Medicare Advantage vs Medicare plus supplement Medicare Advantage vs Medicare plus supplement - Page 2 - Talk of The Villages Florida

Medicare Advantage vs Medicare plus supplement

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  #16  
Old 10-18-2015, 02:36 PM
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Originally Posted by golfing eagles View Post
For my insurance, I'd take either one right now. I'm under 65 and my BC/BS policy is going up to $657/month with a $6300 deductible.. Thank you, 111th congress and prez # 44.
It could depend on "which side of the fence your on"----if you were uninsurable because of a pre-condition or whatever ----I would thank the Congress and Prez that I could get insurance at almost any price. I know some that we're in that situation.

For sure, somebody (including me) is going to pay because it's not going to be free. Just saying..........

We have United Health Care Medicare Advantage PPO because we have no other choice. I'm not happy but when my former employer quit paying my supplement as a retirement benefit it really left us few choices. The good thing about our Plan we can go to any doctor anywhere. That is important to us.
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Old 10-18-2015, 03:09 PM
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It could depend on "which side of the fence your on"----if you were uninsurable because of a pre-condition or whatever ----I would thank the Congress and Prez that I could get insurance at almost any price. I know some that we're in that situation.

For sure, somebody (including me) is going to pay because it's not going to be free. Just saying..........

We have United Health Care Medicare Advantage PPO because we have no other choice. I'm not happy but when my former employer quit paying my supplement as a retirement benefit it really left us few choices. The good thing about our Plan we can go to any doctor anywhere. That is important to us.
No exclusion for pre-existing conditions was probably the one and only good point in 2700 pages. But it does come with a price tag for everybody, at the same time it was the right thing to do. There were probably better ways to accomplish this as well---after all, name one thing that government has interjected itself in that did end up costing way more than it should
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Old 10-18-2015, 09:24 PM
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Originally Posted by RVRoadie View Post
There is an opt out window for Medicare Advantage in Jan/Feb if you change your mind.

MA is real insurance. Medicare pays the insurance company a monthly premium, and they have to cover all your medical expenses, less co-pays. They can't go back to Medicare for more money.

With a MA plan you assume some additional risk up to your out-of-pocket limit. Drugs, under all Medicare plans have separate out-of-pocket risk.

MA works for us because we don't consume much in the way of medical care, and can afford the out-of-pocket risk if something happened.
I think that's the clincher! If you don't have chronic health problems MA is a good option. Not so sure if you have some health problems like heart disease or diabetes or if you are on some "heavy duty" drugs with high price tags.
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Old 10-19-2015, 05:08 PM
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Since there are doctors outside TV the do accept other health plans and would most likely provide the same coverage you had before, why is TV health care so important? They are just another health care provider right?
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Old 10-19-2015, 07:37 PM
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Since there are doctors outside TV the do accept other health plans and would most likely provide the same coverage you had before, why is TV health care so important? They are just another health care provider right?
I am personally very disappointed in the Villages Health Care. I moved here four years ago and found it difficult to find a doctor who provided the same trustworthy relationship I had with my doctors back home.

The Villages announced their plans to meet a need they recognized in the Villages which was, the lack of quality medical care. Marcus Welby medicine would be reborn through their Health Care Centers. I watched with excitement as they built beautiful buildings nesseled within central locations throughout the Villages. I drank the koolaide and signed up as a new patient. Due to growing pains, Physician realignments and my own personal needs, I am now on my third doctor in the Villages System.

I was just informed by the staff my new doctor is very over burdened at this time and seeing a medical assistant and Nurse Practioner will be protacal for semi-annual check-ups.

This system is not what I expected. It reminds me of a Kaiser Permanente model.

I do not have their Medicare Advantage Plan and will make a change. It's just a shame these medical buildings were built to provide this kind of group model medical care.
  #21  
Old 10-19-2015, 08:33 PM
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Originally Posted by OCsun View Post
I am personally very disappointed in the Villages Health Care. I moved here four years ago and found it difficult to find a doctor who provided the same trustworthy relationship I had with my doctors back home.

The Villages announced their plans to meet a need they recognized in the Villages which was, the lack of quality medical care. Marcus Welby medicine would be reborn through their Health Care Centers. I watched with excitement as they built beautiful buildings nesseled within central locations throughout the Villages. I drank the koolaide and signed up as a new patient. Due to growing pains, Physician realignments and my own personal needs, I am now on my third doctor in the Villages System.

I was just informed by the staff my new doctor is very over burdened at this time and seeing a medical assistant and Nurse Practioner will be protacal for semi-annual check-ups.

This system is not what I expected. It reminds me of a Kaiser Permanente model.

I do not have their Medicare Advantage Plan and will make a change. It's just a shame these medical buildings were built to provide this kind of group model medical care.
We also moved here four years ago and after having bad experiences with TWO outside doctors we were hoping to find satisfaction with The Villages Health System. We have been completely satisfied with our care there, however I have switched from my initial choice to a new female doctor whom I have seen only once but was very impressed with her care and concern. I like being able to see my medical records via the patient portal. After having bad experiences with the two outside doctors I'm really hoping The Villages Health system will be successful so I do not have to try to find another doctor. I am really not a picky, needy person. I just need someone that will work with me and not against me in trying to stay healthy.
  #22  
Old 10-20-2015, 06:36 AM
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Originally Posted by Carla B View Post
The "availability of specialists" is what scares me the most about any Advantage plan and especially if doctors come and go from the plan. Whereas, with Medigap supplement plans, any physician who accepts Medicare is available to you, the patient.

