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-   -   UHC Medicare advantage question (https://www.talkofthevillages.com/forums/medical-health-discussion-94/uhc-medicare-advantage-question-337002/)

MX rider 11-29-2022 06:31 PM

Quote:

Originally Posted by Larchap49 (Post 2161884)
I could be totally wrong but I think it would be rare to get an advantage plan that would give you a good network in two different states. When I looked at an advantage plan after moving here from Pinellas County FL I would not be able to continue going to Moffitt Cancer center because of the change of zip codes.

You are 100% wrong. United Healtcare Medicare advantage plans cover you nationwide. They have a huge network. With their ppo you don't have to stay in network either. You have the option to go outside if needed. Trust me we asked all the right questions. Advantage plans evolve and improve every year.

As I said, there's many choices. Just get what works for you.

Ronandmary1983@gmail.com 11-29-2022 06:54 PM

Quote:

Originally Posted by MX rider (Post 2161145)
Medicare question to those of you on a UHC advantage plan. My wife and I are getting ready to retire in 2023 and have been extensively researching Medicare. We're both healthy and very fit (knock on wood). So we've decided the best plan for us is the AARP UHC advantage. We'll be snowbirding in TV starting next fall. The UHC network here in Indiana includes all the providers we need. So we were wondering how good the UHC network is in the TV and surrounding areas? Thanks in advance.


Be sure you also purchase drug coverage if not through UHC another provider (I went with Aetna). If you pass on drug coverage you pay a penalty on the coverage when you do decide to get it!

MX rider 11-29-2022 07:38 PM

Quote:

Originally Posted by Ronandmary1983@gmail.com (Post 2161898)
Be sure you also purchase drug coverage if not through UHC another provider (I went with Aetna). If you pass on drug coverage you pay a penalty on the coverage when you do decide to get it!

Drug coverage is in the plan we're going with.

manaboutown 11-29-2022 08:19 PM

Every year I receive many offers for Medicare Advantage plans which I throw into the recycle bin in my garage. Someone is trying to sell me something to make money off me. I stick with Medicare and an AARP (United Healthcare) supplement F which I have had since I turned 65. It has covered every medical situation I have ever experienced with little or no out of pocket costs wherever I have been in the USA.

Northwoods 11-29-2022 08:23 PM

Quote:

Originally Posted by Larchap49 (Post 2161884)
I could be totally wrong but I think it would be rare to get an advantage plan that would give you a good network in two different states. When I looked at an advantage plan after moving here from Pinellas County FL I would not be able to continue going to Moffitt Cancer center because of the change of zip codes.

I have the FL Blue The Villages Advantage Plan. I specifically picked it because Moffitt is in Network I also have the advantage of having a The Villages Health Primary Care Physician. I am completely satisfied with my Advantage Plan and The Villages Health.

mtdjed 11-29-2022 11:05 PM

I think the choice of going traditional Medicare with a supplement or Choosing an Advantage plan is a decision that you make based upon your personal situation.

The fact is most of us require insurance and many have been paying into Medicare for our entire working life. That basically gets you Medicare A coverage. Going further, most will want Type B coverage which will be a monthly charge. Since that will only cover 80% of the bill, we opt to look at Advantage Plans which replace Medicare or choose to keep Medicare and choose a supplement to cover those costs not covered (The 20% excluded by Medicare.

The difference is that Advantage plans cost less and may expand benefits to include, dental, vision, drugs etc. The downside is the need to deal with a network of providers who agree to work under the networks payment rates. The individual Advantage Networks are businesses working to operate with a profit. Their funding comes from a negotiated rate with Medicare and any income they can get from premiums. Medicare benefits because they have a fixed cost per customer where under traditional Medicare they pay whatever is incurred.

Given the above, the Network costs need to be kept within in their cash flow (The Medicare payment plus the premiums they get if any). If providers decide they want higher rates than the Network can or will pay, then they are changed. You may lose your
your personal physicians.

Supplements are not dependent on Medicare Funding. They are in addition to Medicare.
Assuming that Supplements cost $150/month, that is extra money in the system to pay the bill or become added profit. They don't control Provider cost or selection or providers.

