[wendyquat]

Originally Posted by rexxfan

I am in a similar situation. What is it exactly about the UHC Medicare Advantage plan that is so unattractive to so many? I've read the plan description and it seems reasonable to me, but I admit to having limited experience in this area as I am fortunate to be in excellent health and rarely need to see a doctor (so far, anyway).
--
Bob C

Medicare Advantage is unattractive to me because I have a heart problem and when I considered switching from my supplement, my cardiologist practice told me that they had been dropped from participating in the UHC advantage plan. It takes a while to create a relationship with a doctor and I did not WANT to jump back on The Villages merry-go-round and seek out a new cardiologist! You are correct about one thing though -- if you are in excellent health, ANY health care plan will be fine!

[Tinkerbelle]

Funny only one person has received a letter like this. Anyone else have one? I did get one that I am grandfathered in.

[Buckeyephan]

I got my letter in November. Was told they had negotiated a new contract with UHC and had to clear out those that didn't fit their requirements. Sort of burns me to read glowing reviews of the Villages Health nearly daily in the paper. A great bait-and-switch for the unsuspecting new home buyers.

[TidalWalkers]

I am in the process of exploring my Medicare options for turning 65 in May. I am a retired Ohio teacher and have received the STRS information and visited the Medicare store RE: United Health Care. Any Ohio retirees have pros or cons on the two options? I have struggled to find a DR I liked with my Ohio medical mutual and would like to return to The Villages health system. I found out today that would have to be part of United Health Care. Any comments from Ohio retirees?

[birdawg]

Originally Posted by Buckeyephan

I got my letter in November. Was told they had negotiated a new contract with UHC and had to clear out those that didn't fit their requirements. Sort of burns me to read glowing reviews of the Villages Health nearly daily in the paper. A great bait-and-switch for the unsuspecting new home buyers.

Very sad that we got them started when they first opened, and now after we have a relationship with our doctors they will be dumping us for a better profit margin. Makes you wonder if this is how we will be treated with the rest of the Morse promises.

[Bonny]

I'm 64 and on Social Security and Tri Care. I'm with the Villages Health system. No problems here so far.
Sorry, I meant to say I'm on Medicare.

[goodtimesintv]

Originally Posted by birdawg

Very sad that we got them started when they first opened, and now after we have a relationship with our doctors they will be dumping us for a better profit margin. Makes you wonder if this is how we will be treated with the rest of the Morse promises.

This is where the elephant in the room is:

From the other thread:

"We are all "invested in" the UHC-AARP bed partnership via the federal bedroom:

"“AARP lobbied for the new health care law and now it stands to profit, lawmakers charged Wednesday as they called for the IRS to investigate whether the powerful interest group deserves to keep its federal tax exemption.

“Three veteran representatives released a report that estimates the seniors lobby could make an additional $1 billion over 10 years on health insurance plans whose sales are expected to pick up under the new law. They also questioned seven-figure compensation for some AARP executives.”

Among the key findings from the Ways & Means Committee report are:

As a result of the new health care law, the Administration estimates more than seven million seniors will lose their current Medicare Advantage plans, resulting in a massive migration of seniors to Medigap plans. AARP is the nation’s leading provider of Medigap plans and has a contract in which AARP financially gains for every additional Medigap enrollee.

Based on low, mid and high-range estimates, AARP stands to financially gain, over and above the millions of dollars they currently receive from United, between $55 million and $166 million in 2014 alone as a result of new Medigap enrollees stemming from the health care law’s cuts to MA, which AARP strongly endorsed.

Under the mid-range estimate and under their current contract, AARP’s financial gain from the health care law could exceed $1 billion during the next 10 years. This is because AARP will see their royalty payments increase as seniors are forced out of MA plans and buy AARP Medigap plans instead.

- See more at: AARP Profits from ACA at the Expense of American Seniors, New Report Shows | Speaker.gov

Other TOTV thread discussing this:

TV Healthcare UHC Medicare Advantage

.

