[Howard Marsh]

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.

[cladamson4]

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?

[dblwyr]

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.

[dblwyr]

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

[Dan9871]

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.

Originally Posted by dblwyr

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.

[villagetinker]

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.

[CFrance]

Originally Posted by villagetinker

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!

[villagetinker]

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.