[Indydealmaker]

Originally Posted by Aces4

Read the attached information regarding Medicare Advantage please. I believe The Villages is looking out for The Villages and it is not a benefactor for the citizenry's medical care.

OMG! A business operating for profit!

[Rwirish]

Surprised, shocked, why?

Medicare Advantage hands down IMO. Never had a issue, don’t need referrals and access to providers has been great.

[elle123]

Originally Posted by GreggC69

What do you think the breakdown is for The Villages on Medicare between the two options? Most I talk with are on the advantage plan; I have spoken to very few on traditional Medicare. I have been surprised by that.

Also, I was shocked that The Villages Health Centers only accept Medicare Advantage and not traditional Medicare. Is that because the reimbursement for physician services is that much different between the two options?

In "Newspeak" the term "Advantage" actually means "Disadvantage.

[bobeaston]

Originally Posted by retiredguy123

Personally, I think that The Villages health care facilities do not accept original Medicare because they want to make them more accessible to Villagers. If they accepted original Medicare, they would be required by law to accept all original Medicare patients from the surrounding areas, and they would soon become overcrowded with non-Villagers. These facilities were constructed within The Villages to be convenient to Villagers, not non-Villagers. Otherwise, what is the point of using Villages property to operate health care facilities within The Villages? My opinion.

Wrong! It is not discrimination for / against The Villages residents. Some time ago, I learned from one of The Villages Health leaders, who was part of the original planning, that it was ALL ABOUT the cost structures of what practitioners are paid for Medicare Advantage patients. That cost structure was a key component of recruiting the professionals needed to make the business successful.

[rsmurano]

The advantage plans are terrible, ran by insurance companies, and almost 70% of the time will refuse medical procedures that your Dr wants to do. Don’t believe me, call an advantage plan provider and ask them if they can deny service. I have, they all say yes, and then google advantage plans denial rates, why congress has been looking into this. Medicare will never refuse a Dr for doing a procedure, but insurance companies do this 70% of the time because this is how they make money. While you are googling about the advantage plans, query why hospitals are refusing admitting advantage plan clients. Hundreds of hospitals have done this so far and more every month.

Take Medicare and get a supplement plan, a plan g, plan n, plan right when you retire because after this don’t have to accept you. Little known fact: if you go initially with an advantage plan then find out you don’t like it, a supplement plan doesn’t have to accept you, whereas if you initially go with a supplement plan and want to go to advantage plan, no problem.

[Susan1717]

I’ve been on an advantage and love it! Never been turned down for a procedure and I’ve had the same great service here and up north as I’m a snowbird. I also belong to 2 fitness centers in both locations that they pay for from the silver sneakers.

[jimdecastro]

I am an agent for Florida Blue and can explain the various options and can explain TBH policy as well. Look me up on Facebook, when you search my name, you'll see I'm an agent in my profile picture.

[USNA87]

For the TV veterans who have Parts A and B and TriCare for Life, what are your experiences?

[HJBeck]

We are sold on “traditional Medicare” because we can select the top rated specialists for whatever medical issue we may have. Do not like being restricted to specialists in a particular network. We want the freedom to choose.

[sdeikenberry]

Medicare Advantage Plans work because they are supposed to keep patients healthy. In reality, the plan receives a certain amount of money for each person in the plan and it's in the plan's best interest to not spend money on patient's if they avoid it...because the less spent the more profit they make. That said, they are still obligated to provide the necessary health care to a patient, but they aren't obligated to go beyond what is strictly necessary. The main problem with Advantage Plans is you CANNOT choose to go to any facility or doctor you wish UNLESS they are inside the plans network.
We have traditional medicare with an AARP supplemental plan that covers all of our expenses the traditional medicare won't pay. We've had this plan for over 10 years now. So beyond our monthly premiums we pay zero dollars for healthcare. This works for us...we can go anwhere we choose and have any doctor we choose and it's completely covered...no issues.
I am a former healthcare provider and I would never recommend anyone get an Advantage Plan unless they simply cannot afford regular medicare with a supplemental plan attached. You lose too much control of your healthcare...and you are your best advocate...not someone else.

[bowlingal]

Villages healthcare does accept traditional Medicare for it's specialists. It does not accept traditional Medicare for Primary Care docs.

[crash]

Originally Posted by retiredguy123

I understand your opinion. But, if a Villager cannot get an appointment at a Villages health care facility because of overcrowding, what is the point of building health care facilities on Villages property? The developer is trying to create a convenient environment for people who want to buy houses and get convenient health care.

The developer is interested in who will pay the rent and in The Villages that is medical. He just rents the buildings.

The new hospital that was planned south of. 44 got cancelled because they have staffing issues not enough doctors. Instead they are building free standing emergency rooms. There will be a day when we have a medical crisis because too many people for the number of medical facilities.

[TomPerry]

Originally Posted by rsmurano

The advantage plans are terrible, ran by insurance companies, and almost 70% of the time will refuse medical procedures that your Dr wants to do. Don’t believe me, call an advantage plan provider and ask them if they can deny service. I have, they all say yes, and then google advantage plans denial rates, why congress has been looking into this. Medicare will never refuse a Dr for doing a procedure, but insurance companies do this 70% of the time because this is how they make money. While you are googling about the advantage plans, query why hospitals are refusing admitting advantage plan clients. Hundreds of hospitals have done this so far and more every month.

Take Medicare and get a supplement plan, a plan g, plan n, plan right when you retire because after this don’t have to accept you. Little known fact: if you go initially with an advantage plan then find out you don’t like it, a supplement plan doesn’t have to accept you, whereas if you initially go with a supplement plan and want to go to advantage plan, no problem.

People complain about The Villages Advantage Plan and Advantage Plans in general, but we have had great experiences after switching when we moved to TV! I had heartburn while on my morning walking, went to my PCP at Colony and ended up with a triple bypass. Got an EKG, stress test, heart Catherization then a triple bypass. From initial PCP visit to triple bypass, 17 days! After giving myself 15,000 - 20,000 injections over my life, now down to ONE injection per week, off insulin and A1C is 5.7 - 6.0! My wife has had severe back issues, received back surgery and has NO back issues since! We travel back to Massachusetts every summer and have no issues seeing out former doctors if and when needed. Complain all you want, but you can’t prove it by us!

[Ptmcbriz]

It’s about attracting top talent. Medicare payments won’t make a doctor enough money to want to live here for very long. Private Medicare insurance (Advanrage) does pay a lot more. I have Anthem and have loved it. I was in the hospital for 5 days and I paid out of pocket $100 for the entire stay. Medicare is known for not paying much.

[rustyp]

Originally Posted by GreggC69

What do you think the breakdown is for The Villages on Medicare between the two options? Most I talk with are on the advantage plan; I have spoken to very few on traditional Medicare. I have been surprised by that.

Also, I was shocked that The Villages Health Centers only accept Medicare Advantage and not traditional Medicare. Is that because the reimbursement for physician services is that much different between the two options?

In 2024, 32.8 million people are enrolled in a Medicare Advantage plan, accounting for more than half, or 54 percent of Medicare eligible participants.