I was paying $800 a month for Blue Cross Blue Shield (Florida Blue). The list of Docs I could go to was small. I had co pays and had to meet $4,000 deductible before they started paying,and a small co-pay for prescriptions.. Now for $105 a month, I have a good system of Doctors, some co-pays, no deductibles, small co-pays for prescriptions, a little dental coverage(cleaning). I love the set up at there Health centers. Do the math I am saving $695/month, that is a savings of $8,340 a year in premiums, and $4,000 in deductible.

Do you pay a Premium?

After reading your comments I am more concerned than ever that Villages Health is no longer taking new veteran patients using our military health plan (Tricare/Tricare for Life). My husband and I are both retired AF and I was looking forward to turning 65 so I could join the Villages Health only to learn they are no longer supporting new veteran patients. Our benefits have been a life saver for us and the thought of giving them up is even more disturbing now.

You will be giving up NOTHING. The Villages Health essentially offers the services of Primary Care Physicians. You guys will simply find Primary Care Physicians who are with a practice other than The Villages Health. There are many excellent primary care physicians in this area.

keep in mind that Medicare Advantage is not accepted everywhere. If you are a person who travels, and you need medical assistance when out of The Villages, you could end up paying big bucks for your health care.

As I understand, emergency care accepted anywhere near n US. If a planned treatment go through their Passport program.

I have United Health Care, The Villages. They just paid to have me go to a heart surgeon in Virginia and have a specialized heart operation not available anywhere else in the world, by the creator of the operation. I am so grateful. Not one blip or delay. It was also not a operation for a life threatening disease but an operation for improved quality of life. They have a feature called "Passport" that allows you medical care anywhere in the country. Perfect for Villagers.

Plan ahead for Skilled care / rehab options
 

When making a decision. Ask what inpatient skilled care /rehab facilities you have access to here in the Villages. Right now UHC options are very limited and thus fill up quickly so you may have to go in Ocala or Leesburg. If you have straight Medicare you have the most options and any facility will take you if they have bed available the day of your hospital discharge.

My mother had UHC Advantage plan in NY and we switched her to the UHC Advantage Plan. It says The Villages, however, you can take advantage of any doctor who takes Medicare. I have not yet been to a doctor's office that does not accept it. We recently went to see a hematologist in Leesburg that was not affiliated with The Villages Health and the insurance covered the visit, as well as, blood being drawn through his onsite lab so we received blood results that could be done same day. That being said, I can't say enough about the quality of care that she has received at TV Health Center in Pinellas. She sees Dr. Helene Aisenstat. They are always on time. She has vitals checked, sees the doctor for assessment and dialogue (at times we have been with the doctor for 40 minutes) and has any referrals conducted for her or we make the appt if it is a doctor that is not affiliated with TV health. No referral is needed with UHC for specialists. All referrals that have been made by her doctor produced a call from the doctor within two days.
My mom is also receiving, via doctor's prescription, occupational therapy, physical therapy, visiting nurse in the home via UHC. The expectation is that these services will be provided until she has reached her goals. Via UHC she is provided a combination of services up to 35 hours per week. The Dr. contracted with Greystone health (a UHC partipating provider) for these services In addition, UHC is paying for a home health aid 5 days per week, 4 hours per day without any out of pocket expenses to her. This service will continue after OT and PT have been terminated and may add up to 35 hours per week. Given her health care needs her doctor called for the maximum hours in an effort to have her remain community based and in the home.
I did read the TV Health is no longer accepting new patients who do are not UHC Advantage of TV. Given the plethora of outside doctors who take the plan you are not married to TV Health if you choose not to be married to it but the centers are convenient. I can't say enough about the services that UHC will pay for given patient need.

Your understanding is not true. If an insurance broker told you that, find another broker.

The fact is with a medigap program you can initially enroll without a question of insurability. However once enrolled you have to sty with that plan or be subjected to insurability testing.

My wife and I have a BS/BC Plan F that I find to be reasonable to date. We wonder if a premium increase will occur in 2016? While premiums are higher there is little in the sharing expenses. Most doctors are accepted and treatment location is not confined.

i renewed with my Plan f. i use docs associated with Monroe

Went to a Shine counselor, scared the beegeesus out of me. "you won't be covered if you are out of sumter county.... what if you had a car accident Tampa." Go to the Medicare store to find the real answers about Advantage. Lots of misleading info. on this site.

