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Old 03-02-2023, 08:36 AM
Happydaz Happydaz is offline
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I have been researching different Medicare health plans. I currently have traditional Medicare and a supplement plan. I have looked at the Villages Health plan and United Health Care. The upfront costs of Medicare Advantage plans are lower than my plan. It looks very attractive but I am concerned that at some point Medicare may reign in these Advantage plans as they are costing Medicare more than traditional Medicare. If that were to happen and I had made a switch I couldn’t go back to my former company sponsored plan. I get all drugs for a small co pay in my current plan, a great benefit. My concern is further increased because the Villages sells its assets when they no longer see they are needed, e.g. rec centers, fire departments, water and irrigation systems, etc.. The people making the most money in healthcare are the insurance companies not the medical personnel or hospitals. Now I see the Villages Health is advertising in the Daily Sun and is offering residents bounties for physician referrals. Maybe it is becoming difficult to attract physicians to central Florida? What do you think?
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Old 03-02-2023, 10:05 AM
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Medicare and supplemental you get to decide what doctor to see, etc., Medicare ADVANTAGE is MANAGED CARE you do not get to decide on which doctor to use, your PCP makes this decision for you as well as your insurance company. This seems to work very well if you are healthy, not so good if you have medical problems. We tried it and were able to get back to original Medicare and are much happier. SHINE (Senior Health Information Network) has a lot of unbiased information on this subject and has local meetings for one on one discussions.

The above comments regarding specialists is from 8 years ago and may not be valid under the current insurance coverages. We had very long waits (3 to 4 months) for specialists, and the ones we had been using would NOT accept the advantage plan. We had no option but to drop Advantage and go back to Medicare and supplemental. NOTE: there is a limitation (50 weeks I think), that if you go over that you may be subjected to underwriting to get back to regular Medicare and supplemental.
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Last edited by villagetinker; 03-02-2023 at 02:03 PM. Reason: added clarification
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Old 03-02-2023, 10:30 AM
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Advantage through United Healthcare works for me. The overall grade is an A.
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Old 03-02-2023, 10:54 AM
Keefelane66 Keefelane66 is offline
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Originally Posted by Happydaz View Post
I have been researching different Medicare health plans. I currently have traditional Medicare and a supplement plan. I have looked at the Villages Health plan and United Health Care. The upfront costs of Medicare Advantage plans are lower than my plan. It looks very attractive but I am concerned that at some point Medicare may reign in these Advantage plans as they are costing Medicare more than traditional Medicare. If that were to happen and I had made a switch I couldn’t go back to my former company sponsored plan. I get all drugs for a small co pay in my current plan, a great benefit. My concern is further increased because the Villages sells its assets when they no longer see they are needed, e.g. rec centers, fire departments, water and irrigation systems, etc.. The people making the most money in healthcare are the insurance companies not the medical personnel or hospitals. Now I see the Villages Health is advertising in the Daily Sun and is offering residents bounties for physician referrals. Maybe it is becoming difficult to attract physicians to central Florida? What do you think?
If The Village’s Healthcare can't attract Physicians why would they come on a referral unless they are running away from something.
Our Dr’s used Ocala, Orlando and Davenport very satisfied.
My employer provides a UHC Advantage plan thru retirement for my wife and me not giving it up.
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Old 03-02-2023, 11:15 AM
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Originally Posted by villagetinker View Post
Medicare and supplemental you get to decide what doctor to see, etc., Medicare ADVANTAGE is MANAGED CARE you do not get to decide on which doctor to use, your PCP makes this decision for you as well as your insurance company. This seems to work very well if you are healthy, not so good if you have medical problems. We tried it and were able to get back to original Medicare and are much happier. SHINE (Senior Health Information Network) has a lot of unbiased information on this subject and has local meetings for one on one discussions.
Once again false information. Both the The Villages accepted United Healthcare Medicare Advantage (HMO POS) and AARP Medicare Advantage Choice (PPO) 2023 plans do don't require a specialist referral.
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Old 03-02-2023, 11:20 AM
New Englander New Englander is offline
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Advantage through United Healthcare works for me. The overall grade is an A.
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Old 03-02-2023, 11:27 AM
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Once again false information. Both the The Villages accepted United Healthcare Medicare Advantage (HMO POS) and AARP Medicare Advantage Choice (PPO) 2023 plans do don't require a specialist referral.
To clarify, if you have original Medicare, you can use any provider who accepts Medicare. But, if you have an Advantage plan, you can only use providers that are part of the insurance company's network of providers.
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Old 03-02-2023, 11:37 AM
Michael 61 Michael 61 is offline
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Just transferred my health insurance from Colorado to Florida yesterday. I’m under Medicare age for several years, and receive a very large monthly retirement benefit from my former employer, which basically 90% covers my monthly health insurance premium on the open market. When I went to Villages Health, I was told that majority of primary doctors won’t take new patients under 65 (ugh). They did find me only one I the entire system taking new patients under 65 - no he is way up in Mulberry (I live in Richmond). The earliest appt he had was late April - I’m going with Villages Health for now, but we will see, as many have told me to find better care outside of The Villages. If I end up not satisfied with Villages Health, I’m not opposed to going out to Leesburg or the Clermont/West Orlando area.
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Old 03-02-2023, 12:45 PM
rustyp rustyp is offline
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To clarify, if you have original Medicare, you can use any provider who accepts Medicare. But, if you have an Advantage plan, you can only use providers that are part of the insurance company's network of providers.
I have the AARP Medicare Advantage PPO. For grins I looked up how limited my choices are. For example within 20 miles of Lady Lake the following docs are in network:

