Turning 65.
 

What are the steps we Villagers should take as we move to the 65 year mark with respect to Medicare?


I have almost a year though to plan.

Start here to get sound advice versusTOTV opinions.
SHINE - Counseling Sites

Come on! TOTV answers are so much more fun. :1rotfl:

That they are.

Determine if you want a supplement plan or an Advantage plan. If the former you can get on a plan without answering health questions within 6 months of turning 65. After that you will gave to answer questions about your health.

Omg

:agree:

Go to the county office and apply for your 65 years old Homestead discount

Are you a veteran? If so DAV can answer your questions first.. If not then I agree Shine is a good resource, but you may get a first time volunteering as I did, that really could answer any questions, help, in anyway.

So my recommendations for Shine is to go more than once, different volunteers have better answers for you.

I don’t use a Medicare supplement. I am healthy for my age group due to food choices and activities. I see one physician once a year, so with my regular deductible, I pay out very little.

That may change later in life once the 70s, and beyond comes around, but for right now I just add what I save on advantage plans in my travel account

65 years of Procrastination, but needs answers immediately…taking the bull by the horns is your first step in life’s Rodeo

Try the Elder Helpline. I've never used them but all states have such a service. They should be able to answer your questions.

Elder Helpline 1-800-963-5337
Florida Department of Elder Affairs

go see the people at SHINE ( Serving Health Insurance Needs of the Elderly). several meeting places....Lake Miona Rec Center, Eisenhower Rec Center, Chula Vista Rec Center, Lady Lake Library. All different days and times. They are Medicare trained people, NOT insurance people.

Get a supplement plan and never look back. You can go anywhere in the country (even in the world with some plans) that accept Medicare (except for the villages healthcare places, which could be a plus). These plans cost very little per month and what you get is no copays, $200 deductibles, no referrals, and no refusing medical services. Some of the advantage plans have very high deductibles, copays, and if you listen to people who have these advantage plans, they are constantly getting their health care procedures not approved so the companies can save money.
The biggest decision you have is when you turn 65: this is the only time you won’t get refused getting a supplement plan, after 65, any supplement plan can refuse you. Also, if you have a supplement plan in another state, you don’t need to change to a florida based plan because supplement plans are accepted everywhere medicare is accepted.

The main initial steps are learning about the byzantine Medicare system and choices you have. It’s complicated.

Two areas you might think about to get a fuller understanding of Medicare are: (1) healthcare insurance and (2) healthcare providers. Your personal choices of healthcare providers (e.g., which physician you can see, which cancer center can you go to) may be determined by what Medicare insurance plan you choose.

You can put Medicare consultants into two groups: compensated and not compensated. Generally, the non-compensated Medicare consultants will give you more unbiased information. The State of Florida has an agency that others have mentioned, SHINE, that offers free information for seniors including Medicare information. I believe many compensated Medicare consultants are biased toward Medicare Advantage plans (versus traditional Medicare) because there is more profit for the insurance companies and large health systems, and those organizations have big marketing budgets and pay their agents.

I suggest starting by reading a lot from not-for-profit sources that seem competent (Medicare choices are complicated and overwhelming when first learning about the system). AARP, although they get advertising dollars and tends to get somewhat biased at times, is a relatively good place to start reading about Medicare choices. Then read from there.

The last place I would start learning about Medicare is asking for personal opinions. Start with people who have been trained in that complicated system.

Good luck.

If you are a military retiree, Tricare for Life is your supplement. Must take parts A & B.

Medicare
 

not just villages anywhere -

Medicare basics -
You need to signup for medicare part A, B & D or some advantage plan (part C) 3 months before you turn 65 to 3 months after you turn 65

If you didn't get medicare when you're first eligible, your monthly premium will go up 10% for each 12-month period you could've had Part B, but didn't sign up and that lasts forever. In general, once you are past that signup window they do NOT have to take you especially if you have medical problems or can charge you more. That’s why it really is worth talking to a shine counselor to understand your choices and shop around to choose well.

Yes all the medigap plans and advantage plans have to provide the same basic services. BUT some plans are lousy at paying bills or providing you with medical services where you want especially specialists – you could be denied from where you want to go.

