UHC Medicare advantage question
 

Medicare question to those of you on a UHC advantage plan. My wife and I are getting ready to retire in 2023 and have been extensively researching Medicare. We're both healthy and very fit (knock on wood). So we've decided the best plan for us is the AARP UHC advantage. We'll be snowbirding in TV starting next fall. The UHC network here in Indiana includes all the providers we need. So we were wondering how good the UHC network is in the TV and surrounding areas? Thanks in advance.

Could you get that information from UHC?

You can search by provider. But when you don't know who the good providers are there, that's hard to do.
Sometimes it's best to just not respond to a post if you have nothing constructive to add.

We have UHC The Villages plan, check it out vs. AARP.
We're plenty happy with United HealthCare , 14 years running down here.
Best wishes

I have UHC and also a snowbird have no interest in The Villages UHC PLAN

Wow.

How good? Does The Villages Health take AARP plan? If they do TV health is very good imo.

Shut that down real quick!

Excellent. Been highly satisfied. Never an issue with a claim.

UHC Medicare Advantage
 

We've had UHC Medicare Advantage, PPO, for 12 years, in Illinois first, then snowboarding, and for the last 2 1/2 years full time in TV. We chose the PPO plan so we could go wherever we want. The Villages Health DOES accept UHC-MA, both the HMO and the PPO plans. Our primary care Dr. is in TV Health, as are some specialists, but we still have the OPTION of going to any Dr. we like, without prior "permission." We've been very satisfied with the PPO plan.

UHC is the way to go, here in the villages. BUT with traditional medicare, NOT medicare advantage. If you want more information, go see a SHINE ( Serving health insurance needs of elders) specialist. ln Chula Vista recreation center, or Lake Miona recreation center, or Lady Lake Library, or Eisenhower recreation center, different times and days. These are medicare people, NOT insurance company people. Or call 800-963-5337 for information. You may be healthy now, but you don't know what tomorrow brings. Good Luck!!

For the past 7 years we've had UHC TV Advantage program and used the TV Health Services. Both are very satisfying. You can use, but don't have to use the TVHS. The TVHS is staffed with many highly qualified doctors and specialists. It is the most convenient, comprehensive and accommodating medical care we have had since retiring 15 years ago (have experience with 2 advantage programs in 2 other locations). When traveling you have access to the network of UHC doctors. I would suggest also getting a local personal insurance agent. That helps when you may need some care outside the normal advantage coverage. DM me if you would like the name of a local UHC agent. Shine is an excellent unbiased source for your insurance needs.

Suggestion: contact Debbie Pecerarro @ 352-406-4010. She is one of the best UHC representatives here in TV and is a world of knowledge. She can answer any question you have about UHC.

I worked several years for a Medicare Advantage PPO and HMO insurance company as an RN health coach. Most of the nurses I worked with agreed that when we retire, we would not have an advantage plan. So much of our time and our clients time was spent determining copays, searching for in- network doctors and hospitals, whether certain procedures would be covered and donut hole concerns. Deductibles and co-pays can add up through the year and over a lifetime, and many of my clients would decide not to have a recommended procedure because they could not afford the copay. Or they may not be able to go to a preferred specialist because they were not in network. I am with AARP Medicare Supplement insured by United Health Care and I am very happy. I have been in good health and an advantage plan may have cost less initially. But I am starting to go the the doctor more frequently now and I do not have to worry about any copays or specialist selection. If I would develop a series health issue, those copays can become overwhelming. When you retire and start medicare, you have six months when insurance carriers who provide a supplement plan have to accept you in spite of any health issues. However....after that they do not have to accept you and your option of choosing a medicare supplement plan may not be possible. So I highly recommend a medicare supplement plan over any Advantage program. If down the road you decide you want an advantage plan....you can switch. But you may not be able to switch from an advantage plan to a medicare supplement plan after that initial 6 month period.