If the SHINE counselor told you that, they are misinformed!
With the UHC Villages Advantage plan:

there is no monthly premium,
you can see any of the doctors in Florida that accept Medicare. PERIOD!
You are not limited.
You can see any specialist that accepts Medicare for a co pay of $30. PERIOD!
0 copay for tier1 & tier 2 drugs
Free Silver sneakers membership (24hr fitness and others)
0 copay for your PCP
you can go to any hospital in the state that accepts Medicare
The Passport plan, which is free, covers you in most other states (37, I believe)
In Passport states you can see any medicare doctor of your choice.

we are in fairly good health, Hubby had major surgery by a top specialist and the total cost was $275.00 ( though the bill was $51,000) because he spent one night in the hospital. That covers surgeon, facility costs, equipment, medication, anesthesiology, labs and procedures in the hospital. There are no separate bills. PERIOD.

Our providers at Pinellas are excellent, We have always gotten in to be seen on the same day, when needed. They are very good about booking semi annual visits and labs.

We like seeing our labs on the portal, so we know what is going on as soon as results are back.

If we had multi organ health issues, or chronic conditions, we would have to revisit the other Advantage options which do have a small monthly copay, but provide coverage for those with chronic specialist needs at lower copay.

Being a RN, I was quite concerned about what we would find for coverage with medicare. We have found it to be excellent and love the Villages health care system. Our providers seem happy to be here and very thorough and well qualified. I do not mind seeing a NP if my doc is not available. I know they are very qualified and communication within the team seems excellent.

We got nothing to gripe about!!

Dotti, are you saying that this is a good plan if you are healthy, but not so good if you are not?

Dotti wrote an excellent post. Please visit the Medicare Store. We had a meeting with the folks in Sumter. Get your questions answered correctly. For those with many medical,problems they offer an Advantage 2 plan. A small premium, but much lower copays. If I had numerous medical,problems, this is something I would consider.

Sorry if it seemed like I was blasting her post. I wasn't. Just wanted some clarification. We are not in the market for a new plan and won't take up anyone's time at Shine or Medicare Store. Thanks for your explanation.

The only disadvantage that we have with the Medicare Advantage greatly limits the doctors you can see, and you may need to go to doctors in Ocala or farther. We have had this happen at least 2 or 3 times over the year that we used this policy, and we are going to change.
Talk to SHINE they will give you the straight info.

If you want the straight scoop and a person you can trust to counsel with, call Jay Boylan @ 352-408-3127. He is buried right now but I met with him just today. He is independent and has access to all plans. Much of what I read on here is correct while much is not.

Call Jay but give him a chance to get back to you because he's going nearly 7 days a week right now and they are LONG days.

UHC Villages Advantage
 

[QUOTE=dotti105;1144192]If the SHINE counselor told you that, they are misinformed!
With the UHC Villages Advantage plan:

there is no monthly premium,
you can see any of the doctors in Florida that accept Medicare. PERIOD!
You are not limited.
You can see any specialist that accepts Medicare for a co pay of $30. PERIOD!
0 copay for tier1 & tier 2 drugs
Free Silver sneakers membership (24hr fitness and others)
0 copay for your PCP
you can go to any hospital in the state that accepts Medicare
The Passport plan, which is free, covers you in most other states (37, I believe)
In Passport states you can see any medicare doctor of your choice.

we are in fairly good health, Hubby had major surgery by a top specialist and the total cost was $275.00 ( though the bill was $51,000) because he spent one night in the hospital. That covers surgeon, facility costs, equipment, medication, anesthesiology, labs and procedures in the hospital. There are no separate bills. PERIOD.

Our providers at Pinellas are excellent, We have always gotten in to be seen on the same day, when needed. They are very good about booking semi annual visits and labs.

We like seeing our labs on the portal, so we know what is going on as soon as results are back.

If we had multi organ health issues, or chronic conditions, we would have to revisit the other Advantage options which do have a small monthly copay, but provide coverage for those with chronic specialist needs at lower copay.

