[Boomer]

For those who already have Plan F as a supplement to traditional Medicare, you are probably aware that as of January 2020, Plan F is going away -- except for those who are already enrolled who will be grandfathered. (But who knows really, considering the political climate with more and more talk of privatizing Medicare.)

If Medicare ends up being privatized, that would mean that insurance companies will then be holding allllllllll the cards in this game. Insurance companies and Big Pharma are powerful DC lobbies so nothing would surprise me.

As I read about The Villages "My Way Or Highway Plan" (that big surprise to many, including those who had been told they were grandfathered) I have to wonder if this situation is a bit of a hint of what total privatization would feel like. Choices gone. Insurance companies in total control of what to do with all us aging, often expensive people. Yep. Insurance companies holding all the cards in the game..........Seeya on the ice floes.

Oh, and, btw, UNH is the symbol for United Healthcare stock. During 2016 UNH has gone up more than 35%, closing yesterday at very near its 52-week high.

Why doesn't anybody ever talk about the stockholder and CEO who own a piece of us and get paid before our doctors do?

Now, before somebody comes in here and calls me a commie pinko, let me make clear that I most certainly have absolutely no problem with opportunities offered by investing in stocks.........Telecom........Toothpaste.......... Tape.........and others, but............about that 35% leap UNH took this year? I am glad I do not own a piece of healthcare stocks..........because I do not want to own a piece of you.

A long time ago I heard a quote but I don't know who said it. I have seen it come true too many times in our economic history.........

"Unrestrained greed is not only bad morals, it's bad economics."

The word "unrestrained" says it all.

Boomer Cassandra

[golfing eagles]

Originally Posted by Boomer

For those who already have Plan F as a supplement to traditional Medicare, you are probably aware that as of January 2020, Plan F is going away -- except for those who are already enrolled who will be grandfathered. (But who knows really, considering the political climate with more and more talk of privatizing Medicare.)

If Medicare ends up being privatized, that would mean that insurance companies will then be holding allllllllll the cards in this game. Insurance companies and Big Pharma are powerful DC lobbies so nothing would surprise me.

As I read about The Villages "My Way Or Highway Plan" (that big surprise to many, including those who had been told they were grandfathered) I have to wonder if this situation is a bit of a hint of what total privatization would feel like. Choices gone. Insurance companies in charge of what to do with all us aging, often expensive people. Yep. Insurance companies holding all the cards in the game..........Seeya on the ice floes.

Oh, and, btw, UNH is the symbol for United Healthcare stock. During 2016 UNH has gone up more than 35%, closing yesterday at very near its 52-week high.

Why doesn't anybody ever talk about the stockholder and CEO who own a piece of us and get paid before our doctors do?

Now, before somebody comes in here and calls me a commie pinko, let me make clear that I most certainly have absolutely no problem with opportunities offered by investing in stocks.........Telecom........Toothpaste.......... Tape.........and others, but............about that 35% leap UNH took this year? I am glad I do not own a piece of healthcare stocks..........because I do not want to own a piece of you.

A long time ago I heard a quote but I don't know who said it. I have seen it come true too many times in our economic history.........

"Unrestarained greed is not only bad morals, it's bad economics."

The word "unrestrained" says it all.

Boomer Cassandra

Not sure what your point is----hundreds upon hundreds of stocks from all different sectors have gone up 35+% to 52 week highs this year. I hope you
don't think their stock price has anything to do with what happened at TVH.

I said most of my musings in posts #16 and #19----but I want to repeat that people should get their info FROM THE SOURCE--speak with SHINE or the UHC rep, do not rely on this thread which is sorry to say way off the mark.

One post from a gentleman whose comments I have come to respect greatly was way off target. He implied TV UHC MA plan is restricted to a very small number of local doctors---when there are 20,000 Florida physicians in network. Also, while Shands and Moffit are not in network, MD Anderson in Orlando most certainly is. Anyone can just go to the UHC website and check it out. There are orthopaedists in network that do joint replacement revisions, there are quality urologists, and again, if there is a demonstrated NEED (NOT WANT) for an out of network physician, it will generally be approved---in 30 years I never had that request denied for a patient.

