida than the rest of the country, and that Villages Health is a different and amazing care system than normal care providers.

Sounds too good to be true as we would save a significant amount of money on a Florida Advantage plan, but I don’t want to fall for a sales pitch and regret it later.

Is this a different animal in Florida? Any challenges finding providers around The Villages for Advantage Plans? Any challenges finding providers accepting new patients? Does the UHC Advantage Plan travel provision really work? I’m hesitant to voluntarily join an HMO, but maybe the PPO version would be a better fit for a skeptic.

Looking for real-world experiences with it, especially from those who have been on it awhile.

Thanks for any feedback!

The "freebies" from an Advantage Plan are not worth the hassle and danger of not being able to easily go to a doctor outside the Plan. We have a friend who was diagnosed with an aggressive cancer. The next day she flew to Houston, checked into M D Anderson, and has been there for two months with Medicare and United Health paying the bills. She could never have done that in an Advantage Plan.

TVTVTV 01-25-2025 08:11 AM

Quote:

Originally Posted by JWish (Post 2403910)
We just moved to The Villages from another state, and I just started in Medicare in December. All was set up for the other state as original Medicare, as I had researched Medicare extensively and heard lots of negatives about Advantage plans.

We are now working with a local Medicare insurance broker in The Villages, who is telling us that Advantage plans are totally different in Florida than the rest of the country, and that Villages Health is a different and amazing care system than normal care providers.

Sounds too good to be true as we would save a significant amount of money on a Florida Advantage plan, but I don’t want to fall for a sales pitch and regret it later.

Is this a different animal in Florida? Any challenges finding providers around The Villages for Advantage Plans? Any challenges finding providers accepting new patients? Does the UHC Advantage Plan travel provision really work? I’m hesitant to voluntarily join an HMO, but maybe the PPO version would be a better fit for a skeptic.

Looking for real-world experiences with it, especially from those who have been on it awhile.

Thanks for any feedback!

Don't fall for it. You can always change later, but stay with original Medicare now. It is too good to be true. Lots of interpretation between the lines.

MX rider 01-25-2025 08:27 AM

We've been on UHC Advantage since we retired and are happy with it. We use all the wellness benefits they offer, as well as the vision and dental.
Yes, UHC Advantage plans differ by state and even by county, although not a lot.

We were on it in Indiana but switched to The Villages UHC Advantage when we moved here last year. We like The Villages Health system and had no problem getting a PCP. Appointments are easy to get since they limit how many patients a doctor can have, and only take MA plans. So we never sit in the waiting room more than 15 minutes before we get called back. Take a tour of their facility. They have them all throughout The Villages.

MA plans are a good option, over 50% of new enrollees choose them. But it's not a one size fits all as some like to make you think. For some, regular Medicare is the best way to go.

Not all MA plans are the same, some are better than others. Do your research, check the ratings and as others have said, talk to SHINE.
SHINE told us Medicare Advantage was a very good option for us.

No, not every single hospital or doctor takes UHC MA. But we did our research, and many excellent hospitals do take it, including UF Shands and Advent Health in Orlando.

MX rider 01-25-2025 08:37 AM

Quote:

Originally Posted by lawgolfer (Post 2404274)
The "freebies" from an Advantage Plan are not worth the hassle and danger of not being able to easily go to a doctor outside the Plan. We have a friend who was diagnosed with an aggressive cancer. The next day she flew to Houston, checked into M D Anderson, and has been there for two months with Medicare and United Health paying the bills. She could never have done that in an Advantage Plan.

Thats not true!
With UHC MA we can go to any hospital that takes UHC Advantage anywhere in the country. But there are some that don't take it.

We did our research, and even though we're healthy we checked around and found many highly rated cancer centers in Florida and Indiana (our home state) that take UHC MA.

