Medicare Supplement
 

Hello,

I plan to retire sometime in the future, and hopefully make the big move down to The Villages soon after.
I will be eligible for Medicare, and look to purchase supplemental medical insurance as well.
I heard somewhere that there is a supplemental insurance that’s preferred for the medical facilities in The Villages. Can anyone explain what this supplement is, and any tips for a smoother transition into Medicare itself.

Schmitth, first, the villages health system (VHS) accepts ONLY 4 ADVANTAGE plans, they do not accept Medicare and supplemental.
If you go with Medicare and supplemental you will still have access to VHS specialists, the VHS hospital, all of the outside doctors, etc. I strongly suggest you contact Florida SHINE, SHINE - Home as they will provide UNBIASED health care info. If you decide to go with an advantage plan, and then decide you want to go back to Medicare, THERE IS A TIME LIMIT, keep this in mind. We loved the VHS system, but had to drop out when they decided to drop Medicare patients, we now have a Primary Care doctor about 20 miles away in Leesburg.
SHINE was a great help in getting us the correct information so we could make an informed decision.

Please stop saying there's a time limit without telling the audience what it is. You continue to make it sound like a finite decision - it is not. You can go back to Medicare from an Advantage Plan every single year at enrollment time at a minimum. There are other extenuating circumstances like what's called change of life one can also go back.

When we voluntarily left an employer-sponsored plan in favor of Original Medicare, our acceptance depended on being able to answer certain health questions satisfactorily. And I suspect we had to pay a higher rate than if we enrolled at age 65. That was in 2011. In other words, it was not automatic. Maybe something has changed?

That sounds like it would have been a violation of the Affordable Care Act, passed in 2010.

We were told after 50 weeks, you may have difficulty getting back to Medicare and supplemental IF (yes this is a BIG IF) you have pre-existing conditions, you could be subjected to underwriting, or you may not be able to get a supplemental plan, sorry for the confusion. This was about 4 years ago, I do not think the rules have changed but they may have so please check.

Go to one the Medicare advisors inside a Villages Care Center and sign up for United Health Villages Medicare Plan. There is no premiums and you can go to one of the eight Villages Medical Centers, I go to Brownwood which was just built two years ago and see Dr. Raquet. It also includes free membership in the MVP Health Club, which is a $65 a month value. If you see a specialist there is a $40 co-pay.

Medicare Resources - The Villages Health

Welcome To Brownwood Care Center - The Villages Health

Brownwood Care Center

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Dr. Raquet

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You are close to being correct. You can get back into Medicare and can not be refused. The supplemental does have the option of charging you more at the new time of entry Vs if you originally got in and protected by cost of living type increase. However my point is everytime you post you make the statement you can't get back into Medicare - entirely not true.

I recommend you stay clear of United healthcare.

United healthcare advantage is trying to muscle in and dominate health care in The Villages Florida. There are numerous healthcare supplements available that are not receiving kickback for the developers. There are many qualified drs that are not in the pockets of the developers.

The OP is obviously interested in the Villages Medicare Plan and it's health facilities and you made the biggest mistake anyone can ever do on a message board. Figure it out and then get back to us.

If the health care they providing is good and reliable, then what is the problem. You're obviously someone who has a dislike of the developer, someone who is against corporations and big business. I wonder where you got those ideas? Of course there are many other doctors outside the system. My wife went to Premier for five years, they're a mismanaged zoo. She came over to TV plan and loves it.

And they are providing healthcare; however, at a cost much higher than other like advantage plans. Taking advantage of seniors is the American way, but I find it wrong when it comes to medical issues.

For all you naysayers about Villages Health - did you know they offer classes on over 25 health subjects free of charge to anyone. You do not need to be in the system or have any insurance. What does your system offer ? Call 352 308 1664 for info. By far the best health care system I have been in and I unfortunately have a long trail of experience . The total resentment as I see it in the majority of cases is the patients reluctance to give their existing retirement perk and except in blind faith they can't beat it because of the "once you leave you can't get back in". Do your homework folks. You need to explore what they are really giving you Vs what you can get before you except that principal.

