[Keninches]

Originally Posted by 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.

This is so true. We were with The Villages Health and were told we had to get out if we didn’t change to Advantage.
There was another point made earlier about the doctors at VH. We were told by someone in the healthcare that the doctors get $1200 month per patient whether you go to them or not. We got out. The other point was both of us went to Moffitt in Tampa and would not be accepted there.
What a Disadvantage, Advantage Plans are. I guess it’s ok if you are not sick and a healthy person.

[bumpa]

I think the error that many make, is they let cost alone guide their decision, and also are short-sighted, looking only at their current health situation, rather than anticipating what that could look like 20 years from now.

Very true, cost is often the decision maker. As someone who has had both a Medicare supplement plan and now a UHC advantage plan I can speak to both the benefits and cost issues. When we retired at 65, 15 years ago, we choose Plan F initially and experienced no issues with the plan or the care we required (very very little). Both my wife and I were quite healthy. Now while we could then and now readily afford the high monthly fee for plan F or G the cost seemed to increase dramatically each year.

We arrived at a point 10 years ago where we were paying about $400 a month for plan F with the prospect that it would go even higher. We were healthy and therefore receiving no benefit from a high priced plan. We than looked at the UHC advantage plan with a total cost of $38 per month. A savings of about $320 a month or $3800 a year. We switched and have had zero issues with the care and coverage. Kept all our doctors, picked up dental and vision coverage in addition.

Now we arrive in 2025 and my wife at 77 has been diagnosed with stage 2 breast cancer, it's 99% curable but there are operations (2) and radiation treatments costing well into the 1000's of dollars. Every test and process has been approved without any delay. The treatment process has been excellent

With UHC we have a max out of pocket per year of $6700 and of course with the expected expense we will hit that figure. However over ten years we have saved more than $38000, all of it tucked safely away, so the figure does not concern me in any way.

In my opinion the choice people make should be based first on the state of their health and the health of their elders and ancestors. As always insurance is a bet for or against yourself.

[Taltarzac725]

Originally Posted by bumpa

Very true, cost is often the decision maker. As someone who has had both a Medicare supplement plan and now a UHC advantage plan I can speak to both the benefits and cost issues. When we retired at 65, 15 years ago, we choose Plan F initially and experienced no issues with the plan or the care we required (very very little). Both my wife and I were quite healthy. Now while we could then and now readily afford the high monthly fee for plan F or G the cost seemed to increase dramatically each year.

We arrived at a point 10 years ago where we were paying about $400 a month for plan F with the prospect that it would go even higher. We were healthy and therefore receiving no benefit from a high priced plan. We than looked at the UHC advantage plan with a total cost of $38 per month. A savings of about $320 a month or $3800 a year. We switched and have had zero issues with the care and coverage. Kept all our doctors, picked up dental and vision coverage in addition.

Now we arrive in 2025 and my wife at 77 has been diagnosed with stage 2 breast cancer, it's 99% curable but there are operations (2) and radiation treatments costing well into the 1000's of dollars. Every test and process has been approved without any delay. The treatment process has been excellent

With UHC we have a max out of pocket per year of $6700 and of course with the expected expense we will hit that figure. However over ten years we have saved more than $38000, all of it tucked safely away, so the figure does not concern me in any way.

In my opinion the choice people make should be based first on the state of their health and the health of their elders and ancestors. As always insurance is a bet for or against yourself.

I applied for the UHC Advantage plan. I needed to make a decision by the end of March.


I will probably be in the Villages for a few more years.

[rustyp]

Originally Posted by Taltarzac725

I applied for the UHC Advantage plan. I needed to make a decision by the end of March.


I will probably be in the Villages for a few more years.

As you pick make sure you understand the difference between a HMO and a PPO advantage plan. Being as young as you are I would start with the UHC PPO. Slightly higher deductibles and out of pocket but much more flexible for nationwide coverage. We have TVH since its inception and are snowbirds. We very much like it. With the PPO we have had no issues in either location. In fact we have two primary docs - one here one and one in our seasonal home. We have not encountered one refusal or out of network yet. Been to hospitals, and specialists in both locations and once on our journey between locations - seamless.