RoboVil 01-25-2025 08:42 AM

Hot topic - Go with regular Medicare
 
Quote:

Originally Posted by JWish (Post 2403910)
We just moved to The Villages from another state, and I just started in Medicare in December. All was set up for the other state as original Medicare, as I had researched Medicare extensively and heard lots of negatives about Advantage plans.

We are now working with a local Medicare insurance broker in The Villages, who is telling us that Advantage plans are totally different in Florida than the rest of the country, and that Villages Health is a different and amazing care system than normal care providers.

Sounds too good to be true as we would save a significant amount of money on a Florida Advantage plan, but I don’t want to fall for a sales pitch and regret it later.

Is this a different animal in Florida? Any challenges finding providers around The Villages for Advantage Plans? Any challenges finding providers accepting new patients? Does the UHC Advantage Plan travel provision really work? I’m hesitant to voluntarily join an HMO, but maybe the PPO version would be a better fit for a skeptic.

Looking for real-world experiences with it, especially from those who have been on it awhile.

Thanks for any feedback!

A lot of discussion on this. And while I cannot speak of any specific Medicare Advantage plan, I can tell you that at MD Anderson they really like it when you have regular Medicare. No prior authorizations, just get started on therapy ASAP. Similarly, I met a woman with a Medicare Advantage plan from Arkansas who was in the middle of chemo and received a notification that her Medicare Advantage plan was dropping MD Anderson and she had no idea what she was going to do. It is probably just a negotiating tactic, but it was causing her real stress. If you travel regularly back and forth across the US you may be out of network from an Advantage plan. The benefit of an Advantage plan they are less expensive up front, the risk of an Advantage plan is that it is an insurance company whose main goal is to make a profit. Also, one important point. If you go with an Advantage plan, it is almost impossible to go back to Regular Medicare.

mraines 01-25-2025 08:49 AM

Quote:

Originally Posted by Ptmcbriz (Post 2404253)
We have our Advantage plan through my husband’s retirement union in California. It’s Anthem Blue Cross Blue Shield Medicare Advantage. Even though it’s a California based plan it’s nationwide. The Villages Health bills Florida Anthem BCBS and they in turn bill California Anthem BCBS. We love it. We have never been turned down for anything and they have covered everything except very minimal copays ($5 office visit). So you can have Advantage plans from anywhere if they are Nationwide.

I have this plan as well and have not had any problems. Just curious, I have mine through MPIP (IATSE). What union was your husband in?

biker1 01-25-2025 08:52 AM

The short version is you can switch during the one year trial period when you first become eligible for Medicare. After that, you can switch but will typically have to go through underwriting for a Supplemental Plan. If you have health issues, you may not be able to obtain a Supplemental Plan.

Quote:

Originally Posted by RoboVil (Post 2404301)
A lot of discussion on this. And while I cannot speak of any specific Medicare Advantage plan, I can tell you that at MD Anderson they really like it when you have regular Medicare. No prior authorizations, just get started on therapy ASAP. Similarly, I met a woman with a Medicare Advantage plan from Arkansas who was in the middle of chemo and received a notification that her Medicare Advantage plan was dropping MD Anderson and she had no idea what she was going to do. It is probably just a negotiating tactic, but it was causing her real stress. If you travel regularly back and forth across the US you may be out of network from an Advantage plan. The benefit of an Advantage plan they are less expensive up front, the risk of an Advantage plan is that it is an insurance company whose main goal is to make a profit. Also, one important point. If you go with an Advantage plan, it is almost impossible to go back to Regular Medicare.


gwenhwalker@yahoo.com 01-25-2025 09:50 AM

I have had UHC since I moved here 10 yrs ago. Wonderful doctor. Always seen by someone same day if medical issue comes up in between 6 month visits. No copay unless specialist. No complaints

Birdrm 01-25-2025 10:57 AM

You can switch back from and Advantage plan to a Supplement plan you just have to go through underwriting. Yes, if you have an existing health issue they can reject your switch but if fairly healthy and no major issues you can switch to a Supplement plan!

