United Health
 

A friend of mine told me that he pays no monthly premium for the United Health Advantage HMO, which includes Rx's and Silver Sneakers. My company offers United Health Advantage PPO for almost $200 a month. Only difference I can see is I can go out of Network versus the HMO staying in Network.

Am I missing something on the HMO? It seems almost too good to be true.

We have the UHC HMO plan you reference and it works well for us, but you need to look a little deeper to judge if it is better for you. Consider the co-pays, co-insurance, Rx costs, and your dental and vision needs. If you're relatively healthy, don't go to the Dr often, and take few Rx drugs, then it is great. The Dr visit copay is $40 except for primary care physician which is $0. Every blood test is $19. Some procedures have a co-ins of 20% so for a PET/CT scan that's about $300. The dental and vision coverage is very minimal. Just food for thought so I hope this helps.

Get The Villages Insurance and put your money in a savings for a cruise. We have it it's fine.

UHC Medical Advantage Plan is $111.00 per month, (it's what I pay), and it includes drug coverage. You would need to stay in network. As always, one would need to see what medications are covered in the plan but the list is extensive. For some reason, the cost was $104.90 per month and they increased social security .3% and increased the medical payment to $111.00 per month. It was a wash in the terms of net income.

I take a couple of tier one medications and the cost is zero if you use the "preferred mail service, OptumRx, pharmarcy", (90 day supply). Your medications are shipped to your home via postal service. I have found it works exceedingly well.

Saying it cost nothing is is not true unless you consider $111 per month nothing.

I've been with the UHC Villages Medicare Advantage since July 2015, close to 2 years. I pay zero premiums, my doctor is at Pinellas Office, which is only a mile from my house, and I've paid very little for anything else.

When I do lab work once a year, they do an additional test for TSH which checks my thyroid since I'm on medication for that. That test is $10 to Labcorp, I've not been charged for any other tests. I go to two specialist, Dr. Casper a dermatologist and I paid $30 the first year and this year it went up to $40. By most in TV he's considered the best dermatologist in or out of network. I also go to a plumonary doctor and I pay the same $40. I've needed a couple of drugs and I got them at Walgreens and they were just generic so I paid $9 each.

To me it's the best value you can get. A year ago I had pneumonium and they sent me to Lake Imaging for a chest x-ray and I paid nothing and the doctor followed up and I had another x-ray to make sure I had recovered.

The medical social security deduction is for everyone, no matter what plan you have. I think the OP meant no additional monthly charge.

I have Tufts HMO, and have seen specialists out of network, with referral. I also have no monthly premium. I would also consider myself a very healthy person. If I would need more insurance, I could upgrade in the fall for the next year.

Contact SHINE and get some completely unbiased information, while the HMO (aka ADVANTAGE) plans can work well for some people, they do NOT work well for all people. There can be potential gottachs if you decide that you want to got back to traditional Medicare, you may have to pay higher premiuns, you may not be covered for a preexisting condition, etc. Florida SHINE organization can provide a lot of additional information. There are also several previous threads on this subject.

My wife and I have the UHC Advantage plan.She broke her hip on a cruise and had hip replacement surgery in Port Canaveral Hospital.I was very concerned with my medical bills but everything was covered except my co-pay for hospital stay of $1100.I paid that myself and because I purchased supplemental travel insurance prior to the cruise,I was reimbursed the $1100.The travel insurance also paid for my hotel in Cape Canaveral.By the way excellent hospital at Cape Canaveral.

insurance
 

How do I contact SHINE

I didn't find SHINE very helpful, personally. I thought their seminar info was outdated (ie: HMO's are bad).

The UnitedHealtcare rep down at Brownwood had the best info. I went with UHC Villages Medicare Advantage which works great if you're fairly healthy. Yes, the providers are a bit limited (find an ENT closer than Tavares, for example) but it works great for me thus far.

If you have a lot of health issues, I'm not so sure it's the best choice though. Good luck.

I believe you are compating apples and organges. UHC Advanate PPO costs zero per month. Gov't Medicare is probably the $111.00. If you dropped UHC or any other supplemental play you would still pay for Medicare. UHC has a bunch of plans, but the one I use for The Villages Health costs zero. So far, no issues with the plan or the service at the care centers.

Gee, and I thought for sure they would recommend Blue Cross.

Medicare fraud
 

So this is cute... Medicare fraud..

hgoogle it

The Justice Department has sued UnitedHealth Group, saying that senior executives knew the company was overbilling Medicare by hundreds of millions of dollars a year, and halted a repayment plan in 2014 so the money could be used to meet Wall Street’s revenue expectations.

In a complaint filed Tuesday in United States District Court in Los Angeles, the Justice Department said UnitedHealth routinely combed through millions of patients’ medical charts, searching for data it could use to make patients look sicker than they really were, in what the lawsuit called “strictly a one-sided revenue generating program.”

Under the government’s popular old-age health program, Medicare Advantage, reporting unhealthier customers led to bigger payments from the federal government — $3 billion worth to UnitedHealth from 2010 to 2015 alone, according to the complaint. The Justice Department said misrepresenting people’s health was a civil fraud and sued for triple damages and other penalties.

Remember that auto oil commercial that have the slogan "Pay me now or pay me later" well it applies to health insurance. The decision every policyholder has to make is a calculation on now or if later will ever occur. Make your best guess based on your household health history.

Personal Best Regards;