[Boomer]

Originally Posted by Boomer

For those who already have Plan F as a supplement to traditional Medicare, you are probably aware that as of January 2020, Plan F is going away -- except for those who are already enrolled who will be grandfathered. (But who knows really, considering the political climate with more and more talk of privatizing Medicare.)

If Medicare ends up being privatized, that would mean that insurance companies will then be holding allllllllll the cards in this game. Insurance companies and Big Pharma are powerful DC lobbies so nothing would surprise me.

As I read about The Villages "My Way Or Highway Plan" (that big surprise to many, including those who had been told they were grandfathered) I have to wonder if this situation is a bit of a hint of what total privatization would feel like. Choices gone. Insurance companies in total control of what to do with all us aging, often expensive people. Yep. Insurance companies holding all the cards in the game..........Seeya on the ice floes.

Oh, and, btw, UNH is the symbol for United Healthcare stock. During 2016 UNH has gone up more than 35%, closing yesterday at very near its 52-week high.

Why doesn't anybody ever talk about the stockholder and CEO who own a piece of us and get paid before our doctors do?

Now, before somebody comes in here and calls me a commie pinko, let me make clear that I most certainly have absolutely no problem with opportunities offered by investing in stocks.........Telecom........Toothpaste.......... Tape.........and others, but............about that 35% leap UNH took this year? I am glad I do not own a piece of healthcare stocks..........because I do not want to own a piece of you.

A long time ago I heard a quote but I don't know who said it. I have seen it come true too many times in our economic history.........

"Unrestrained greed is not only bad morals, it's bad economics."

The word "unrestrained" says it all.

Boomer Cassandra

- - - - -

Originally Posted by golfing eagles

Not sure what your point is----hundreds upon hundreds of stocks from all different sectors have gone up 35+% to 52 week highs this year. I hope you
don't think their stock price has anything to do with what happened at TVH.

I said most of my musings in posts #16 and #19----but I want to repeat that people should get their info FROM THE SOURCE--speak with SHINE or the UHC rep, do not rely on this thread which is sorry to say way off the mark.

One post from a gentleman whose comments I have come to respect greatly was way off target. He implied TV UHC MA plan is restricted to a very small number of local doctors---when there are 20,000 Florida physicians in network. Also, while Shands and Moffit are not in network, MD Anderson in Orlando most certainly is. Anyone can just go to the UHC website and check it out. There are orthopaedists in network that do joint replacement revisions, there are quality urologists, and again, if there is a demonstrated NEED (NOT WANT) for an out of network physician, it will generally be approved---in 30 years I never had that request denied for a patient.

----
Oh my! GE, have I been dismissed? (I can't find that little thingy that rolls on the floor laughing or I would put it in this spot.)

It might surprise you to know that this woman knows very well what the stock market has been doing. geez I just happen to believe in picking and choosing for various reasons. Mine.

As far as your not understanding my point..........I have great concerns over the potential we are facing for total privatization of Medicare. And I think what has happened in TV is a bit of a taste of total privatization. UNH is making lots of money and if Medicare is privatized, profits will know no limits. And who will pay for that. (rhetorical question) Thus, my opinion piece above.

I was involved in contract talks for many years and saw what happened to our benefits costs. For instance, the drug card was a Trojan Horse. As soon as everybody was out there clutching plastic instead of collecting receipts to send eventually to the insurance company for reimbursement, drug prices skyrocketed because nobody was watching. All they could see was the convenience of that card. Ironically, when my people were clamoring for the card, in the early 90s, I told them we would be sorry, but they did not believe me. I do not think it is a good plan for the sheep to welcome the wolf to guard them, to be completely in charge of the flocking.

GE, I would love to have a real life discussion with you about all this. Seriously. I am not back there behind Door Number 2 yet but when this abominable snowbird gets there, maybe I will show up at Crispers or something. -- Do not take offense that I am not put in my place. When I say I would welcome a real discussion, I mean that. I think it would be fun and each of us could learn something. But, for now, I better go Christmas shopping.