Being a RN, I was quite concerned about what we would find for coverage with medicare. We have found it to be excellent and love the Villages health care system. Our providers seem happy to be here and very thorough and well qualified. I do not mind seeing a NP if my doc is not available. I know they are very qualified and communication within the team seems excellent.

We got nothing to gripe about!![/QUOTE]



Dottie: Which UHC Advtange plan are you talking about? I have UHC Advantage thru AARP and, while there are no premiums, my co-pays are higher, specialists are higher and a minor, outpatient surgical procedure resulted in a $1600 hospital bill. And no Silver Sneakers. I want what you have.

Have multiple health problems and use UHC supplement health plan F. Had surgeries at Florida hosp. in Orlando and Moffitt in Tampa. Would not have been able to seek out top specialists if I had been in an Advantage program.
Yes, premium is higher but being able to go anywhere in the country is worth it!

PS: Never had a bill YET with over $250,000 in charges!

Villages Health is pressing hard to get everyone into Medicare Advantage. If you don't mind being locked into that network, it's OK, but if you want the flexibility to go to the best specialist or hospital (like Johns Hopkins in Baltimore and many other first-rate hospitals) you would be out of luck. With standard Medicare (plus supplement) you have much more flexibility to manage your own health care, and that's worth a lot to me and my wife. My understanding is that you would pay a cost penalty if you wanted to switch from Medicare Advantage to standard Medicare. Be sure that you check this carefully, since if you develop a serious health problem, you may want to be able to choose the best specialists and hospitals, not just stay with the network. My opinion is that cost is way down on the list of concerns regarding my and my wife's health.

Alwann and Dottie, and anyone willing to help...

I am a "daughter" trying to make sure my mom (who is 78 and still working full time at The Villages), retires into a good program. Though she will not retire this month, should she be switching her ins over during open enrollment? Right now medicare is secondary to her Villages ins., which is not that cheap. She wants to stay in the Villages system as she likes going to MDs right there but she gets confused about plans taking more out of her social security check before she even sees it and as I live up in CT, its difficult to figure out where and to whom I should be directed to start weeding this out. I can make the spread sheets of the Medicare complete vs the UHC plans, but it gets more complicated than that if what she is most concerned about is this does not account for what will be taken out of her retirement check to actually pay for the particular plan?

While this is an excellent post, it leaves me with a question. You say that the UCH Advantage Villages Plan permits a member to see any doctor that accepts Medicare. Since I know a number of doctors that do not accept any Advantage plans, I wonder how this can be. Also, it would mean that the Plan would have to pay the physician the fee for a member's visit. This is not typical in advantage plans. I am not being negative, just raising a question as this is not typically how Advantage plans operate.

Typo
 

Meant 'UHC' plan..sorry for the typo.

There are a number of different advantage plans that the Villages Health accepts. The UHC plans are HMO's and restrict to to in network doctors. The AARP/UHC plans are PPO's and do not restrict you to in network doctors.

I'm pretty sure Gracie is referring to one of the PPO plans.

Both are zero premium plans but co-pays are different as are out of pocket expense limits.

Go the UHC site and put in a zip code like 32163 and check the advantage plans. Look at the ones that Villages Health accepts and you will see the differences.

The site is uhcmedicaresolutions dot com.

Call SHINE, they will give you the straight scoop. Unbiased info, very good. Do a search on the word SHINE for all the contact info and more.

This is very good advice. Some posters are claiming they pay a lot for their services with Advantage plans and are limited as to whom they can see, and others are claiming they pay no premium with their Advantage plan and go to just about anyone they want, including specialists out of state, with little to no co-pays. I've never been so confused!

We are happy with our setup and don't plan to change. I was reading because I'm interested to learn what other people have. But Villagetinker's post is the only one that's clear as a bell!

Please contact SHINE, State of FL Department of Elder Affairs, website: SHINE - Home
SHINE Program
or
Department of Elder Affairs
4040 Esplanade Way, Suite 270 Tallahassee, FL 32399-7000
Toll Free 1-800-96-ELDER
1-800-963-5337
TDD/TTY 1-800-955-8770
Fax 850-414-2150
Email information@elderaffairs.org

or go to one of the local meetings, see the Rec NEWS for time and locations. They will give you the straight scoop on this, and YES The villages Health care is placing limits on the carriers they accept.
Hope this helps.