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/)

rustyp 01-25-2025 12:04 PM

If you take the advice posted on this subject in this thread I have a bridge to sell you. This has got to be a record of how much misinformation has been published per post.

I'll make a bet 75% of the Medicare / Supplement supporters of whom the overwhelming majority never had an advantage plan can not tell you the difference between a HMO and a PPO. Do yourself a huge favor - GO TO SHINE.

BrianL99 01-25-2025 12:12 PM

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!

Quote:

Originally Posted by biker1 (Post 2404367)
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.

If's unfortunate that Florida isn't as flexible as many other states, that give you an almost unlimited right to switch back to a Medicare Supplement. Given the insurance climate in FL, I guess I shouldn't be surprised.

Rainger99 01-25-2025 12:18 PM

For those of you with supplemental plans, what is the approximate cost of your plan per month?

And does it go up every year?

MX rider 01-25-2025 01:24 PM

Quote:

Originally Posted by rustyp (Post 2404377)
If you take the advice posted on this subject in this thread I have a bridge to sell you. This has got to be a record of how much misinformation has been published per post.

I'll make a bet 75% of the Medicare / Supplement supporters of whom the overwhelming majority never had an advantage plan can not tell you the difference between a HMO and a PPO. Do yourself a huge favor - GO TO SHINE.

Well said!
Pretty much what I said too. Most of the people bad mouthing MA plans really know very little about them except "what I heard is".

Not all MA plans are the same and some are better than others. That's why people need to actually research the plans.
SHINE said The Villages UHC MA plan was a very good option for us.

Having a choice is a good thing imo.

Blueblaze 01-25-2025 01:42 PM

Quote:

Originally Posted by Janie123 (Post 2404262)
I have not heard of any doctor or hospital no longer accepting a supplemental plan, but it seems like every year, hospitals and practices are dropping Advantage plans left and right. Currently the Mayo Clinic in Jax is not accepting any advantage plans and Moffitt in Tampa is not accepting certain advantage plans. We have a pancreatic cancer survivor via the Mayo Clinic. Treatment went from August thru April. I can’t imagine what we would have done when they stopped mid treatment.

The survivor was exceptionally healthy and one day, she got very bad indigestion, two days later, a tumor was found in her pancreas. Two weeks later chemo was started.

I will never roll the dice on healthcare. Today we both have a Cigna Supplemental G plan that is accepted everywhere.

Well. I guess is depends on your situation, but a typical supplemental plan costs about $150/mo per person, plus the $185/mo medicare payment. That works out to $8,400/year per married couple, just to be able to see any doctor you want.

Personally, I think it's a better deal to spend $840/yr for PPO insurance that pays everything except the co-pay to stay in-network for routine stuff -- or 80% of any doctor or treatment I want up to $6700 total out of pocket (and then all of it) -- if I have a medical disaster. And Moffit being in-network even saves the $6700 if I get cancer.

So far, neither Humana nor United have ever refused me anything, unless you consider staying in-network for primary care and the typical specialists old folks have to see every year. United covered almost everything a couple of years ago when I had to go to Orlando to have a super-duper specialist make sure a pancreatic cyst wasn't cancer. And Humana covered almost everything when my wife spent a week in the hospital last year from a (thankfully minor) stroke. But I guess its possible some out-of-network doctor or hospital could refuse to take Humana's money for some reason some day.

I guess I'll never know until something really bad happens. Then I guess I'd have to spend our savings or sell the house. Life's a gamble. I guess I'm willing to bet a multi-billion-dollar company isn't lying to me in any serious way that millions of customers haven't have already discovered.

biker1 01-25-2025 01:53 PM

My Plan N runs $170 per month and it does go up each year.

Quote:

Originally Posted by Rainger99 (Post 2404379)
For those of you with supplemental plans, what is the approximate cost of your plan per month?

And does it go up every year?


biker1 01-25-2025 01:56 PM

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" ;-)

Quote:

Originally Posted by BrianL99 (Post 2404378)
If's unfortunate that Florida isn't as flexible as many other states, that give you an almost unlimited right to switch back to a Medicare Supplement. Given the insurance climate in FL, I guess I shouldn't be surprised.


MaryMS 01-25-2025 02:31 PM

We’ve had great service and care through the Villages Health United Advantage plan. No trouble seeing specialists or Marion West Hospital. We tried Premier Medical, but was unhappy with service and facilities.

Lottoguy 01-26-2025 11:53 AM

We have nothing but positive things to say about our Plan. Our United Healthcare plan includes $5,000 for dental. Max out of pocket is $2,400 per person.

Happydaz 01-26-2025 11:58 AM

Quote:

Originally Posted by BrianL99 (Post 2404378)
If's unfortunate that Florida isn't as flexible as many other states, that give you an almost unlimited right to switch back to a Medicare Supplement. Given the insurance climate in FL, I guess I shouldn't be surprised.

Don’t single out Florida. This happens in any other state.

Aces4 01-26-2025 12:03 PM

Quote:

Originally Posted by Blueblaze (Post 2404405)
Well. I guess is depends on your situation, but a typical supplemental plan costs about $150/mo per person, plus the $185/mo medicare payment. That works out to $8,400/year per married couple, just to be able to see any doctor you want.

Personally, I think it's a better deal to spend $840/yr for PPO insurance that pays everything except the co-pay to stay in-network for routine stuff -- or 80% of any doctor or treatment I want up to $6700 total out of pocket (and then all of it) -- if I have a medical disaster. And Moffit being in-network even saves the $6700 if I get cancer.

So far, neither Humana nor United have ever refused me anything, unless you consider staying in-network for primary care and the typical specialists old folks have to see every year. United covered almost everything a couple of years ago when I had to go to Orlando to have a super-duper specialist make sure a pancreatic cyst wasn't cancer. And Humana covered almost everything when my wife spent a week in the hospital last year from a (thankfully minor) stroke. But I guess its possible some out-of-network doctor or hospital could refuse to take Humana's money for some reason some day.

I guess I'll never know until something really bad happens. Then I guess I'd have to spend our savings or sell the house. Life's a gamble. I guess I'm willing to bet a multi-billion-dollar company isn't lying to me in any serious way that millions of customers haven't have already discovered.

As long as you remember that your medicare advantage plan does not have fixed rates for the rest of your lives. The more people on the plan, the more restricted care and higher rates to pay for the aging population. You're looking through a magnifying glass at your current situation and missing the complete view.

Why did Humana only cover most of the charges when your spouse had a stroke? IMHO, that should be totally covered unless she was ordering steak for dinner every night.

People can elect advantage medicare if they want. My irritation is how there is such a concerted effort to get all senior citizens on a limited care, private insurance plan. There is an effort to close out original Medicare, which is arguably the gold standard of health care for all senior citizens struggling with health care issues.

JohnN 01-26-2025 12:56 PM

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.

Arlington2 01-26-2025 01:19 PM

Quote:

Originally Posted by JohnN (Post 2404776)
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.

But,but,but you didn't go to Mayo Clinic or Cleveland Clinic or some other nationally high rated hospital. No way you could have survived (sarcasm)

Rainger99 01-26-2025 01:21 PM

Quote:

Originally Posted by JohnN (Post 2404776)
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.

What hospital did you go to?

Aces4 01-26-2025 03:44 PM

Quote:

Originally Posted by JohnN (Post 2404776)
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.

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.


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