Talk of The Villages Florida - Should I switch from Medicare Advantage to regular Medicare?

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- Medical and Health Discussion (https://www.talkofthevillages.com/forums/medical-health-discussion-94/)

- - Should I switch from Medicare Advantage to regular Medicare? (https://www.talkofthevillages.com/forums/medical-health-discussion-94/should-i-switch-medicare-advantage-regular-medicare-353203/)

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Originally Posted by Rainger99 (Post 2373016)

I don’t need a referral to see a specialist in my UHC advantage plan.

And when I was working and before I had Medicare, I had to get a referral to see a specialist. It wasn’t a problem. My primary care doctor would always refer me.

I believe Medicare Advantage is the pathway for private insurers to take over and Medicare itself to disappear. All the goodies were thrown in there for seniors to be enticed into the Advantage Plan and then slowly be taken away.

A friend went to the ER after suffering chest pain and it was determined he needed stents and the surgery was scheduled. Imagine his surprise when he received notice that upon further examination of his test results, they think medication should work. Yikes! Yes, he has Medicare Advantage and it's not impressive to us. You have to make your own decision.

CNN has an article from October 14th, 2024 regarding the changes coming to Medicare Advantage as open enrollment starts. And it begins...

There's no right or wrong. We were on the same UHC MA plan for 24 in Indiana. But since we moved here we switched to The Villages UHC MA plan yesterday. Before you make a decision, make an appointment with a insurance agent that is with UHC and check out their Medical facilities.

Quote:

Originally Posted by Rainger99 (Post 2379625)

I agree that it is smaller. However, UHC has over 1.3 million physicians and care professionals nationwide. I am not limited to Sumter County or even Florida.

Exactly. We're on UHC Advantage and have had no trouble finding good doctor and specialists that take it.

Quote:

Originally Posted by Aces4 (Post 2379690)

MA plans differ greatly. We know, we did lots of research before we chose UHC. We just renewed with The Villages UHC Advantage plan.
They have their own doctors and facilities and only take advantage plans, no medicare. But we're also free to go to any provider in the nationwide UHC network if we choose. Plenty of good doctors, specialists and hospitals take UHC.

Plus we have $2500 in dental and $300 in vision benifits, which we use. We also like the wellness benefits. Since we're very fit and take care of ourselves, the free gym membership is something we really like. Genesis gym at Brownwood is an excellent, top notch gym. My wife takes 2 classes a day there.

And yes our plan did change, for 2025 we both get back $16 a month on our SS check. Other than that very minor changes.
Anyone looking at MA plans should do their research. Check ratings, talk to SHINE and try to talk to people on the plan if possible.

Btw, SHINE said it was a very good option

If you care about your health and ability to get the services and care you might need and can afford the extra cost then definitely YES!

The really big elephant in the room is that you are making decisions now, based upon what the choices are now, and the conditions now, but they will change. Just because someplace like Moffit takes my UHC Advantage plan NOW, doesn't mean they'll take it in 3 years,. Likewise, however, with the Supplemental plans. That is also a shifting landscape.

Quote:

Originally Posted by Rainger99 (Post 2373252)

As far as I can tell, you can switch if you are in reasonably good health.

I called a company that sells medigap. He said plan G and plan N are the two most popular medigap policies. N is quite a bit cheaper than G. As far as I can tell, the main difference is that G does not have a copay when you visit the doctor but N does have a copay.

He said I could get G for about $205 a month and N for about $152. Drugs are about $75 a month.

I also asked him about the difficulty in switching from advantage to Medicare. He said it is pretty easy unless you have significant pre-existing conditions such as dialysis, severe heart problems, diabetes, or advanced cancer. He estimated 95% are approved.

I think you may be right about it being easy to switch when you are in fairly good health. However, the Medicare Supplement Plans differ in cost depending on which one you choose.
I am currently in Plan G with Florida Blue & it is $221, but my Plan D drug premium is zero dollars a month, so about $58 less than you were told. I chose those plans. There are MediGap Plan G High Deductibles with premiums ranging from $52 - $97 (this is Sumter County). You can look through your options at the Medicare.Gov website. You do not have to belong to look through the options. Choose to 'continue without logging in'. Find a Medicare plan

(One of the reasons I liked the Florida Blue plan was it is one of the ones that say they will not raise premiums as we age. I also agree with the advice of one of the earlier respondents: marry the supplement, date the drug plan. Pick a good plan for life, but review drug plans each year to meet your potentially changing needs).

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Originally Posted by mrf6969 (Post 2379582)

Reading through the comments here, I have not seen any comments about doctor choice. We choose Medicare Supplement over Advantage because we are not locked into just a pool of doctors. We can go to any doctor, anywhere in the country. Love that freedom.

Can you use the doctors at the Villages Health??

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Originally Posted by Dotneko (Post 2381384)

Can you use the doctors at the Villages Health??

No, they can’t see a PCP. Specialists only.

Quote:

Originally Posted by Dotneko (Post 2381384)

Can you use the doctors at the Villages Health??

Currently if you have Medicare + Medigap you can see specialist doctors at Villages Health.