[rustyp]

Originally Posted by Dan9871

We have the Villages Health Advantage Plan and are very satisfied with everything including the quality of care and the convenience.

We've had one major medical event that involved a stay in Villages Hospital and later to Munroe. All was covered very well with the providers in the network. The way care is managed at Villages Hospital if you are in the Villages Advantage Plan is especially nice... your stay is managed by Villages Health doctors, not the hospital's Hospitalist doctors.

Lot's of other smaller things too, but no problem getting them taken care of with in-network providers.

We also had no problem getting permission and coverage to go to an out-of-network provider one time simply because the in-network providers were not conveniently located.

Before we came to The Villages we were in an HMO with limited providers to choose from and references needed and all that. We had a number of major medical events... but never had a problem getting quality services from inside that network either.

So for the past 35 years or so we've only had a limited network of providers and referral requirements. Yes, all that time we've had some worry that this would limit the availability and quality of our health care. But it has never been a issue.

Thank you. It is refreshing to get the facts Vs emotional roller coaster.

[goodtimesintv]

It's in here, but you don't want to see it.......

Originally Posted by goodtimesintv

"

.....Impossible Burden For The Elderly And The Disabled

About half the cost of the ACA (Affordable Care Act) is paid for by cuts in Medicare spending and the only practical way those cuts can be made is by reduced fees to providers.

The Medicare actuaries have noted with alarm that Medicare fees to doctors will drop below Medicaid levels in the near future and the combined effect of lower Medicare and Medicaid hospital spending will drive one in seven hospitals from the market in the next five years.

Although the administration talks about making Medicare more efficient, three separate reports by the Congressional Budget Office (CBO) have concluded that the pilot programs and demonstration projects that are supposed to find these efficiencies are not working.

In fact, the only place in Medicare that shows any promise at all is in the Medicare Advantage (MA) program. But the administration is determined to proceed with cuts in MA subsides and appears to be paying no attention whatever to the efficiencies MA entrepreneurs are discovering.

Because no serious budget analyst believes the Medicare spending cuts can withstand the inevitable political backlash and because they don’t believe the pilot programs will work either, both the CBO and the Medicare Trustees are annually publishing “alternative forecasts” in an effort to predict how Congress will cave. But if Congress does cave and restores the previous Medicare spending path, that means that the ACA isn’t paid for; and that, in turn, means large unfunded liabilities stretching out indefinitely into the future and increasing federal debt......"

Six Problems With The ACA That Aren’t Going Away

.

[larcha]

Is UHC Medicare Advantage guaranteed issue if you switch?

[Jimmydoodlebug]

Could someone who uses this Medicare Advantage plan tell me how you get care when you're traveling to another state?

My wife is interested but we travel the country a lot and need to know if we'd be better staying with Medicare and a secondary provider.

Thanks

[ColdNoMore]

Originally Posted by goodtimesintv

It's in here, but you don't want to see it.......

Originally Posted by goodtimesintv

"

.....Impossible Burden For The Elderly And The Disabled

About half the cost of the ACA (Affordable Care Act) is paid for by cuts in Medicare spending and the only practical way those cuts can be made is by reduced fees to providers.

The Medicare actuaries have noted with alarm that Medicare fees to doctors will drop below Medicaid levels in the near future and the combined effect of lower Medicare and Medicaid hospital spending will drive one in seven hospitals from the market in the next five years.

Although the administration talks about making Medicare more efficient, three separate reports by the Congressional Budget Office (CBO) have concluded that the pilot programs and demonstration projects that are supposed to find these efficiencies are not working.

In fact, the only place in Medicare that shows any promise at all is in the Medicare Advantage (MA) program. But the administration is determined to proceed with cuts in MA subsides and appears to be paying no attention whatever to the efficiencies MA entrepreneurs are discovering.

Because no serious budget analyst believes the Medicare spending cuts can withstand the inevitable political backlash and because they don’t believe the pilot programs will work either, both the CBO and the Medicare Trustees are annually publishing “alternative forecasts” in an effort to predict how Congress will cave. But if Congress does cave and restores the previous Medicare spending path, that means that the ACA isn’t paid for; and that, in turn, means large unfunded liabilities stretching out indefinitely into the future and increasing federal debt......"

Six Problems With The ACA That Aren’t Going Away

Interestingly enough, if you look at the letters to your Opinion Article (written by someone who obviously wants to repeal ACA) you find this.......

6.) Impossible burden for the elderly and disabled: This section is purely speculative and the problems with Medicare financing are largely independent of the ACA.

The ACA does not cut coverage or provider reimbursement to Medicare. These budget pressures were coming with, or without the ACA.

I also don’t understand your argument for MA. First of all, this is essentially a national Medicare version of the state exchanges, which you seem vehemently against. The government was explicitly overpaying MA plans since its induction and the ACA eliminates this clause. If these plans are finding efficiencies as you claim, they should be able to cope with these cuts just fine. Also, one or two years of data on ACOs, which represent quite a radical change in the way organizations must think about health care financing (moving from fee-for-service, where billing more is encouraged, to a budgeted scheme where the goal is to control costs will take time and experience, trial and error), and we should not abandon them, but continue to monitor what is successful and make adjustments as we go.