I remain, Boomer Cassandra

[golfing eagles]

Originally Posted by Boomer

- - - - -


----
Oh my! GE, have I been dismissed? (I can't find that little thingy that rolls on the floor laughing or I would put it in this spot.)

It might surprise you to know that this woman knows very well what the stock market has been doing. geez I just happen to believe in picking and choosing for various reasons. Mine.

As far as your not understanding my point..........I have great concerns over the potential we are facing for total privatization of Medicare. And I think what has happened in TV is a bit of a taste of total privatization. UNH is making lots of money and if Medicare is privatized, profits will know no limits. And who will pay for that. (rhetorical question) Thus, my opinion piece above.

I was involved in contract talks for many years and saw what happened to our benefits costs. For instance, the drug card was a Trojan Horse. As soon as everybody was out there clutching plastic instead of collecting receipts to send eventually to the insurance company for reimbursement, drug prices skyrocketed because nobody was watching. All they could see was the convenience of that card. Ironically, when my people were clamoring for the card, in the early 90s, I told them we would be sorry, but they did not believe me. I do not think it is a good plan for the sheep to welcome the wolf to guard them, to be completely in charge of the flocking.

GE, I would love to have a real life discussion with you about all this. Seriously. I am not back there behind Door Number 2 yet but when this abominable snowbird gets there, maybe I will show up at Crispers or something. -- Do not take offense that I am not put in my place. When I say I would welcome a real discussion, I mean that. I think it would be fun and each of us could learn something. But, for now, I better go Christmas shopping.

I remain, Boomer Cassandra

Wasn't trying to "dis" you at all, and I'm certainly not trying to put anyone "in their place". I thought you had very valid points on privatization. And you may very well know more about the stock market than I do. I poorly worded the concept that a stock price and company policy often does not correlate. Sorry.
My main point was really that people need to get first hand info---the ideas about the UHC MA plan floating around on this thread range from incorrect to bizarre.

[NYGUY]

Originally Posted by golfing eagles

....Also, while Shands and Moffit are not in network, MD Anderson in Orlando most certainly is.

I believe Orlando Health replaced MD Anderson with UF Health awhile back.

[golfing eagles]

Originally Posted by NYGUY

I believe Orlando Health replaced MD Anderson with UF Health awhile back.

I don't know. All I can say is I ran MD Anderson thru the UHC MA website under "Am I covered" a few hours ago and it came up yes.

[NYGUY]

Originally Posted by golfing eagles

I don't know. All I can say is I ran MD Anderson thru the UHC MA website under "Am I covered" a few hours ago and it came up yes.

Well lets see....does anyone know if MD Anderson is still in Orlando?

[golfing eagles]

Originally Posted by NYGUY

Well lets see....does anyone know if MD Anderson is still in Orlando?

You never know---sometimes websites have out of date info, seen it before, will see it again.......

[paulascorpio]

My husband and I were on UHA through The Villages starting January of last year. Great not having to pay anything. We were originally on Medicare with a plan F supplement but switched to the UA plan. Then in July last year he developed Multiple Myeloma. Within 4 weeks, we incurred $16,500 additional cost of co-pay bills. We immediately switched back to Medicare and a Plan F supplement as we were allowed to switch back within the year. The only bills incurred with his cancer from that point on, were those while on United.
I am so grateful that we were able to switch back.

[rivaridger1]

Originally Posted by golfing eagles

Wasn't trying to "dis" you at all, and I'm certainly not trying to put anyone "in their place". I thought you had very valid points on privatization. And you may very well know more about the stock market than I do. I poorly worded the concept that a stock price and company policy often does not correlate. Sorry.
My main point was really that people need to get first hand info---the ideas about the UHC MA plan floating around on this thread range from incorrect to bizarre.

