I for one will not do advantage plans glad to hear that you were not happy with them plus I know they can change your Dr on you too without any notice

Who is your supp plan with?

This thread got me thinking about Villages Health - I’m 61, so too young for Medicare - had set up an initial appointment with the only primary care doctor taking patients under 65 - and he is way up in Mulberry, which is about a 35 minute drive for me. Since, I have had several people reach out to me advising me to find a doctor outside of Villages Health for multiple reasons. Also, doctor was booked out until end of April, as there seems to a problem attracting doctors to The Villages, which concerns me long term. I decided to back out of Villages Health, and went with Orlando Health - found a primary doctor at Hwy 27 and the Turnpike (about a 20 minute drive, way closer than Mulberry) - and they can get me in two weeks - was also very impressed with their phone service (they actually pick up right away, not being transferred to a phone tree that leads nowhere) - Hopefully, I’ll be impressed with Orlando Health.

Medical care in certain parts of Florida is not very good, so if you buy a home in Florida check the medical care facilities first where you intent to live..

Medicare Advantage plan etc.
 

I used to work for a BCBS plan (10+) years. An insurance company "bids" on Medicare business. Medicare basically offers insurance companies a cost plus (the plus being administrative costs primarily) for handling Medicare's members' medical costs. The insurance companies generally only cover what Medicare covers. The "advantage" plans ARE NOT Village owned - United Health Care and Blue Cross (to name a few) are national plans and they have been in the Medicare business a long time. The real consideration is what coverage works best for you based upon your health situation. Generally, medicare advantage plans are free but supplement plans cover more - especially if you have any chronic conditions. BEFORE SWITCHING, I would suggest making use of the medicare resources in the villages and fully understand the coverage differences.

Ref my post above re my PPO plan. The out of state in network coverage is now vast. I looked up PCPs in 5 areas all within a 20 mile radius. Again these are all within network on that plan:

Sumter Landing - 305 PCPs
Albany NY - 865
Cleveland OH - 1871
Denver CO - 1891
Madison WI - 510

My thoughts exactly. Advantage plans are not an advantage when something unforeseen comes up. We left Villages Health for the lack of doctors. Also the turnover is crazy. We both have had cancer in the last 4 years and would choose to pick our own doctors and hospitals. Moffitt Cancer inTampa is the Best.
If in any way you can afford Regular Medicare and a great supplement do so. We have an AARP supplement.
Good luck.

Medicare Supplement
 

1) Bottom line: Anyone who can afford Medicare Supplement should have supplement, not "Advantage" (which is actually disadvantage).
2) The decision should be considered permanent. Once you are 66, you cannot get Medicare Supplement without underwriting, e.g., passing a health exam that something like a heart attack or cancer that happened suddenly would cause you to "fail".
3) Advantage does not let you see any doctor. For instance, when I needed the "Inspire" device for sleep apnea, there was no doctor United would let me see with Advantage. - I had United Advantage for the freebies and Village Primary Care when I was 65, but went Supplement just before turning 66.
4) Advantage chooses your drug plan for you - you may wind up on a plan that makes medicines you need very expensive. It's "one size fit all" whereas with Supplement you choose your Part D drug plan.
5) Advantage can and does turn down treatments that a doctor says you need!!! The United Advantage and Supplement representative in The Villages said this tends to happen more and more after one year of advantage coverage - because you will have trouble leaving advantage after one year, and at the very least, you will have to pay a high premium than you would have for Supplement, because you joined Supplement after age 65.
6) There are many cases of Advantage plans finding loopholes to force people to leave respite care before the full 100 days (that Supplement always covers) are up.
7) Advantage does not cover certain drugs at all, for instance, infusions are not covered.
8) Advantage has "max out of pocket" costs that can tend to be high. If you need plenty of care, say with cancer treatment, you will pay the max out of pocket, which is more than Supplement would have cost.
9) Yes, Supplement will probably cost more than Advantage in the early years of your retirement. But Advantage has all the dangers, such as denial of necessary treatment, listed above, and in the end, can cost more Plus you cannot be sure of ability to switch to Supplement. So - back to the bottom line - if you can afford Supplement, you should get a Medicare Supplement plan, not "Advantage" (disadvantage).

Good to know there is an opt out if health turns south. We have had been in advantage programs for nearly 15 years and have been very satisified and especially satisfied with TVHS. Our health problems have been less than yours but not insignificant involving a couple of surgeries and hospital stays. Good to know we can change to a supplemental if that turns out to be advantageous.

In most states MediGap supplemental plans can deny coverage if you are switching after a number of years from an Advantage Plan to a MediGap plan. The MediGap plan can deny coverage for preexisting conditions for a certain time period. (Six month+) For example, suppose you got cancer and wanted treatment at Moffitt Cancer Center. If you switched to a MediGap plan you would be responsible for all your cancer treatment costs at Moffitt until you got beyond the six month preexisting exclusionary period. This is just an example but MediGap plans are allowed to exclude preexisting conditions if you are switching from an advantage plan. Your rates may be much higher as well. This was my main concern in going with an Advantage plan and then looking at switching back to a MediGap plan. It might not work out.

They can deny coverage coming from a private plan as well. Ask me how I know.

i had the same experience. the Villages health advantage took care of my spinal fusion, i had it over in orlando. the hosp stay, procedures and fees were included. i paid 1,500 out of pocket total for a fee well over $50,000. i was never denied care, or told i couldnt be treated. if a dr in the Villlages area wasn't available, i was sent to a specialist outside the bubble. i'm staying on the advantage plan

I had Aetna. As others have said, they can and will deny you MRIs as happened to me. Thanks but no thanks. Co-pay on an MRI if they allow it was $350 - in Plan G it would be $0. If surgery is needed, then the co-pay goes up even more till you hit your max OOP. $124/mo for Plan G and I'm saving a bundle over the Advantage plan in more ways than one.

There are lots of MA plans out there. Some are better than others. The ones that VH takes are the best. I’ve had MRIs, sonograms and other imaging all with very low copays. All of my lab work is no fee as are all of my prescriptions. I’m in my third year and so far have put out less than $200 in copays with zero premiums.

You definitely have to do due diligence on plans. But our Advantage plan saves us thousands each year. We are very happy with it.