It would seem that the bottom line would be that Advantage plans would have to pay their provider network at least 20% less than Medicare allows in order to break even. Draw your own conclusion what that means to experience or quality of providers.

So, you are in good health now as you join. But what happens in 6 months, 1 Yr, 5 Yrs, etc? What happens when you need the best i.e. Moffit, Shands, or Mayo? Even if your plan allows out of network, what are the costs? Can you get out of Advantage and switch to Supplement?

If your budget doesn't allow cost of supplement, the choice is easy. If you can afford the Supplement, consider wisely.

My wife and I have had supplements since we have enrolled in Medicare. In retrospect, we have paid more than an Advantage program. But we could afford the supplement. Assuming $3600 premium per year to cover us both, my former employer pays $1000 each for a retirement insurance benefit (No insurance cost, no benefit) and my UHC Supplement pays our combined $1300 yearly premium for Genesis Health Cub. That makes our total cost for Supplement $300/year.

Having a spouse is also a big decider. More chance for a need for enhanced care needs.

MX rider 11-30-2022 08:00 AM

Quote:

Originally Posted by mtdjed (Post 2161942)
I think the choice of going traditional Medicare with a supplement or Choosing an Advantage plan is a decision that you make based upon your personal situation.

The fact is most of us require insurance and many have been paying into Medicare for our entire working life. That basically gets you Medicare A coverage. Going further, most will want Type B coverage which will be a monthly charge. Since that will only cover 80% of the bill, we opt to look at Advantage Plans which replace Medicare or choose to keep Medicare and choose a supplement to cover those costs not covered (The 20% excluded by Medicare.

The difference is that Advantage plans cost less and may expand benefits to include, dental, vision, drugs etc. The downside is the need to deal with a network of providers who agree to work under the networks payment rates. The individual Advantage Networks are businesses working to operate with a profit. Their funding comes from a negotiated rate with Medicare and any income they can get from premiums. Medicare benefits because they have a fixed cost per customer where under traditional Medicare they pay whatever is incurred.

Given the above, the Network costs need to be kept within in their cash flow (The Medicare payment plus the premiums they get if any). If providers decide they want higher rates than the Network can or will pay, then they are changed. You may lose your
your personal physicians.

Supplements are not dependent on Medicare Funding. They are in addition to Medicare.
Assuming that Supplements cost $150/month, that is extra money in the system to pay the bill or become added profit. They don't control Provider cost or selection or providers.

It would seem that the bottom line would be that Advantage plans would have to pay their provider network at least 20% less than Medicare allows in order to break even. Draw your own conclusion what that means to experience or quality of providers.

So, you are in good health now as you join. But what happens in 6 months, 1 Yr, 5 Yrs, etc? What happens when you need the best i.e. Moffit, Shands, or Mayo? Even if your plan allows out of network, what are the costs? Can you get out of Advantage and switch to Supplement?

If your budget doesn't allow cost of supplement, the choice is easy. If you can afford the Supplement, consider wisely.

My wife and I have had supplements since we have enrolled in Medicare. In retrospect, we have paid more than an Advantage program. But we could afford the supplement. Assuming $3600 premium per year to cover us both, my former employer pays $1000 each for a retirement insurance benefit (No insurance cost, no benefit) and my UHC Supplement pays our combined $1300 yearly premium for Genesis Health Cub. That makes our total cost for Supplement $300/year.

Having a spouse is also a big decider. More chance for a need for enhanced care needs.

Good points made. Choice and competition is a good thing, imo.
The UHC Advantage ppo is a good fit for us, so we're going with that. It allows out of network if you need that. Plus, if needed we can easily go back to medicare during open enrollment. I've confirmed this in writing with medicare. Now, medigap can be an issue when switching back. If you have some major health issues they can require underwriting or deny you that coverage.

All that said, there's no right or wrong here. Just do the research, ask a lot of questions and make an informed choice. No plan is right for everyone.

Advantage plans can be a very good option and they inprove every year. The UHC plan got better for 23.

Btw, medicare.gov has lots of good info, live chat and they also show the star rating for advantage plans.


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