1. The Villages United Healthcare Advantage Plan is best for younger healthy seniors. The docs associated with The Village Healthcare system want to practice preventive medicine. Just read the material in the local paper every Sunday and that will tell what they are emphasizing.
2. Once you are in an Advantage plan the insurance company has the opportunity once a year to change the provider network and thus exclude access to expensive specialized care. The decisions to do this will be governed by the overall profits being generated under the plan.
3. If you get seriously ill and need very specialized services outside the Advantage provider network and as a result need to change back to Medicare and a Supplement policy, coverage can be denied and/or re-priced. If re-priced, the premium is whatever the for-profit insurer decides to charge. Whether you can afford it or not is not an issue.
4.No one in The Villages is getting any younger. All of us our going to pass on to join our ancestors. When we do from a medical perspective it will probably be something quite medically expensive to deal with that kills us.
5. The Villages Healthcare Advantage Plan is provided by the largest for-profit insurance company in the United States. The people that run it are not dumb and will do whatever is necessary in the future to assure its continued profitability including restrictions to network access if it such a change is needed.
6.Your red, white and blue Medicare Card and a Supplement policy to go with it are equal in value to a vault filled with gold bars when you are seriously ill. Some day, no matter what you do from a preventative standpoint, you are going to be seriously ill.
7. A lot of people are risk takers and prefer to put every available savings in their pockets when available. That is fine, but the old adage of penny wise and pound foolish might have some application when evaluating Medicare Advantage Plans.

[golfing eagles]

Originally Posted by paulascorpio

My husband and I were on UHA through The Villages starting January of last year. Great not having to pay anything. We were originally on Medicare with a plan F supplement but switched to the UA plan. Then in July last year he developed Multiple Myeloma. Within 4 weeks, we incurred $16,500 additional cost of co-pay bills. We immediately switched back to Medicare and a Plan F supplement as we were allowed to switch back within the year. The only bills incurred with his cancer from that point on, were those while on United.
I am so grateful that we were able to switch back.

Having just switched to UHC MA from Plan F, could you please elaborate on just how this happens? The max out of pocket expense on option 1 is $4400/yr. and $1900/yr. on option 2, exclusive of drug cost, which is identical to plan F. There are co-pays on MA, but they are $15 and $30 in general, so $16,500 in 4 weeks is unlikely in co-pays. Did you include the cost of very expensive tier 5 drugs that you received in the first 4 weeks, in which case the cost would have been the same on plan F? Did the cost of drugs push you into the catastrophic phase and therefore the main cost fell on the MA plan? Was there a bone marrow transplant in the first 4 weeks? And finally, did you choose to utilize an out of network provider without prior approval? Since the formulary and terms of coverage are virtually identical in the 2 plans, the main difference is the network restriction.

[golfing eagles]

Originally Posted by rivaridger1

1. The Villages United Healthcare Advantage Plan is best for younger healthy seniors. The docs associated with The Village Healthcare system want to practice preventive medicine. Just read the material in the local paper every Sunday and that will tell what they are emphasizing.
2. Once you are in an Advantage plan the insurance company has the opportunity once a year to change the provider network and thus exclude access to expensive specialized care. The decisions to do this will be governed by the overall profits being generated under the plan.
3. If you get seriously ill and need very specialized services outside the Advantage provider network and as a result need to change back to Medicare and a Supplement policy, coverage can be denied and/or re-priced. If re-priced, the premium is whatever the for-profit insurer decides to charge. Whether you can afford it or not is not an issue.
4.No one in The Villages is getting any younger. All of us our going to pass on to join our ancestors. When we do from a medical perspective it will probably be something quite medically expensive to deal with that kills us.
5. The Villages Healthcare Advantage Plan is provided by the largest for-profit insurance company in the United States. The people that run it are not dumb and will do whatever is necessary in the future to assure its continued profitability including restrictions to network access if it such a change is needed.
6.Your red, white and blue Medicare Card and a Supplement policy to go with it are equal in value to a vault filled with gold bars when you are seriously ill. Some day, no matter what you do from a preventative standpoint, you are going to be seriously ill.
7. A lot of people are risk takers and prefer to put every available savings in their pockets when available. That is fine, but the old adage of penny wise and pound foolish might have some application when evaluating Medicare Advantage Plans.