I am also a retired RN, and I agree completely regarding Traditional Medicare vs Medicare Advantage. With Medicare Advantage, not only are you limited to which physicians and facilities you can go to, physicians are also limited to which procedures they can order for you. A Neurologist friend once told me he had a patient that badly needed an MRI of the brain, but Medicare Advantage would not allow it. To me, that was monumental. So save a few bucks in the beginning, but take a chance of a serious issue not being diagnosed? No thank you! I have Traditional Medicare with Florida Blue Supplemental and am very pleased with both.

Actually talked to SHINE a while back when we were there in Oct. They said for us the UHC advantage plan is a great option.
We've done a lot of research and talked to an agent here in Indiana. Copays don't bother us.

There's no perfect plan. They all have pluses and minuses. The fact is over 50% choose advantage plans now and the satisfaction rate is 88%. So they're not all bad.

Just like anything in life you can find bad stories out there about these plans. But in our research the reviews have been mostly positive.

we have it too. it works well for us, costs are under control, & any major procedure is covered if an outside facility is needed. my entire spinal fusion was a 150$ co-pay @ the time of service, then billed $400 for remaining cost. not too bad, imo. i also had 1 of the best doctor's in Orlando Health. you will need to shop around if you want, we did & chose the Villages plan

You don’t say why you are against advantage plan

Villages Health Care has the best doctors I have ever had.

healthgrades.com

UHC will send you a list of providers in TV. Call the number on the back of your Medicare Advantage card.

I have FL BL Med Advantage & it is grrrrrrrrrrrrrrrreat

I’m in the same boat- 2 yrs until retirement-I spent numerous hrs on the phone with an agent discussing all the plans finally decided on the UHC advantage plan - next I spent an hr on phone with underwriters going over everything with underwriters- I’m healthy and only take pantropazole since I had a peptic ulcer 3 yrs ago from very stressful job- and also a low dose antidepressant- my agent said oh no problem to get approved- 4 days later I get letter NOT approved due to medications ! Really ??? All that time wasted so now going to a great agent my husband has at Fl blue and will be picking a plan with him

We have UHC Advantage Plan Regional PPO and we are very pleased with it. We have not been refused usage of it by any doctor or facility here in The Villages, we still routinely drive to Sarasota to see a couple of our old doctors, and because it is a nationwide plan we can find in-network providers anywhere we go. The benefits will get even better in January. They are eliminating co-pays for primary doctors and tier one drugs, lowering co-pays for specialists and expanding the dental and eye plans. We have changed plans several times since retirement and this plan meets or exceeds all others we have had.

I have always felt that having "choices" is the best situation to be in. I feel that it actually is the definition of health. As I stated earlier, I worked many years with the advantage plans provided by a major health insurance company....and one that is currently available in The Villages. I found that I had many more "choices" through a medicare supplement plan. No matter where I live, what doctors I want to see or what conditions I may develop...if they accept medicare, I will not be denied. There are too many unknowns in our life and I did not want to add the ever changing advantage plans to that list.

We have that plan. Big savings. We have very little issues with the plan. There are increases the benefits in Jan. 2023. No referrals needed. Call UHC about having coverage in IN and FL. We had coverage in CT and FL for many years as snowbirds.

Since several plans are being discussed, perhaps you would identify to which plan you are referring.

I have UHC Medicare Advantage - Walgreens. I'm perfectly happy with it. I pay no monthly fee, no prescription costs, and my deductible for seeing a specialist is very affordable.

Thanks everyone for the helpful feedback. We're going with the UHC advantage ppo. That's the plan that checks the most boxes for us. The nice part is that there are many options when it comes to medicare. No one plan is right for everyone.

Network
 

I could be totally wrong but I think it would be rare to get an advantage plan that would give you a good network in two different states. When I looked at an advantage plan after moving here from Pinellas County FL I would not be able to continue going to Moffitt Cancer center because of the change of zip codes.