UnitedHealthcare The Villages Medicare Advantage Plan has worked out beautifully for us so far. Our primary Doctor is fantastic but busy sometime so we see Nurse Practitioners which are very good also. They will do their best to help you out any way they can. We swear by them and are grateful to have them. :pray:

For a full explanation you should call 1-866-627-7806 and ask about anything you have on your mind. We found the customer service to be great. Good Luck & Welcome.

Choosing the right Medicare option.
 

I did a lot of research of Medicare before I turned 65. As part of my research I contact Florida SHINE as they provided unbiased information. The choice you make is very important and should not be made until you understand all the options and decide what options will work best for you now and in the future.

Remember what works great for one person may not be right for you.

Good Luck

I also went to SHINE as one of my resources. They were excellent. Explanations at the layman's level and unbiased. If possible try to avoid going at enrollment time. They get very busy then and usually need to limit sessions to a time limit.

Also make sure you understand TV Regional Medicare Advantage Plan...it’s regional.

Regarding pre-existing conditions, this is what the HHS.gov website says:

"Pre-Existing Conditions - Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. These rules went into effect for plan years beginning on or after January 1, 2014."

We've been in the Villages Health Care for the last seven years. It's the best health care system we've ever been in. We've also had a lot of first hand experience with Villages Hospital, which is not part of Villages Health, and are totally satisfied with the care they have provided.

Villages Health does require you to be in a United Health or Florida Blue Advantage plan. That might not work our for you. Keep in mind that by law any Advantage plan has to cover all the services that regular Medicare does.

What happens if you get sick out of state and you are on an Advantage Plan? My understanding is they only cover in FL and certain facilities.

Do you think that will change when UF takes over VHS? I suspect so. I got Medicare Plan F - a bit pricier but the most comprehensive.

Each plan is different that is why there are so many myths about this subject out there. For example this year I chose UHC AARP Medicare Advantage which is one of The Villages accepted plans for 2020. This plan basically covers the entire US "UHC" system as in network. Last few years I had the UHC Passport Plan in which you had to make a phone call when you were traveling out of the area to the new area to get in network coverage within the UHC system. This plan did have a downfall of many mid western states were not in it. The new plan I got this year has much larger area of coverage with no phone call required.

There are a lot of good doctors here - may not be with Villages Health - don't just go with them, they are no better than any others here.

I always call United Healthcare before each trip up north to be certain that the policies that were in place on the previous trip have not changed. I suggest you do the same and never assume that things stayed the same as the last trip you took.

I am covered on the trip and when we get to Jersey. We just change the zip code in the Doctor Finder and then call to confirm that the Doctor we select is still active with United Healthcare because they may show that they are in Network and actually it may not be the case. Sometimes the Doctor may drop off the Network and the info on the computer is not updated quickly. Finding out anything from UHC is a pleasure, not a hassle but dot the I's & cross the T's. I tape the calls and get names and save all information.

Its a Good feeling to have such Great Insurance. :pray:

SHINE is an amazing organization! The volunteers who work there are incredibly knowledgeable. When I became eligible for Medicare, I do not believe they gave me a single incorrect statement. They have meetings in various rec centers and will spend as much time with you as you need.

Just food for thought, if you take a Part C plan, you can switch back to using a supplemental plan BUT you will be subject to underwriting and you are not guaranteed acceptance (the Affordable Care Act did not change this aspect of Medicare).

Also, be aware that premiums for a supplmental plan are based on where you live. If you receive Social Security, the address used by that organization IS your address. But, if you do not receive Social Security, then SS does not know where you live. You can sign my for a plan in any place that you have a connection...such as a winter home or summer home or temporary home. That will be the locus for your supplemental plan for the rest of your live...even if you move. Since supplemental plans (defined by the various letters) is the same wherever you live in the country, you might consider taking out a supplemental plan from the cheapest location. But, do note, supplemental plan premiums do go up from time to time.