[Taltarzac725]

Originally Posted by rustyp

As you pick make sure you understand the difference between a HMO and a PPO advantage plan. Being as young as you are I would start with the UHC PPO. Slightly higher deductibles and out of pocket but much more flexible for nationwide coverage. We have TVH since its inception and are snowbirds. We very much like it. With the PPO we have had no issues in either location. In fact we have two primary docs - one here one and one in our seasonal home. We have not encountered one refusal or out of network yet. Been to hospitals, and specialists in both locations and once on our journey between locations - seamless.

I might change next year. The Medicare site kind of pushed me towards what I applied for. Not sure if it was the PPO or the HMO. Just went by what they had online. I do not see myself moving for a few years and if I did it probably would be very close to the Villages unless family matters pull me somewhere else.

[Aces4]

Originally Posted by bumpa

Very true, cost is often the decision maker. As someone who has had both a Medicare supplement plan and now a UHC advantage plan I can speak to both the benefits and cost issues. When we retired at 65, 15 years ago, we choose Plan F initially and experienced no issues with the plan or the care we required (very very little). Both my wife and I were quite healthy. Now while we could then and now readily afford the high monthly fee for plan F or G the cost seemed to increase dramatically each year.

We arrived at a point 10 years ago where we were paying about $400 a month for plan F with the prospect that it would go even higher. We were healthy and therefore receiving no benefit from a high priced plan. We than looked at the UHC advantage plan with a total cost of $38 per month. A savings of about $320 a month or $3800 a year. We switched and have had zero issues with the care and coverage. Kept all our doctors, picked up dental and vision coverage in addition.

Now we arrive in 2025 and my wife at 77 has been diagnosed with stage 2 breast cancer, it's 99% curable but there are operations (2) and radiation treatments costing well into the 1000's of dollars. Every test and process has been approved without any delay. The treatment process has been excellent

With UHC we have a max out of pocket per year of $6700 and of course with the expected expense we will hit that figure. However over ten years we have saved more than $38000, all of it tucked safely away, so the figure does not concern me in any way.

In my opinion the choice people make should be based first on the state of their health and the health of their elders and ancestors. As always insurance is a bet for or against yourself.

So in 5 1/2 to 7 years you could be behind the eight ball coverage wise. Nothing like playing a little Russian roulette. BTW, is that out-of-pocket per person or a total for the two of you per year?

[MX rider]

Originally Posted by bumpa

Very true, cost is often the decision maker. As someone who has had both a Medicare supplement plan and now a UHC advantage plan I can speak to both the benefits and cost issues. When we retired at 65, 15 years ago, we choose Plan F initially and experienced no issues with the plan or the care we required (very very little). Both my wife and I were quite healthy. Now while we could then and now readily afford the high monthly fee for plan F or G the cost seemed to increase dramatically each year.

We arrived at a point 10 years ago where we were paying about $400 a month for plan F with the prospect that it would go even higher. We were healthy and therefore receiving no benefit from a high priced plan. We than looked at the UHC advantage plan with a total cost of $38 per month. A savings of about $320 a month or $3800 a year. We switched and have had zero issues with the care and coverage. Kept all our doctors, picked up dental and vision coverage in addition.

Now we arrive in 2025 and my wife at 77 has been diagnosed with stage 2 breast cancer, it's 99% curable but there are operations (2) and radiation treatments costing well into the 1000's of dollars. Every test and process has been approved without any delay. The treatment process has been excellent

With UHC we have a max out of pocket per year of $6700 and of course with the expected expense we will hit that figure. However over ten years we have saved more than $38000, all of it tucked safely away, so the figure does not concern me in any way.

In my opinion the choice people make should be based first on the state of their health and the health of their elders and ancestors. As always insurance is a bet for or against yourself.

Very well said. We're on UHC Advantage and our experience has been excellent as well.

