Talk of The Villages Florida

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-   Medical and Health Discussion (https://www.talkofthevillages.com/forums/medical-health-discussion-94/)
-   -   Medicare Advantage vs Medicare plus supplement (https://www.talkofthevillages.com/forums/medical-health-discussion-94/medicare-advantage-vs-medicare-plus-supplement-167025/)

OCsun 10-20-2015 06:10 PM

Quote:

Originally Posted by Shadow8IA (Post 1132673)
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.

I stand corrected. You are right. If for some reason you must make a change because your insurer is no longer offering an advantage plan or if you move and your advantage plain is not available, you can switch to regular Medicare and apply for supplemental without underwriting requirements.

Carla B 10-20-2015 09:18 PM

Quote:

Originally Posted by Medtrans (Post 1132323)
What were the 6 questions or type of questions?

When I tried to think of the AARP/UHC questions we had to answer satisfactorily to be accepted for supplemental insurance I didn't remember all of them so had to do some research. It turns out there were more than six. They all required a "NO" answer. Apart from the usual tobacco use question, I think there may have been weight qualifications also. Any "Yes" answer to the following meant automatic denial:

End Stage Renal disease?
Dialysis is required?
Admitted to a hospital within the past 90 days?
Within the past two years has a medical professional recommended or discussed as a treatment option any of the following that has not been completed:
Hospital admittance as an inpatient
Organ transplant
Back or spine surgery
Joint replacement
Surgery for cancer
Heart surgery
Vascular surgery.

These were AARP/UHC questions. In trying to find these online I came across Gerber Co.s' questions and they seem to be much more stringent. Apparently, each insurer can set their own underwriting guidelines within each state's regulations. I was curious about Gerber & asked for a quote. It was more expensive than the AARP plan.

Some years after turning 65 we voluntarily gave up my husband's employer insurance (in another state) to get AARP Supplemental, as few of our providers here were in network. We always ended up with a balance to pay. If our insurance had terminated us or gone insolvent, we would have been guaranteed enrollment without medical underwriting but we voluntarily left (and cannot return) so it required much thought.

A person enrolling in a Medigap plan within 6 months of turning 65 is guaranteed acceptance, no matter what their health. Same if their Advantage plan becomes insolvent or terminates them. There are complicated rules to follow in other situations, such as moving from Advantage to Supplemental plans.

Of course, the negative thing is the cost of the premium, especially if you join late and the added cost of getting Medicare Rx. On the other hand, we've had absolutely 0 copays since enrolling. We can choose any provider in the U.S. who accepts Medicare. As long as we can afford it, we plan to keep Medigap.

Medigap subscribers and the government have been forced to subsidize Advantage plans for years. The government is trying to wean Advantage plans off the dole and bring the costs more in line with Original Medicare + supplement; that is why copays are getting larger for Advantage plans. IMHO it's the right thing to do.

gomoho 10-21-2015 08:52 AM

So I wonder if the government does away with Advantage Plans if people will go on supplemnts without the penalty?

gomoho 10-21-2015 03:45 PM

Quote:

Originally Posted by dstege (Post 1133106)
I am an independent agent here in The Villages. 0 , For those of you concerned that you won't have enough doctors to choose from in the UHC Medicare Advantage HMO plans, consider the 9,000 Primary Care doctors, and 24,000 specialists you can see in the state of Florida! !

Do I understand you correctly that you can go to any of those 9,000 Primary Care doctors and 24,000 specialists in the state of Florida with an UHC Medicare Advantage HMO plan? You don't have to stay in your network?

looneycat 10-27-2015 12:07 PM

Quote:

Originally Posted by gomoho (Post 1133156)
Do I understand you correctly that you can go to any of those 9,000 Primary Care doctors and 24,000 specialists in the state of Florida with an UHC Medicare Advantage HMO plan? You don't have to stay in your network?

any dr. that accepts medicare is the network!

kofficer 11-02-2015 04:18 AM

The other thing is, as I understand it, you only have a small window when you first set these things up to get a Medicare Supplement. It is not necessarily available to you again if you don't get it to start with, and if you drop a Supplement, you won't get it back. I found a nice one if you are looking to have a Supplement and don't want to pay for Plan F, take a look at Plan L, it has a ceiling of 2600 a year, and although it says it covers 75%, it covers 75% of the 20% left after Medicare pays, so if you had a $100 bill, medicare pays 80 and the supplemental insurance pays $15 and you pay $5. I see both a cardiologist (which does not take Advantage Plan members any more), and a neurologist, and an endocrinologist (diabetes). I pay my Cardiologist $11 a visit. It's worked out well for me. I don't like changing my doctors. This plan costs me $108 a month, much more cost effective than Plan F.

jblum315 11-02-2015 07:07 AM

I switched from a UHC supplement plan to Advantage 2 years ago. I regretted it right away when I found I had to give my own doctor a copay. Also worried that if I became ill away from home I wouldn't be able to find a doctor that accepted Advantage.
Switching back to UHC sipplemrentv wasn't easy and it was several months beforebthevswitch was completed

Villageswimmer 11-02-2015 07:38 AM

I would encourage anyone with questions to visit one of the SHINE counseling sessions at various rec centers.

I stopped by Eisenhower Friday afternoon. The volunteer counsellors are well trained and have resources to answer questions at their fingertips. My questions were answered.

Well meaning folks on TOTV can give incorrect info and/or communication may be misinterpreted.

Consult the SHINE experts for help in making what is a very important decision. This service is free.

Avista 11-02-2015 07:51 AM

We visited the United Medicare store last week. Have had the Villages Advantage plan, but wanted to review it and see what changes were available for 2016.
Continues to be no copayment for pcp. $30 co pay for specialists. And very happy to hear zero co pay for medications that areTier 1 and Tier 2.

Using their passport services I could have planned surgery near my daughter in NC If I wanted to.(would use docs who accept United). Not planning to do this, but asked a theoretical question.

We are glad we set up an appointment to ask questions. So much false info around.

dave from deland 11-02-2015 08:27 AM

Quote:

Originally Posted by wendyquat (Post 1131212)
Since this is open enrollment and since it seems we are being pressured to obtain UHC Medicare Advantage, I'd like to hear personal experiences with the UHC Medicare Advantage Plan in the Villages. We have had Medicare plus a UHC supplement for 6 years and have been very pleased. When we looked into changing to a UHC Advantage Plan a couple of years ago I was disappointed to find that my cardiologist had just been dropped from participating in the plan and that doctors could be dropped or withdraw at any time. I also thought it strange that none of the UHC agents I talked to could tell me if I might be able to switch back to regular Medicare (without penalty for pre-existing conditions) should I not be pleased with the Advantage plan. Thanks for sharing!

I have had Humana Plan F since I hit Medicare age. No co-pays, no deductible and a Silver Sneakers plan. They will pay the entire difference that Medicare doesn't pay. They will pay for any doctor that accepts Medicare. No preexisting conditions restrictions.

pjeffrey 11-02-2015 08:57 AM

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.

Avista 11-02-2015 09:01 AM

Quote:

Originally Posted by dave from deland (Post 1139100)
I have had Humana Plan F since I hit Medicare age. No co-pays, no deductible and a Silver Sneakers plan. They will pay the entire difference that Medicare doesn't pay. They will pay for any doctor that accepts Medicare. No preexisting conditions restrictions.

Do you pay a Premium?

deemelvin1@gmail.com 11-02-2015 09:05 AM

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.

champion6 11-02-2015 09:27 AM

Quote:

Originally Posted by deemelvin1@gmail.com (Post 1139133)
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.

Bada15 11-02-2015 11:27 AM

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.


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