[JoMar]

Originally Posted by goodtimesintv

This is where the elephant in the room is:

From the other thread:

"We are all "invested in" the UHC-AARP bed partnership via the federal bedroom:

"“AARP lobbied for the new health care law and now it stands to profit, lawmakers charged Wednesday as they called for the IRS to investigate whether the powerful interest group deserves to keep its federal tax exemption.

“Three veteran representatives released a report that estimates the seniors lobby could make an additional $1 billion over 10 years on health insurance plans whose sales are expected to pick up under the new law. They also questioned seven-figure compensation for some AARP executives.”

Among the key findings from the Ways & Means Committee report are:

As a result of the new health care law, the Administration estimates more than seven million seniors will lose their current Medicare Advantage plans, resulting in a massive migration of seniors to Medigap plans. AARP is the nation’s leading provider of Medigap plans and has a contract in which AARP financially gains for every additional Medigap enrollee.

Based on low, mid and high-range estimates, AARP stands to financially gain, over and above the millions of dollars they currently receive from United, between $55 million and $166 million in 2014 alone as a result of new Medigap enrollees stemming from the health care law’s cuts to MA, which AARP strongly endorsed.

Under the mid-range estimate and under their current contract, AARP’s financial gain from the health care law could exceed $1 billion during the next 10 years. This is because AARP will see their royalty payments increase as seniors are forced out of MA plans and buy AARP Medigap plans instead.

- See more at: AARP Profits from ACA at the Expense of American Seniors, New Report Shows | Speaker.gov

Other TOTV thread discussing this:

TV Healthcare UHC Medicare Advantage

.

If this offends you make sure you vote in November. Your choices will be to keep the status quo or to change it.

[outlaw]

Originally Posted by Bonny

I'm 64 and on Social Security and Tri Care. I.m with the Villages Health system. No problems here so far.

Wait until you are eligible for medicare. That's the issue here.

[CritterLover]

I was told initially than the plans pay for more of the things that they provide as "standard" care, and Medicare does not, so the issue seems to be whether or not, relative to MY specific health needs, United Healthcare Medicare Advantage will work for ME, and I've found that it will. It's clear that it doesn't work for some, but it feels like lots of folks think that they are the only group of doctors around. I felt no pressure to join the villages health, but that it was one choice. What am I missing?

[outlaw]

Originally Posted by CritterLover

I was told initially than the plans pay for more of the things that they provide as "standard" care, and Medicare does not, so the issue seems to be whether or not, relative to MY specific health needs, United Healthcare Medicare Advantage will work for ME, and I've found that it will. It's clear that it doesn't work for some, but it feels like lots of folks think that they are the only group of doctors around. I felt no pressure to join the villages health, but that it was one choice. What am I missing?

The way these plans work, based on my understanding of them through my own research, is that the government pays the medicare C insurance company a fixed amount of money per year to provide healthcare to you. I think it is around $10,000 per year. You still pay the government your medicare premium each month. The government is not in the business of making a profit. So they probably calculated what the average cost is for a medicare eligible person ($10,000?). Based on that average cost they pay the insurance company a flat fee of $10,000?. The insurance company is in the business to make a profit. So the insurance company wants to be sure that, on average, the customer, you, does not cost $10,000, or even close to $10,000 per year. They can do this by limiting the doctors/specialists you are allowed to see, or they can change your copays, or your deductibles, limit drug choices, etc. Now, on the surface, do you think you're going to get better overall healthcare deal with the profit driven insurance healthcare providing company or the non-profit government medicare system? If you think the insurance company that is paid a flat fee from the government will do a better job in your interest, then go with the insurance company. If not, then you need to look outside TVHC if you are close to 65.