[Taltarzac725]

I am on UHC the Villages Medicare Advantage HMO-POS. They did assign a doctor for me. I have just been using Urgent Care so far but did have Florida Blue.

It will take me a while to figure out how all this works.

[BrianL99]

Originally Posted by bumpa

Very true, cost is often the decision maker.

$38000, all of it tucked safely away, so the figure does not concern me in any way.

Originally Posted by Aces4

So in 5 1/2 to 7 years you could be behind the eight ball coverage wise. Nothing like playing a little Russian roulette. BTW, is that out-of-pocket per person or a total for the two of you per year?

It is almost always about "cost".

In the 1000's of posts about this subject on TOTV and other sites, I have never ONCE heard ...

"Oh, I have a Medicare Advantage Plan", because the health care is soooooo much better".

Cost or convenience is always the driving force.

If you're willing to pay enough to have a Medicare Supplemental, you are in control of your healthcare.

If you want to save a few bucks and go with Medicare Advantage, an Insurance company is in charge of your healthcare.

This is not a complicated or mysterious subject.

[jimbomaybe]

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.

People buy things on the basis of perception to a greater extent than the reality , that one deals with when the devil in the details emerge

[ROCKETMAN]

We have had advantage plans for 15 years and no issues until now. My wife has cataracts both eyes and Freedom had only 1 provider. Unfortunately for cataract surgery you needed a third party approval which we never got. Appointment got cancelled 15 minutes before we got to appointment. Fortunately freedom now has mid Florida eye and finally have appointment for pre surgery. Dr. Panzo has been great to work with.

[MX rider]

Originally Posted by BrianL99

It is almost always about "cost".

In the 1000's of posts about this subject on TOTV and other sites, I have never ONCE heard ...

"Oh, I have a Medicare Advantage Plan", because the health care is soooooo much better".

Cost or convenience is always the driving force.

If you're willing to pay enough to have a Medicare Supplemental, you are in control of your healthcare.

If you want to save a few bucks and go with Medicare Advantage, an Insurance company is in charge of your healthcare.

This is not a complicated or mysterious subject.

Wrong!
You're painting with a broad brush, never a good idea.
For us it was about value not cost.
We chose UHC Advantage because of the overall package that includes vision, dental and the wellness benefits.

Many of us did our homework and chose MA. It works for us. Btw, SHINE said it was a very good option.

Their provider network is nationwide and we were very happy with the in network providers available to us. We're part of The Villages Health and really like it. Now, does every doctor and hospital take UHC MA? No, but many excellent providers do. We know because we checked.

Btw, our out of pocket max is $3700. That's less than the max I had with my insurance when I was working.

[Aces4]

Originally Posted by BrianL99

It is almost always about "cost".

In the 1000's of posts about this subject on TOTV and other sites, I have never ONCE heard ...

"Oh, I have a Medicare Advantage Plan", because the health care is soooooo much better".

Cost or convenience is always the driving force.

If you're willing to pay enough to have a Medicare Supplemental, you are in control of your healthcare.

If you want to save a few bucks and go with Medicare Advantage, an Insurance company is in charge of your healthcare.

This is not a complicated or mysterious subject.

You mean Medicare Advantage is kinda like having all our products come from China, it's cheaper.

[eremite06]

The wife and I were enrolled in UHC with an original Villages Health PCP. When I picked up regular Medicare with a supplement I was thrown out. We now have doctors in the Villages Health Specialty system and no PCP. My wife lost her endocrinologist and two cardiologists. They want to refer her to Citrus or Advent for cardiology. We have no desire to go with Medicare Disadvantage. But it seems as though the Advantage PCP patients are being prioritized and kept in their Speciallty system over us.

[mrsstats]

One of my biggest concerns about moving to the Villages at our ages of 74 and 75 are having medical care. We have Medicare and AARP supplemental insurance now on Long Island. While our health is ok we are starting to deal with age issues. DH will need hip replacement within the next few years. While we love the Villages and know our life would be better there the health issue is a concern.