[biker1]

Yes, the Medicare Part B varies with income but the poster seemed to indicate that $144.80 was the amount he would be paying.

Originally Posted by retiredguy123

With Option 1, you would need to add the cost for a prescription drug plan, which is Part D. Option 2 would usually include prescription drugs.

Also, the $144.80 cost is not for everyone. It is based on income and many people pay a lot more than that.

[Pedrocarrasco01@yahoo.com]

Originally Posted by biker1

Are you saying that you had zero cost for the surgeries or you had zero cost because you had hit your out-of-pocket maximum prior to the surgery? The reason I ask is that Medicare Advantage Plans typically have pretty high out-of-pocket maximums (say around $6K).

Hospital is $250 regardless of days there that is all. Emergency Room is $90, Regular Dr copay is $5, Specialist is $35 those are the copays, never had to pay any more than that (wife stayed 8 days in hospital), I am EXTREMELY happy to the point that I am not even considering anything else, I had United Health Care for 2 years for wife and I $400 per month and we still had copays one of my great mistakes, changed to Humana after that plus we get over the counter meds Free, we order them from Humana

[Pedrocarrasco01@yahoo.com]

Originally Posted by biker1

I was essentially asking him if he paid out-of-pocket expenses. Here is his statement:

Recommend it highly, had two surgeries at U of F in Gainesville (wanted the best Dr.) and wife had one at Advent in Orlando (again the best Dr, recommended by our MD) no issues, all hospitals here accept it as payment in full,

By "payment in full", I assumed he meant that the hospitals accepted his Medicare Advantage Insurance as payment in full (i.e. no additional cost). I don't believe this has anything to do with his premiums.

Payment in full is just that, I paid only my copay which hospital was $250.00
With my plan Hospital copay is $250, Specialist is $35, regular MD. Is $5, THAT IS ALL PROVIDING YOUR HOSPITAL IS A HUMANA APPROVED FACILITY (all hospitals here in The Villages, Leesburg, Ocala or Gainesville are approved)

[jojo]

My mother had HUMANA which I think was a PPO. Worked fine for doctors but was disastrous for rehab. They only approved the absolutely worst two facilities in The Villages. I could write a book about her stay.

[Quixote]

Message accidentally erased; will repost.

[Quixote]

Originally Posted by biker1

Are you saying that you had zero cost for the surgeries or you had zero cost because you had hit your out-of-pocket maximum prior to the surgery? The reason I ask is that Medicare Advantage Plans typically have pretty high out-of-pocket maximums (say around $6K).

We have both unfortunately have had the need for extensive medical care. With original Medicare and United HealthCare (not to be confused with a United HealthCare Advantage plan), ALL our medical costs are covered IN FULL—no deductibles, no co-pays, no out-of-pocket costs. ZERO.

However, we are paying premiums for this coverage. In addition, we pay for Medicare Part D Prescription Drug coverage, as it’s a great program—for the insurance and pharmaceutical drug industries—not especially for many (most?j seniors. For those with high prescription drug costs, check out the GoodRx app and pharmacy checker . com.

A we’ve heard too many horror stories of seniors who in good health switched to an Advantage plan because it APPEARED to be a,good deal. However, once the inevitable health problems showed up, they discovered (1) how much was NOT covered, and (2) the virtual impossibility of switching back.

All we can suggest is to exercise due diligence. As pointed out by another poster, you get what you pay for....

[Quixote]

Originally Posted by Quixote

We have both unfortunately have had the need for extensive medical care. With original Medicare and United HealthCare (not to be confused with a United HealthCare Advantage plan), ALL our medical costs are covered IN FULL—no deductibles, no co-pays, no out-of-pocket costs. ZERO.

However, we are paying premiums for this coverage. In addition, we pay for Medicare Part D Prescription Drug coverage, as it’s a great program—for the insurance and pharmaceutical drug industries—not especially for many (most?j seniors. For those with high prescription drug costs, check out the GoodRx app and pharmacy checker . com.

We’ve heard too many horror stories of seniors who in good health switched to an Advantage plan because it APPEARED to be a,good deal. However, once the inevitable health problems showed up, they discovered (1) how much was NOT covered, and (2) the virtual impossibility of switching back.

All we can suggest is to exercise due diligence. As pointed out by another poster, you get what you pay for....

I have no idea why my post is repeating as a quote. I must have done something wrong, sorry.

[newgirl]

I have had it since day 1 and never any issues at all. I have a disability and love it only costs $10. to see a specialist.

[kimgarwel12@gmail.com]

We have Humana Choice PPO and yesterday I was refused an appt to get established with a primary Dr because she recently stopped taking patients with Humana Choice, but still takes Humana Advantage. My insurance agent says legally she can't deny services if she accepts Medicare at all. He's checking into this for us, but it definitely has me concerned!

[retiredguy123]

Originally Posted by kimgarwel12@gmail.com

We have Humana Choice PPO and yesterday I was refused an appt to get established with a primary Dr because she recently stopped taking patients with Humana Choice, but still takes Humana Advantage. My insurance agent says legally she can't deny services if she accepts Medicare at all. He's checking into this for us, but it definitely has me concerned!

Your insurance agent is wrong.

[Stu from NYC]

Originally Posted by kimgarwel12@gmail.com

We have Humana Choice PPO and yesterday I was refused an appt to get established with a primary Dr because she recently stopped taking patients with Humana Choice, but still takes Humana Advantage. My insurance agent says legally she can't deny services if she accepts Medicare at all. He's checking into this for us, but it definitely has me concerned!

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.

[BAT777]

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.

[Mrprez]

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.

[Mrprez]

Originally Posted by BAT777

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.

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.

[TSO/ISPF]

Originally Posted by biker1

Yes, the Medicare Part B varies with income but the poster seemed to indicate that $144.80 was the amount he would be paying.

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.