[Avista]

Originally Posted by outlaw

The way these plans work, based on my understanding of them through my own research, is that the government pays the medicare C insurance company a fixed amount of money per year to provide healthcare to you. I think it is around $10,000 per year. You still pay the government your medicare premium each month. The government is not in the business of making a profit. So they probably calculated what the average cost is for a medicare eligible person ($10,000?). Based on that average cost they pay the insurance company a flat fee of $10,000?. The insurance company is in the business to make a profit. So the insurance company wants to be sure that, on average, the customer, you, does not cost $10,000, or even close to $10,000 per year. They can do this by limiting the doctors/specialists you are allowed to see, or they can change your copays, or your deductibles, limit drug choices, etc. Now, on the surface, do you think you're going to get better overall healthcare deal with the profit driven insurance healthcare providing company or the non-profit government medicare system? If you think the insurance company that is paid a flat fee from the government will do a better job in your interest, then go with the insurance company. If not, then you need to look outside TVHC if you are close to 65.

But the thing is Villages Health covers so much more without paying a supplemental to a for profit company. Even our Tier One and Tier Two meds are covered without a copay.

[goodtimesintv]

Originally Posted by outlaw

The way these plans work, based on my understanding of them through my own research, is that the government pays the medicare C insurance company a fixed amount of money per year to provide healthcare to you. I think it is around $10,000 per year. You still pay the government your medicare premium each month. The government is not in the business of making a profit. So they probably calculated what the average cost is for a medicare eligible person ($10,000?). Based on that average cost they pay the insurance company a flat fee of $10,000?. The insurance company is in the business to make a profit. So the insurance company wants to be sure that, on average, the customer, you, does not cost $10,000, or even close to $10,000 per year. They can do this by limiting the doctors/specialists you are allowed to see, or they can change your copays, or your deductibles, limit drug choices, etc. Now, on the surface, do you think you're going to get better overall healthcare deal with the profit driven insurance healthcare providing company or the non-profit government medicare system? If you think the insurance company that is paid a flat fee from the government will do a better job in your interest, then go with the insurance company. If not, then you need to look outside TVHC if you are close to 65.

Well those "profit-driven insurance healthcare companies" are what the "non-profit government" officeholders and employees choose for themselves, and so I would say they "profit" by us taxpayers having to pay for about 70+ percent of their private insurance plan premiums:

https://www.opm.gov/healthcare-insur...postal-hmo.pdf

Florida Plan Choices for Federal Employees:
https://www.opm.gov/healthcare-insur.../2016/state/fl

[golfing eagles]

Originally Posted by outlaw

The way these plans work, based on my understanding of them through my own research, is that the government pays the medicare C insurance company a fixed amount of money per year to provide healthcare to you. I think it is around $10,000 per year. You still pay the government your medicare premium each month. The government is not in the business of making a profit. So they probably calculated what the average cost is for a medicare eligible person ($10,000?). Based on that average cost they pay the insurance company a flat fee of $10,000?. The insurance company is in the business to make a profit. So the insurance company wants to be sure that, on average, the customer, you, does not cost $10,000, or even close to $10,000 per year. They can do this by limiting the doctors/specialists you are allowed to see, or they can change your copays, or your deductibles, limit drug choices, etc. Now, on the surface, do you think you're going to get better overall healthcare deal with the profit driven insurance healthcare providing company or the non-profit government medicare system? If you think the insurance company that is paid a flat fee from the government will do a better job in your interest, then go with the insurance company. If not, then you need to look outside TVHC if you are close to 65.

You forget that government run healthcare is at 34% overhead. Private insurers do it for 12%, and still make a profit. This leaves a lot more dollars to be spent on YOUR health, rather than bureaucrats, gov't waste, and Las Vegas parties.

[NECHFalcon68]

Originally Posted by Bonny

I'm 64 and on Social Security and Tri Care. I.m with the Villages Health system. No problems here so far.

Thats where I am...but turn 65 next week...They told me that as of Jan 1st, I am considered a new patient when I turn 65 (due to Medicare) and required an Advantage plan administered by United Health to stay in the Villages health system. The alternative was to find another Doctor who is in the Tricare system.

The letter stated that "If you choose a different insurance option other than Medciare Advantage, we will help you transition your care from Villages Health."

So I signed up for a PPO plan,no monthly premium, and Tricare for life said they will cover most of the deductible/copays.