No offense, but I'd really like to know the basis upon which you came up with these 7 "talking points"

1. Don't you think "preventative medicine" benefits older seniors as well? Even the government concurs with this, hence all their chronic care management, Optum QA criteria and PQRI initiatives. Like most physicians, the doctors of TVH are well trained in treating chronic and serious illness, in fact, it is the preventative medicine issues that in general are newer to us.

2. The provider network can, and frequently does change somewhat every year in ALL insurance plans. The insurance company can decide to drop certain providers, and the providers can opt out of participation in an insurance plan, just as patients have the option to change insurers. So what. Most of the insurers changes are QA driven, profit being a secondary motive in that decision.

3. True, AFTER the first year it is harder to change back to supplemental policy, there may be underwriting criteria and there may be a premium increase--but it's not "whatever they want to charge". But why would someone really need to change back? If you get "seriously ill" , there are more than enough in network physicians to treat you. If you have a NEED for care that cannot be provided in network, 99.5% of the time the insurer will approve the out of network provider. The main problem is when someone WANTS, not NEEDS out of network care, with exception of certain states such as California

4. Yes, we will all die, and yes the bill can be expensive. What is your point---it is the coverage that counts, not the raw bill, and your exposure is limited under either plan

5. Aha! Now we come to the crux of your philosophy---you used that most vulgar word to the far left---PROFIT. Of course, when it comes to health care administration, insurers "profits" are far, far less than government waste. As far as single payer government health insurance goes, I'll take a pass on VA medicine for all.

6. Actually, your Medicare card and supplement will probably COST the average patient about $2000/yr. MORE than the MA plan. If you are seriously ill, it may save you a few thousand. IF you CHOOSE to go out of network without approval, then it will save you a fortune, but then that would be on you, not the insurer.

7. I agree with that adage, but if you look at the plans it detail, you will find it does not apply here.

[OCsun]

Originally Posted by rivaridger1

1. The Villages United Healthcare Advantage Plan is best for younger healthy seniors. The docs associated with The Village Healthcare system want to practice preventive medicine. Just read the material in the local paper every Sunday and that will tell what they are emphasizing.
2. Once you are in an Advantage plan the insurance company has the opportunity once a year to change the provider network and thus exclude access to expensive specialized care. The decisions to do this will be governed by the overall profits being generated under the plan.
3. If you get seriously ill and need very specialized services outside the Advantage provider network and as a result need to change back to Medicare and a Supplement policy, coverage can be denied and/or re-priced. If re-priced, the premium is whatever the for-profit insurer decides to charge. Whether you can afford it or not is not an issue.
4.No one in The Villages is getting any younger. All of us our going to pass on to join our ancestors. When we do from a medical perspective it will probably be something quite medically expensive to deal with that kills us.
5. The Villages Healthcare Advantage Plan is provided by the largest for-profit insurance company in the United States. The people that run it are not dumb and will do whatever is necessary in the future to assure its continued profitability including restrictions to network access if it such a change is needed.
6.Your red, white and blue Medicare Card and a Supplement policy to go with it are equal in value to a vault filled with gold bars when you are seriously ill. Some day, no matter what you do from a preventative standpoint, you are going to be seriously ill.
7. A lot of people are risk takers and prefer to put every available savings in their pockets when available. That is fine, but the old adage of penny wise and pound foolish might have some application when evaluating Medicare Advantage Plans.

I agree!

[golfing eagles]

Originally Posted by OCsun

I agree!

Question remains---On what basis do you "agree".... I disagree, but have plenty of facts and experience for my opinion. You are certainly entitled to yours, but all I can suggest is to get the FACTS directly from a source---UHC or SHINE, after all, I could be wrong.......

[OCsun]

Originally Posted by golfing eagles

Question remains---On what basis do you "agree".... I disagree, but have plenty of facts and experience for my opinion. You are certainly entitled to yours, but all I can suggest is to get the FACTS directly from a source---UHC or SHINE, after all, I could be wrong.......

My opinion is right for me based on my personal experience and of course, as you pointed out, your opinion is right for you based on your experience. Shine is an excellent point to start a search for health insurance details if, you have no health insurance knowledge. UHC representatives will only help you to understand how their product can work for you.

Please don't take my opinion personally. It is just my opinion.