Surgeons - 134
Orthopedic Surgeons - 53
Urologists - 24

I hope you were not trying to paint a picture that there are very limited Advantage Plan choices Vs Medicare at least on The Villages Health accepted plans.

Another point - Approx 48% of all Medicare seniors have enrolled in Advantage Plans.

Last edited by rustyp; 03-02-2023 at 12:53 PM.
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Old 03-02-2023, 02:27 PM
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Originally Posted by rustyp View Post
I have the AARP Medicare Advantage PPO. For grins I looked up how limited my choices are. For example within 20 miles of Lady Lake the following docs are in network:

Surgeons - 134
Orthopedic Surgeons - 53
Urologists - 24

I hope you were not trying to paint a picture that there are very limited Advantage Plan choices Vs Medicare at least on The Villages Health accepted plans.

Another point - Approx 48% of all Medicare seniors have enrolled in Advantage Plans.
I don't have any issue with Advantage plans. I was just explaining the difference between Original Medicare and Advantage plans. According to Forbes Health, in an article reviewing the AARP Advantage plan:

"What are the downsides of a Medicare Advantage plan?

With many Medicare Advantage plans, you can only see doctors in your plan’s network. Furthermore, insurance companies that manage Medicare Advantage plans can deny claims for some expenses that they deem too expensive or unnecessary, such as imaging tests, even when they fall under Medicare coverage rules."
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Old 03-02-2023, 04:50 PM
KatieRN KatieRN is offline
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I buy my own health insurance as I am 63 so I don't get Medicare yet. I used to work at a hospital in Wesley Chapel. I moved to Bradenton and still kept my doctors in Wesley Chapel. It was an hour drive but worth it to keep my doctors and my dentist as well. Just moved to Richmond and based on all the chit chat about the difficulty in finding good doctors in the Villages I will continue to keep my doctors in Wesley Chapel and its still an hour drive but its worth it not to start over. Wesley Chapel might be a place to consider if your looking at Orlando. Much easier drive. Advent health and a new Bay care hospital also!
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Old 03-02-2023, 04:57 PM
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Originally Posted by Happydaz View Post
I have been researching different Medicare health plans. I currently have traditional Medicare and a supplement plan. I have looked at the Villages Health plan and United Health Care. The upfront costs of Medicare Advantage plans are lower than my plan. It looks very attractive but I am concerned that at some point Medicare may reign in these Advantage plans as they are costing Medicare more than traditional Medicare. If that were to happen and I had made a switch I couldn’t go back to my former company sponsored plan. I get all drugs for a small co pay in my current plan, a great benefit. My concern is further increased because the Villages sells its assets when they no longer see they are needed, e.g. rec centers, fire departments, water and irrigation systems, etc.. The people making the most money in healthcare are the insurance companies not the medical personnel or hospitals. Now I see the Villages Health is advertising in the Daily Sun and is offering residents bounties for physician referrals. Maybe it is becoming difficult to attract physicians to central Florida? What do you think?
Advantage Plans are really great until the s*it hits the fan... Keep your traditional Medicare and Supplement.
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Old 03-02-2023, 05:02 PM
Joeint Joeint is offline
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Originally Posted by rustyp View Post
Once again false information. Both the The Villages accepted United Healthcare Medicare Advantage (HMO POS) and AARP Medicare Advantage Choice (PPO) 2023 plans do don't require a specialist referral.
But to have any procedure done they require approval. A friend's doctor told him he needed a hip replacement the advantage plan required 1 year of pt... after the pt and a year of suffering, he got his hip replaced!
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Old 03-02-2023, 05:39 PM
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What do you think?
A View of not only VHealth, The Villages "model".

Keep in mind, TV is a DEVELOPER.
They develop land............primary: residential.
Included in their model is to develop "all the amenities".
Very Cool Model.

They develop the amenities because no one else is crazy enough to start-up a water system, golf courses, invest in retail space, build a hospital, on and on and on and on.

So, as a developer.............they will operate amenities until they are able to stand on their own and a specific investor can project a return.

So...............will TV sell off health assets...............Yep!!
But that's a good thing.
Why good....................well, it's established now and an industry specific investor is willing to joint the party.

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Old 03-03-2023, 04:39 AM
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If you want the insurance company to manage your health care then get an advantage plan. If you don’t believe me then ask the people who work in the doctors office
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