When we moved here the DR recommended to us would not take the Humana plan we had been taking but would accept Humana Gold. We do have to get referrals thru our Doc but very happy with the suggested referrals.

And $ 10 co pay for specialists is very welcome. You might want to consider going to this.

Still no idea why Humana would close their office here.

Which one pays for CT scans and other tests? We just had to pay 85 dollars for a scan. We have United Healthcare the Villages plan but seem to be paying quite a bit in addition to the monthly. :(

My wife was in the hospital for two nights. Total charges billed was just under $16,000 which was covered 100% by Medicare and FEPBlue. Some of the charges were outrageous! $3884 for the X-ray tech to do a CT scan? He made more than the doctor who saw her in the ER.

According to the webpage, CT copays are $85 for your plan. I would get off that plan as it is not rated very highly.

2021 UnitedHealthcare The Villages Medicare Advantage (HMO) H1045-025 By UnitedHealthcare.

The max income for a married couple filing jointly is 176K a year. If your making more than that after retirement taxable, more power to you and what the heck are you doing in a low rent retirement community? Just kidding. They call it irma(income related monthly adjustments)! In 2021 the
max adjustment makes part b 504.90 a month for income over 750K. It also raises your cost for Part
D.

I understand the concept of progressive tax rates based on income. But, Medicare Part B is a product that has different prices for the same thing based on income. It's like buying a television at Best Buy and paying more because you have a higher income. I don't think many people would accept that idea.

Unfortunately, I think this is a lousy place for young primary care doctors to open a business...
Most of their billing is Medicare, which pays less than traditional insurance.
If they want to see professional sports or culture, they have to drive to either Orlando or Tampa. Or... they live in Orlando or Tampa and drive over an hour to get to work each day.
The selection of good restaurants and shopping is poor.
If they have children, they can't send them to the Charter School.
They'll have a hard time finding competent workers.

Why do you think The Villages Health pays their primary physicians a salary and caps the number of patients they have? They have to attract physicians to a retirement community. I know of at least 1 physician in TVH who stays here because he is so impressed with the Charter School.

great video on Medicare plans
 

I just watched a really good video on Medicare choices.

🔥2021 Medicare Plans CAUTION - Urgent Updates - YouTube

I watched. Very biased toward supplement plans. Look at footage around 16 minute mark. He is explaining most advantage plans pay 80% of chemotherapy. He explains how expensive this could get. AND then in almost a whisper he says up to OOP (out of pocket) cost which for most advantage plans is somewhere between $3000 - $7000 per year.

Also so much talk about Doctors not in network. We have United Healthcare PPO (The Villages Healthcare plan). They have a published list by state what docs and facilities take the plan. Unfortunately we used the plan heavily this year and mostly out of Florida. We have bills from over 50 docs and facilities. 100% was in network even the ambulance. The plan has a $5900 OOP stop and that is what we paid and our share indeed did stop.

I like another poster here suggest you go to SHINE (an independent organization) for help selecting a type of plan that fits you and even more important a non biased education on the facts.

I worked with a shine rep in the villages. They run the numbers and explain the details but try to
avoid offering too much advice. If you can afford the supplement plans, it's the
way to go IMHO. It's unfortunate they locked up all the Villages health care clinic's primary care doctors.
I don't understand that but there must be a reason. Any guesses? I did see the post about attracting
doctors.

Looks like three points here
1 - Shine is independent and won't make the decision for you. It's an educational process. That's the beauty of them. If you went to a Ford dealer and asked what car is best for me guess what the response would be.
2 - I do disagree with your statement if you can afford supplemental plan it's the way to go. Maybe perfect plan for you but everybody's circumstance is different. From what drugs one takes to are you a snowbird to who and where you want your primary, etc.
3 - The reason why they locked up all The Villages health care clinics and primary doctors. The doctors work for The Villages. They are paid a salary. The Villages decides what is the best way to run their facility. One would guess one limit the amount of paperwork involved on their part while maximizing their ability to negotiate plan particulars is one motive.

One thing that is good is that no matter what plan you sign up for, you can always change plans every year if your situation changes.

Answer to point #2.
 

[QUOTE=rustyp;1863274]Looks like three points here

2 - I do disagree with your statement if you can afford supplemental plan it's the way to go. Maybe perfect plan for you but everybody's circumstance is different. From what drugs one takes to are you a snowbird to who and where you want your primary, etc.


The many part B supplemental plans give you the most freedom to choose which doctors and the part D plans which drug plans based on your needs. The advantage plans limit your choices and make being a snowbird more difficult. After your first year on Medicare, you get
pretty locked into using the advantage plans. The "medical underwriting" aspect of moving from an advantage plan back to original Medicare with supplemental plan scares me.

That should only be an issue if you were in poor health. As long as you don’t have any serious health problems leaving MA for Medigap shouldn’t be an issue.

It would be best to call your ins provider to see how many Drs accept your insurance in the zip codes around here. We have UHC Advantage and many, many Drs accept it.

I don't know what the future holds for me health wise. Odds are, if you live long enough you are going to
have issues and once you sign up for advantage plans it can be difficult to move back to Original Medicare at least according to the things I have seen. After the first year on a plan I believe you would have to wait until open enrollment to switch back and if you needed to see a doctor outside your plan, Well that's when you better know your out of pocket Max spend outside the network. That's just my 2 cents.
Everyone is free to make their own decision.

There have been Medicare reimbursement cutbacks; however, practitioners have told me time and again that they are grateful when a patient is covered by Medicare. A physical therapist told me that one private insurance company paid him $2 per session! Is that believable?...

[QUOTE=heims01;1863287]I agree completely. I’ve heard hair-raising stories of people desperately trying—at times unsuccessfully—to return to original Medicare when they inevitably developed some medical issue if they lived long enough.


And the reverse—to go from Medicare Advantage back to original Medicare?! Okay, who’s willing to gamble on their health—and possibly their lives?...

Thanks, helpful you tube video

I have had UH plan F for 30 years and it has always met my requirements. One year they talked me into trying an Advantage plan. None of my doctors would accept it. I had to cancel my Plan F in order to get the Advantage thing and it took 4months to get back on it. So look before you leap