SHINE - Sumter

Video for medicare
 

Avoid "Advantage" Plans
 

Sign up for regular Medicare and the Prescription Plan. Then add a Supplement. While there are several grades of Supplemental plans, those grades are all the same from carrier to carrier. The easiest is to join AARP and buy the United Health plan.

Avoid the Advantage plans, which are HMO's and severely limit your choice of doctors to those in the HMO. With regular Medicare, you can go to the doctor of your choice anywhere in the country, provided the doctor accepts Medicare. If you are healthy at present, you may think this is not important. However, if you become sick or injured and are in an Advantage plan, you will quickly learn the plan's limitations, will be unhappy, and, will realize you made a mistake. As mentioned by one RP, all the Supplemental plans must accept you when you first enroll in Medicare. However, if you enroll in an Advantage plan and, in later years, try to switch to a Supplemental plan, you can be rejected because of your medical problems.

I speak from personal experience. At age 65, I chose regular Medicare and United Health. In the past 15 years, I have had few, if any, problems getting the medical care I need from the doctors by whom I want to be treated. In contrast, my wife chose an Advantage plan because she wanted the "free" fitness club membership and the small dental benefits. However, when she came down with an unusual and severe kidney problem, we went through hell to have her seen by one of the handful of doctors in the country who specialized in treating her condition. As soon as she was cured, she immediately dropped the Advantage plan and purchased a regular Supplemental plan.

Ask someone you know that is already on Medicare, then you will learn all the horror stories...

Simple if you want the insurance company to manage your health care then get an advantage plan. Ask the people who work in the doctors office they will tell you.

Look in the Rec News as to when SHINE holds sessions. They are simply the best. They provide information. They do not sell anything. When I was crossing the bridge that you are about to, I received a ton of unbiased info from the SHINE volunteers and I can not speak highly enough of them.

They do a wonderful service!

SHINE is a good non biased place to get advice. This is not a one size fits all subject. However I urge you to watch the following short video about advantage plans. Most people don't understand the difference between an advantage HMO vs a PPO. There is a world of difference. Pay attention and you will see a PPO is very similar to basic Medicare plus a supplement. I am not recommending which way to go at all however throwing out an advantage PPO because of having limited choices and substandard care is simply not true.
https://www.youtube.com/watch?v=hypDLs71TA0
Another very short video:
Medicare Advantage HMO VS. PPO 👩🏽*⚕️🥰 #shorts - YouTube

I’m still 4 years away from Medicare age, but doing my research now, I agree with what you have said above - I am heavily leaning towards supplement instead of advantage. You can always change to advantage (during open enrollment each year) if you later change your mind - not so much the other way around - supplement premiums aren’t that much - and the flexibility with supplement is wonderful - I’m currently not with Villages Health right now anyway, because of my age - so I really have no desire to get on advantage just to be part of villages health network.

Here is another good video explaining the difference between Medicare and Advantage plans in layman's terms. Unfortunately the title uses the click bait approach but has little relevance to the content.

https://www.youtube.com/watch?v=gNzqGYctWis

Who do you think sells supplement plans? The very same insurance companies.

And finally if you watch all 3 of the videos before going to SHINE you will be far better off than just walking in. Without some backdrop it is highly likely your mind won't be able to keep each option separate the first time around - too much at once.

Turning 65 years old and Medicare
 

One of the considerations in addition to the other suggestions is, when one turns 65 years old, your current provider/PCP may or may not accept Medicare assignment. More often than not, primary care MDs allow their current patients to "age in" when they turn 65 years old. It would be helpful to find out, if you can continue with your current PCP or do you need to also find a new doctor when you turn 65 years old.

It can generally be a bit difficult to find a good primary care doctor when over 65 years old, because MDs take fewer Medicare patients because to their medical needs as they age.

Many people stick with basic Medicare + a supplement if they don't have a lot of medical conditions as the costs are a bit less. A medical advantage plan can provide a number of additional services such as vision, hearing, meds, gym memberships etc. for the same cost as basic Medicare.

As a military retiree, I was able to find a Medicare Advantage plan (Florida Blue-Patriot) that covered a # of services PLUS I receive $50 back on Medicare payment each month. That being said, I don't use vision, hearing or medications through them but receive these services through the VA since my disability is high enough for these services. My "supplement" to Florida Blue is TRICARE which covers co-pays for most services.

