Talk of The Villages Florida

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-   -   Medicare Supplement (https://www.talkofthevillages.com/forums/medical-health-discussion-94/medicare-supplement-303342/)

rustyp 03-02-2020 07:12 AM

Quote:

Originally Posted by ankeny (Post 1723350)
I did a lot of research of Medicare before I turned 65. As part of my research I contact Florida SHINE as they provided unbiased information. The choice you make is very important and should not be made until you understand all the options and decide what options will work best for you now and in the future.

Remember what works great for one person may not be right for you.

Good Luck

I also went to SHINE as one of my resources. They were excellent. Explanations at the layman's level and unbiased. If possible try to avoid going at enrollment time. They get very busy then and usually need to limit sessions to a time limit.

Singerlady 03-02-2020 07:20 AM

Also make sure you understand TV Regional Medicare Advantage Plan...it’s regional.

retiredguy123 03-02-2020 07:21 AM

Regarding pre-existing conditions, this is what the HHS.gov website says:

"Pre-Existing Conditions - Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. These rules went into effect for plan years beginning on or after January 1, 2014."

Dan9871 03-02-2020 07:35 AM

We've been in the Villages Health Care for the last seven years. It's the best health care system we've ever been in. We've also had a lot of first hand experience with Villages Hospital, which is not part of Villages Health, and are totally satisfied with the care they have provided.

Villages Health does require you to be in a United Health or Florida Blue Advantage plan. That might not work our for you. Keep in mind that by law any Advantage plan has to cover all the services that regular Medicare does.

MinPin 03-02-2020 08:17 AM

What happens if you get sick out of state and you are on an Advantage Plan? My understanding is they only cover in FL and certain facilities.

WindyCityzen 03-02-2020 09:05 AM

Do you think that will change when UF takes over VHS? I suspect so. I got Medicare Plan F - a bit pricier but the most comprehensive.

rustyp 03-02-2020 09:12 AM

Quote:

Originally Posted by MinPin (Post 1723391)
What happens if you get sick out of state and you are on an Advantage Plan? My understanding is they only cover in FL and certain facilities.

Each plan is different that is why there are so many myths about this subject out there. For example this year I chose UHC AARP Medicare Advantage which is one of The Villages accepted plans for 2020. This plan basically covers the entire US "UHC" system as in network. Last few years I had the UHC Passport Plan in which you had to make a phone call when you were traveling out of the area to the new area to get in network coverage within the UHC system. This plan did have a downfall of many mid western states were not in it. The new plan I got this year has much larger area of coverage with no phone call required.

gatorbill1 03-02-2020 09:37 AM

There are a lot of good doctors here - may not be with Villages Health - don't just go with them, they are no better than any others here.

Nucky 03-02-2020 10:10 AM

Quote:

Originally Posted by MinPin (Post 1723391)
What happens if you get sick out of state and you are on an Advantage Plan? My understanding is they only cover in FL and certain facilities.

I always call United Healthcare before each trip up north to be certain that the policies that were in place on the previous trip have not changed. I suggest you do the same and never assume that things stayed the same as the last trip you took.

I am covered on the trip and when we get to Jersey. We just change the zip code in the Doctor Finder and then call to confirm that the Doctor we select is still active with United Healthcare because they may show that they are in Network and actually it may not be the case. Sometimes the Doctor may drop off the Network and the info on the computer is not updated quickly. Finding out anything from UHC is a pleasure, not a hassle but dot the I's & cross the T's. I tape the calls and get names and save all information.

Its a Good feeling to have such Great Insurance. :pray:

dougjb 03-02-2020 01:01 PM

SHINE is an amazing organization! The volunteers who work there are incredibly knowledgeable. When I became eligible for Medicare, I do not believe they gave me a single incorrect statement. They have meetings in various rec centers and will spend as much time with you as you need.

Just food for thought, if you take a Part C plan, you can switch back to using a supplemental plan BUT you will be subject to underwriting and you are not guaranteed acceptance (the Affordable Care Act did not change this aspect of Medicare).

Also, be aware that premiums for a supplmental plan are based on where you live. If you receive Social Security, the address used by that organization IS your address. But, if you do not receive Social Security, then SS does not know where you live. You can sign my for a plan in any place that you have a connection...such as a winter home or summer home or temporary home. That will be the locus for your supplemental plan for the rest of your live...even if you move. Since supplemental plans (defined by the various letters) is the same wherever you live in the country, you might consider taking out a supplemental plan from the cheapest location. But, do note, supplemental plan premiums do go up from time to time.

Use SHINE, it is the single best source for walking through this mine field!

LuvtheVillages 03-02-2020 04:43 PM

Quote:

Originally Posted by WindyCityzen (Post 1723409)
Do you think that will change when UF takes over VHS? I suspect so. I got Medicare Plan F - a bit pricier but the most comprehensive.

UF is not taking over Villages Health. They purchased The Villages Hospital and Leesburg Hospital.

The VHS clinics are a separate entity, and were not in that deal.

Dan9871 03-02-2020 08:50 PM

Quote:

Originally Posted by MinPin (Post 1723391)
What happens if you get sick out of state and you are on an Advantage Plan? My understanding is they only cover in FL and certain facilities.

It depends on your plan. The United Healthcare Advantage covers emergency services worldwide. United Health also has Passport that lets you switch to any other UHC network for regular medical services. Note that regular Medicare provides no coverage, not even emergency, outside of the US.

Also the UHC network is pretty extensive in FL, though it doesn't cover all providers.

But, as always, check the plan to see what the coverage is. Almost all Advantage Plans, not just UHC, cover things that regular Medicare doesn't.

Tankerrich 03-08-2020 11:19 AM

Does anyone have info about Medicare Advantage (Part C) with Tricare for Life? I was told that there are no copays and I would get extra benefits like Dental, Vision, OTC & Gym with no increase in cost. Also, my Part B would go down $50. This would be a no brainier, so what's the catch? Any retired veterans out there that might shed some light on this?

Dan9871 03-08-2020 02:04 PM

Quote:

Originally Posted by Tankerrich (Post 1725372)
I was Any retired veterans out there that might shed some light on this?

A couple of our neighbors who are veterans are using Advantage.

But check with Shine SHINE - Sumter
and check with Villages Health The Villages Health

LuvtheVillages 03-08-2020 03:59 PM

Quote:

Originally Posted by Tankerrich (Post 1725372)
Does anyone have info about Medicare Advantage (Part C) with Tricare for Life? I was told that there are no copays and I would get extra benefits like Dental, Vision, OTC & Gym with no increase in cost. Also, my Part B would go down $50. This would be a no brainier, so what's the catch? Any retired veterans out there that might shed some light on this?

With traditional Medicare and TFL, there already are no co-pays, so there is no difference.

Ask which providers are included in the dental and vision. Then look up their reputation. Is there an annual $ limit? Dental coverage here is very tricky, and most (all?) dentists do not take insurance. You have to submit the claim yourself. Usually the dentists charge more than the reimbursement amount.

I have no experience with vision coverage.

Also be aware that you will have to file claims with Express Scripts. It will no longer be automatic because you will have Other Health Insurance, and Tricare insists on being the last to pay.

Also be aware that if you decide to return to traditional Medicare, you may be subject to underwriting and perhaps increased premiums.


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