Whoaboy 01-25-2025 10:57 AM

Quote:

Originally Posted by JWish (Post 2403910)
We just moved to The Villages from another state, and I just started in Medicare in December. All was set up for the other state as original Medicare, as I had researched Medicare extensively and heard lots of negatives about Advantage plans.

We are now working with a local Medicare insurance broker in The Villages, who is telling us that Advantage plans are totally different in Florida than the rest of the country, and that Villages Health is a different and amazing care system than normal care providers.

Sounds too good to be true as we would save a significant amount of money on a Florida Advantage plan, but I don’t want to fall for a sales pitch and regret it later.

Is this a different animal in Florida? Any challenges finding providers around The Villages for Advantage Plans? Any challenges finding providers accepting new patients? Does the UHC Advantage Plan travel provision really work? I’m hesitant to voluntarily join an HMO, but maybe the PPO version would be a better fit for a skeptic.

Looking for real-world experiences with it, especially from those who have been on it awhile.

Thanks for any feedback!

I cant speak as to the advantage plans here but I stuck with regular and a supplement. What I wanted to tell you though is that though is that since you are now in Florida, you have to get a different drug plan or perhaps keep same but it costs more ( at least for me because my previous state was less) BUT you can keep your supplement and that price stays the same as your home state. Again cheaper in my home state than here. If you change supplement plans then yes you have to pay Florida prices . I will probably never change as I paying lots less . Found this out purely by accident but I glad I did!

OrangeBlossomBaby 01-25-2025 11:18 AM

Quote:

Originally Posted by Birdrm (Post 2404353)
You can switch back from and Advantage plan to a Supplement plan you just have to go through underwriting. Yes, if you have an existing health issue they can reject your switch but if fairly healthy and no major issues you can switch to a Supplement plan!

Most people over 65 have a "pre-existing condition." That's why it's a risk to start with Advantage with the presumption that you can always just switch to regular Medicare. If they decide some day that YOUR pre-existing condition is a disqualifying one, then they'll deny you.

mtdjed 01-25-2025 11:29 AM

Quote:

Originally Posted by Birdrm (Post 2404353)
You can switch back from and Advantage plan to a Supplement plan you just have to go through underwriting. Yes, if you have an existing health issue they can reject your switch but if fairly healthy and no major issues you can switch to a Supplement plan!

The true test is which plan is best without considering cost. Sure, no problem
with Medicare Advantage if you are healthy. You will save money and it may continue that way.

But, when you some serious care, you may be excluded from some of the best care resources. May never happen, but if need cancer care, does your plan cover Moffit, Shands or Mayo. I understand that UHC Advantage may now cover but several years ago it didn't. What about other Advantage programs?

I am fortunate that my pension pays $1000/year toward my Medicare supplement plan. I am also fortunate enough that I can afford Medicare Supplement Plan. I would rather have the assurance that I can get the best medical care. I will give up my need to have a new Tesla, Geneses, or Lexus every year.

biker1 01-25-2025 11:35 AM

Not exactly. There is no issue with switching back to traditional Medicare. The only issue might be if you also want to add a Supplemental Plan. There is no requirement to have a Supplemental Plan although most people do enroll in one. Exactly which preexisting conditions would cause a rejection during underwriting for a Supplemental Plan will vary. I had asked my broker this and she could only speak in general terms.

Quote:

Originally Posted by OrangeBlossomBaby (Post 2404359)
Most people over 65 have a "pre-existing condition." That's why it's a risk to start with Advantage with the presumption that you can always just switch to regular Medicare. If they decide some day that YOUR pre-existing condition is a disqualifying one, then they'll deny you.


Keninches 01-25-2025 11:55 AM

Stay away from Advantage Plans. If you have any medical issues or you may never know when an issue will happen.
What sounds too good to be true is Bad. Someone said earlier, “It’s Medicare DisAdvantage, instead of Advantage.


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