So your decision on where/what to choose is:
1. What are your health care needs currently? i.e. do you need specialty medical services such as cardiac, pulmonary etc. If so, a Medicare Advantage plan might be the best choice.
2. Do you desire to continue with your current PCP and does he/her accept Medicare assignment? What other health insurances does your PCP accept as this will determine which Medicare Advantage plan you'll join should you stay with your current PCP.
3. Do you have other supplements or insurances available to you?
4. Discuss possible insurance companies with SHINE (very helpful), VA etc.

Straight Medicare plus a supplemental insurance ie UHC (United Health Care) is the best way to go! You can go anywhere and see any doctor on Medicare!

Bro…he gave himself a year to figure it out. Seems reasonable. Lighten up. 😂

Find a good doctor that accepts Medicare.

I got the Mutual Of Omaha supplement plan G.
 

I have Mutual Of Omaha plan G supplement. I had a reverse shoulder replacement in March last year and three new discs in my neck vertebrae. Other than prescription cost my total out of pocket for the year was $1200!!! I think it only cost me 160 a month

Research Healthcare
 

[QUOTE=Taltarzac725;2198536 What are the steps we Villagers should take as we move to the 65 year mark with respect to Medicare?e almost a year though to plan.[/QUOTE]

Research the avaiLability of doctors and hospitals .

The plan announced by UFHealth more than a year ago to make The Villages Regional Hospital a teaching hospital has been cancelled. UFHealth has not been successful in attracting new doctors and nurses to staff TVRH and train doctors doing their residencies, let alone properly staff TVRH for normal operations.

Possibly for the same reason, the plan to build a large new hospital and medical complex in the southern end of The Villages has also been tabled. UFHealth has withdrawn from the partnership with The Villages to build the hospital. The Developer is scrambling to find a new partner to joint-venture in the construction of the large, new hospital.

If you’re considering moving and living here, who will your doctor be? What hospital will you go to, if necessary? What insurance will be accepted? Now that The Villages has a population at least double that when the last expansion of TVRH or Leesburg Hospital, what hospital would you use if necessary?

Ask your doctors what they know about these issues. You certainly won’t be reading about it in The Daily Sun.

Some of the new doctors who moved and built homes nearby are rethinking their decisions. The move of all the schools to the south end of TV near the new high school now requires a 45-minute drive each way to get their kids to-and-from school.

Huge difference between Advantage and Supplement. Advantage is comparable to an HMO where your "gatekeeper" doctor determines when and if you can see a specialist. With a supplement, you can at any time decide for yourself to see any doctor who accepts Medicare. All supplement plans offer the same benefits, regulated by Medicare. The only difference is the cost of the premium. If you're eligible for USAA, they offer a supplement and it's as good as all the rest of their insurances.

Medicare Ect.
 

Rebecca Brewer at 803.614.8330 is a Florida agent. Lives in the villages She does mine.

Lots of good information here. Thanks.

Don’t get sick

If you are receiving Social Security benefits, you already applied for Medicare and will get your card in the mail. Your are eligible on the first day of the month you turn 65. If you postponed Social Security, you need to contact that agency to apply for Medicare (Title XVIII of the Social Security Act) entitlement.

For accurate and unbiased information about Medicare, start with the Medicare.gov website. Be careful about, and skeptical of so-called “Medicare consultants “, who are for the most part insurance brokers.

Another example of a poster giving incorrect info - go to shine

1. An HMO is an advantage plan but not the only type of advantage plan
2. A PPO is an advantage plan also and requires no gatekeeper to see a specialist.
FYI - TV AARP medicare advantage choice PPO is accepted at Shands and many other teaching hospitals as in network (the big scare).

Medicare Advantage HMO VS. PPO ������������*⚕️������ #shorts - YouTube

No one plan is right for everyone. We're both very healthy and fit. Yeah, I know that can change. But for us, after much research and also consulting with SHINE, we decided the UHC Advantage plan was best for us.
They're highly rated and get very good reviews. We also know some people who are on this plan and like it.

The new advantage plans have a lot of flexibility and get a little better every year. These plans have changed a lot in the last few years.

But for unhealthy people who go to the doctor a lot medicare can be a better choice. Again, one size does not fit all.