Use SHINE, it is the single best source for walking through this mine field!

UF is not taking over Villages Health. They purchased The Villages Hospital and Leesburg Hospital.

The VHS clinics are a separate entity, and were not in that deal.

It depends on your plan. The United Healthcare Advantage covers emergency services worldwide. United Health also has Passport that lets you switch to any other UHC network for regular medical services. Note that regular Medicare provides no coverage, not even emergency, outside of the US.

Also the UHC network is pretty extensive in FL, though it doesn't cover all providers.

But, as always, check the plan to see what the coverage is. Almost all Advantage Plans, not just UHC, cover things that regular Medicare doesn't.

Does anyone have info about Medicare Advantage (Part C) with Tricare for Life? I was told that there are no copays and I would get extra benefits like Dental, Vision, OTC & Gym with no increase in cost. Also, my Part B would go down $50. This would be a no brainier, so what's the catch? Any retired veterans out there that might shed some light on this?

A couple of our neighbors who are veterans are using Advantage.

But check with Shine SHINE - Sumter
and check with Villages Health The Villages Health

With traditional Medicare and TFL, there already are no co-pays, so there is no difference.

Ask which providers are included in the dental and vision. Then look up their reputation. Is there an annual $ limit? Dental coverage here is very tricky, and most (all?) dentists do not take insurance. You have to submit the claim yourself. Usually the dentists charge more than the reimbursement amount.

I have no experience with vision coverage.

Also be aware that you will have to file claims with Express Scripts. It will no longer be automatic because you will have Other Health Insurance, and Tricare insists on being the last to pay.

Also be aware that if you decide to return to traditional Medicare, you may be subject to underwriting and perhaps increased premiums.

"Go to one the Medicare advisors inside a Villages Care Center and sign up for United Health Villages Medicare Plan. "

I did just that when we move to TV. The salesperson recommended that I chose Aspen Dental for my free cleanings. A whopping mistake.

Anyway, we both are now with Careplus, CareFree and receive a reimbursement each month towards our Medicare deduction. But, you must be reasonably healthy. It's worth some investigation.

Our healthcare has been exemplary. Our PGP is first rate and all our test and diagnostics have been either free or low cost.

you might get a few extra bennies from the MA plan, but you might get more hassle, too.


it is my understanding that original medicare will automatically forward remainder bills to TFL. Not sure if an MA plan will do that.

Thanks to all that replied, but is there anyone that is retired military that are actually in my situation. My understanding is that there are over 7000 veterans at the local VFW. At least there must be a couple that use the village health care system. Anyone have a contact number for the local VFW?

Blue Cross (Mid Florida Agencies) your only local Florida Blue agency located in The Villages at Palm Ridge Plaza off CR 466 at 11962 CR 101, Suite 303 in addition to offices at Colony and Pinellas Health Care on CR 466A, phone 352-259-0666 can help. Talk to one of their agents before making a decision. You can also email Robin Gump, owner at Rgump@midfloridaagencies.com

Due to virus our agents are taking care of all clients by phone. Call us and we will answer all your questions.

Every Medicare health plan receives a yearly star rating on a scale from 1 to 5, with 5 being the highest. For the second year in a row (2019 and 2020), we're proud to say our Florida Blue Medicare and FHCP Medicare HMO plans have earned a 5-star rating from CMS.

Medicare supplement plans can refuse patients who want to switch.

I originally enrolled in an Advantage plan at 65, which I was not entirely happy with. Two years later during open enrollment, I was prohibited from switching to regular Medicare plus supplement because the dosage of my medication exceeded their limits.

Medicare supplement plans are not permitted to ask about pre-existing conditions during initial enrollment, but under certain conditions, they can refuse patients who want to switch back. My only option was getting a different advantage plan.

Another question to verify with SHINE if you think it might apply to you.

(My needs are not everyone's, but I wish I had stayed with a Medicare supplement. It was more expensive, but in hindsight I should have just paid it.)