I appreciate your commentary, but find it confusing and contradictory. If you are against everything the ACA stands for, stand up for yourself and call for its repeal. Outline your alternative that avoids these “problems” with the ACA yet still manages to extend health insurance to more people at a reasonable cost. I recognize and appreciate your budgetary concerns with health care in the US, but I don’t blame the ACA at all, nor do I think the ACA does anything to notably better or worsen the situation.

I see our staggering high number of uninsured as an even more critical failing, particularly among the developed world where our high rate of uninsurance is unique (and shameful).

Rather than address cost, the ACA is essentially a budget neutral policy that seeks to broaden insurance coverage in the US, and it does just that.

[donbettyr]

All things are relative. I was paying $2000 per month, with each of us having to pay the first $1000 each year, so $4000 a year is cheap. I go directly to my specialists, and can go to the best of them in this area. As a someone in practice for 34 years, Who you see matters. Spent a lot of time when moved here, asking M.D.'s, RN's, and others from this area who we should see(and they also offered opinions on who NOT to see.

[Avista]

Originally Posted by Jimmydoodlebug

Could someone who uses this Medicare Advantage plan tell me how you get care when you're traveling to another state?

My wife is interested but we travel the country a lot and need to know if we'd be better staying with Medicare and a secondary provider.

Thanks

The best thing to do is pose your questions to the folks at the Medicare Store. We've used the one in Sumter. They are great. Present as many "what if" scenarios you can think of.

You are covered at any hospital or urgent care in an emergency. If you are going to stay in a place for awhile you can get what is called a Passport. They can explain this much better than I can.

[2BNTV]

Originally Posted by Avista

The best thing to do is pose your questions to the folks at the Medicare Store. We've used the one in Sumter. They are great. Present as many "what if" scenarios you can think of.

You are covered at any hospital or urgent care in an emergency. If you are going to stay in a place for awhile you can get what is called a Passport. They can explain this much better than I can.

It's best to check if the area you are traveling to will have adequate coverage. You must call them to activate your passport and call them to deactivate when you return home. It can be used for 9 months in a row.

Emergency care is covered worldwide for all MA plans.

Please check for your self.

[Jimmydoodlebug]

Originally Posted by Avista

The best thing to do is pose your questions to the folks at the Medicare Store. We've used the one in Sumter. They are great. Present as many "what if" scenarios you can think of.

You are covered at any hospital or urgent care in an emergency. If you are going to stay in a place for awhile you can get what is called a Passport. They can explain this much better than I can.

Thank you for that answer. Where can I find the Medicare Store?

[Jimmydoodlebug]

Originally Posted by 2BNTV

It's best to check if the area you are traveling to will have adequate coverage. You must call them to activate your passport and call them to deactivate when you return home. It can be used for 9 months in a row.

Emergency care is covered worldwide for all MA plans.

Please check for your self.

Thanks, that's very interesting. Not having coverage while traveling is my biggest concern.

[2BNTV]

Originally Posted by Jimmydoodlebug

Thank you for that answer. Where can I find the Medicare Store?

I'm pretty sure they are all in the squares. I know for sure their is one in Lake Sumter Landing and Spanish Springs.

[Avista]

Originally Posted by Jimmydoodlebug

Thank you for that answer. Where can I find the Medicare Store?

We spoke with Cheri at 1049 Lake Sumter Landing 352-391-5262

[LvmyPug2]

The Medicare Store is a United Health Store. To get an unbiased opinion you should speak to a Shine Counselor. They will give you info on all the different plans and companies without trying to sell you a product.

[Joejohnson]

Originally Posted by LvmyPug2

The Medicare Store is a United Health Store. To get an unbiased opinion you should speak to a Shine Counselor. They will give you info on all the different plans and companies without trying to sell you a product.

Yes, do this. UHC Medicare store has their company in mind, and that may or may not be in your best interest. VHC has grandfathered some but not MOST. I am grandfathered, but my wife who has had the same insurances as I all our married life of 47 years, is not grandfathered. She accepts United Health Care or its see ya and goodbye. For some, UHC may be an improvement over their current medical insurance, but for us it would be loss of benefits, choice of Drs and more exspensive even with the loss of benefits. We don't wish to leave Villages Health Care, but we also will not change plans that cost more with less benifits.

[cavalier65]

Originally Posted by Joejohnson

Yes, do this. UHC Medicare store has their company in mind, and that may or may not be in your best interest. VHC has grandfathered some but not MOST. I am grandfathered, but my wife who has had the same insurances as I all our married life of 47 years, is not grandfathered. She accepts United Health Care or its see ya and goodbye. For some, UHC may be an improvement over their current medical insurance, but for us it would be loss of benefits, choice of Drs and more exspensive even with the loss of benefits. We don't wish to leave Villages Health Care, but we also will not change plans that cost more with less benifits.

You are exactly right! TVH made a business decision to enhance revenue and profits. So be it. But please it should not be disguised as better serving the Villages residents.