You are 100% wrong. United Healtcare Medicare advantage plans cover you nationwide. They have a huge network. With their ppo you don't have to stay in network either. You have the option to go outside if needed. Trust me we asked all the right questions. Advantage plans evolve and improve every year.

As I said, there's many choices. Just get what works for you.

Be sure you also purchase drug coverage if not through UHC another provider (I went with Aetna). If you pass on drug coverage you pay a penalty on the coverage when you do decide to get it!

Drug coverage is in the plan we're going with.

Every year I receive many offers for Medicare Advantage plans which I throw into the recycle bin in my garage. Someone is trying to sell me something to make money off me. I stick with Medicare and an AARP (United Healthcare) supplement F which I have had since I turned 65. It has covered every medical situation I have ever experienced with little or no out of pocket costs wherever I have been in the USA.

I have the FL Blue The Villages Advantage Plan. I specifically picked it because Moffitt is in Network I also have the advantage of having a The Villages Health Primary Care Physician. I am completely satisfied with my Advantage Plan and The Villages Health.

I think the choice of going traditional Medicare with a supplement or Choosing an Advantage plan is a decision that you make based upon your personal situation.

The fact is most of us require insurance and many have been paying into Medicare for our entire working life. That basically gets you Medicare A coverage. Going further, most will want Type B coverage which will be a monthly charge. Since that will only cover 80% of the bill, we opt to look at Advantage Plans which replace Medicare or choose to keep Medicare and choose a supplement to cover those costs not covered (The 20% excluded by Medicare.

The difference is that Advantage plans cost less and may expand benefits to include, dental, vision, drugs etc. The downside is the need to deal with a network of providers who agree to work under the networks payment rates. The individual Advantage Networks are businesses working to operate with a profit. Their funding comes from a negotiated rate with Medicare and any income they can get from premiums. Medicare benefits because they have a fixed cost per customer where under traditional Medicare they pay whatever is incurred.

Given the above, the Network costs need to be kept within in their cash flow (The Medicare payment plus the premiums they get if any). If providers decide they want higher rates than the Network can or will pay, then they are changed. You may lose your
your personal physicians.

Supplements are not dependent on Medicare Funding. They are in addition to Medicare.
Assuming that Supplements cost $150/month, that is extra money in the system to pay the bill or become added profit. They don't control Provider cost or selection or providers.

It would seem that the bottom line would be that Advantage plans would have to pay their provider network at least 20% less than Medicare allows in order to break even. Draw your own conclusion what that means to experience or quality of providers.

So, you are in good health now as you join. But what happens in 6 months, 1 Yr, 5 Yrs, etc? What happens when you need the best i.e. Moffit, Shands, or Mayo? Even if your plan allows out of network, what are the costs? Can you get out of Advantage and switch to Supplement?

If your budget doesn't allow cost of supplement, the choice is easy. If you can afford the Supplement, consider wisely.

My wife and I have had supplements since we have enrolled in Medicare. In retrospect, we have paid more than an Advantage program. But we could afford the supplement. Assuming $3600 premium per year to cover us both, my former employer pays $1000 each for a retirement insurance benefit (No insurance cost, no benefit) and my UHC Supplement pays our combined $1300 yearly premium for Genesis Health Cub. That makes our total cost for Supplement $300/year.

Having a spouse is also a big decider. More chance for a need for enhanced care needs.

Good points made. Choice and competition is a good thing, imo.
The UHC Advantage ppo is a good fit for us, so we're going with that. It allows out of network if you need that. Plus, if needed we can easily go back to medicare during open enrollment. I've confirmed this in writing with medicare. Now, medigap can be an issue when switching back. If you have some major health issues they can require underwriting or deny you that coverage.

All that said, there's no right or wrong here. Just do the research, ask a lot of questions and make an informed choice. No plan is right for everyone.

Advantage plans can be a very good option and they inprove every year. The UHC plan got better for 23.

Btw, medicare.gov has lots of good info, live chat and they also show the star rating for advantage plans.