What I don't understand is: what is the incentive to the provider, if any, for agreeing to participate in an Advantage plan, like The Villages Health is doing? I always thought a provider would have to accept a lesser fee in an Advantage plan than they do for traditional Medicare but I don't know.

In answer to an earlier question, I don't think it would be easy to go back to original Medicare from an Advantage plan. A call to AARP might clarify that. We joined AARP/UHC late and I think were penalized in the monthly premium for not joining within six months of being 65. We did have to answer six health questions satisfactorily before joining.
What were the 6 questions or type of questions?
  #23  
Old 10-20-2015, 08:11 AM
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Originally Posted by OCsun View Post
I am personally very disappointed in the Villages Health Care. I moved here four years ago and found it difficult to find a doctor who provided the same trustworthy relationship I had with my doctors back home.

The Villages announced their plans to meet a need they recognized in the Villages which was, the lack of quality medical care. Marcus Welby medicine would be reborn through their Health Care Centers. I watched with excitement as they built beautiful buildings nesseled within central locations throughout the Villages. I drank the koolaide and signed up as a new patient. Due to growing pains, Physician realignments and my own personal needs, I am now on my third doctor in the Villages System.

I was just informed by the staff my new doctor is very over burdened at this time and seeing a medical assistant and Nurse Practioner will be protacal for semi-annual check-ups.

This system is not what I expected. It reminds me of a Kaiser Permanente model.

I do not have their Medicare Advantage Plan and will make a change. It's just a shame these medical buildings were built to provide this kind of group model medical care.
TVH was supposed to be designed to make sure the doctors were not overburdened and you would receive personalized care from your doctor. Maybe it has more to do with you not being under the "preferred med adv plan". They are not kicking you out; just making it inconvenient enough that you will either convert or leave.
  #24  
Old 10-20-2015, 08:17 AM
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TVH was supposed to be designed to make sure the doctors were not overburdened and you would receive personalized care from your doctor. Maybe it has more to do with you not being under the "preferred med adv plan". They are not kicking you out; just making it inconvenient enough that you will either convert or leave.
Knowing some of the doctors there and the overall philosophy of TV Health I doubt it. On the other hand, the doctors are employees and don't have the final word on overall policy. I would think, physician recruitment issues aside, that they would be very happy to fulfill their original plan of 8 primary care centers with 6 docs each and sign up as many residents as possible. This in turn would attract more specialists and ancillary services and make for a more vibrant healthcare system in TV
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Old 10-20-2015, 08:32 AM
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Originally Posted by golfing eagles View Post
Knowing some of the doctors there and the overall philosophy of TV Health I doubt it. On the other hand, the doctors are employees and don't have the final word on overall policy. I would think, physician recruitment issues aside, that they would be very happy to fulfill their original plan of 8 primary care centers with 6 docs each and sign up as many residents as possible. This in turn would attract more specialists and ancillary services and make for a more vibrant healthcare system in TV
The advertised policy is only 1250 patients per doctor. TVH has already stated no new patients w/o UHC Med Adv plan. I and many others have received the email stating when you reach 65 we need to have an insurance "review". In my opinion, that is legalese for "convert or leave". The writing is pretty much on the wall. So why do you say "sign up as many residents as possible"? That is contrary to what is actually happening.
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Old 10-20-2015, 08:36 AM
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The advertised policy is only 1250 patients per doctor. TVH has already stated no new patients w/o UHC Med Adv plan. I and many others have received the email stating when you reach 65 we need to have an insurance "review". In my opinion, that is legalese for "convert or leave". The writing is pretty much on the wall. So why do you say "sign up as many residents as possible"? That is contrary to what is actually happening.
My post contained an implied conditional. Should have said IF they completed the original plan........
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Old 10-20-2015, 10:20 AM
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It is my understanding that you can be turned down by a supplemental insurance company if you don't meet their underwriting standards, but not a Medicare Advantage company. There are separate MA plans if you have certain chronic medical issues.
  #28  
Old 10-20-2015, 04:03 PM
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there is a great deal of misinformation here. I was accepted into a supplemental plan with a heart transplant, an amputation and a blood clotting disorder. Affordable care also forced the acceptance of pre existing conditions...no questions. If you go to the hospital on an advantage plan good luck with the bills.
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Old 10-20-2015, 05:19 PM
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It is my understanding that you can be turned down by a supplemental insurance company if you don't meet their underwriting standards, but not a Medicare Advantage company. There are separate MA plans if you have certain chronic medical issues.
Your understanding is not true. If an insurance broker told you that, find another broker.
  #30  
Old 10-20-2015, 05:29 PM
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I was told that that since a lot of people don't like the advantage plans that they allow you to switch one time at renewal time without health questions. I'm not sure if that's federal and if it is the same for everyone.
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