Talk of The Villages Florida

Talk of The Villages Florida (https://www.talkofthevillages.com/forums/)
-   The Villages, Florida, General Discussion (https://www.talkofthevillages.com/forums/villages-florida-general-discussion-73/)
-   -   Anyone have Medigap G instead of the Advantage plans? (https://www.talkofthevillages.com/forums/villages-florida-general-discussion-73/anyone-have-medigap-g-instead-advantage-plans-329436/)

BrianL99 02-22-2022 06:37 AM

It's really a very simple equation.

If you want control of your Healthcare, stick with a Medicare Supplemental Plan.

If need to save a few bucks and are willing to compromise your healthcare to do that, get a Medicare Advantage Plan.

Oneiric 02-22-2022 07:00 AM

In response to your question, if you want to select your physicians and facilities, you would do better avoiding Advantage plans and The Villages system, which is essentially an HMO. If you never need a doctor, HMO's are fine. If you want the best physicians available, God help you.

rsmurano 02-22-2022 07:16 AM

If you can get plan G, plan N, plan X, get any of them because they are Cadillac plans vs. an advantage plan, according to a Medicare insurance broker. I can go to any doctor that is covered under Medicare, even to a villages health specialist. My deductible is < $200. I also have a prescription supplement that costs $15 a month.
Most advantage plans have high deductibles and you probably will pay a copay and if it’s a specialist, it’s around $65. Plan G, no copays.
Since the supplement plans are much better, the biggest restriction is that after your initial welcome to Medicare at 65, they don’t have to accept you. So if you have an advantage plan now and get cancer or afib and you want to get a plan G, they will probably refuse you. Once you are in a plan G, you will always be in.
1 more thing, you can get a plan G from any state it doesn’t have to be from a florida insurance company. I save over $60 a month by keeping my out of state plan

rsmurano 02-22-2022 07:17 AM

If you can get plan G, plan N, plan X, get any of them because they are Cadillac plans vs. an advantage plan, according to a Medicare insurance broker. I can go to any doctor that is covered under Medicare, even to a villages health specialist. My deductible is < $200. I also have a prescription supplement that costs $15 a month.
Most advantage plans have high deductibles and you probably will pay a copay and if it’s a specialist, it’s around $65. Plan G, no copays.
Since the supplement plans are much better, the biggest restriction is that after your initial welcome to Medicare at 65, they don’t have to accept you. So if you have an advantage plan now and get cancer or afib and you want to get a plan G, they will probably refuse you. Once you are in a plan G, you will always be in.
1 more thing, you can get a plan G from any state it doesn’t have to be from a florida insurance company. I save over $60 a month by keeping my out of state plan

msilagy 02-22-2022 07:28 AM

That is an excellent choice plan G. Choosing your own DR's and hospitals is very important If you need to go to the top hospital/Dr's in the country for a severe illness you can. Don't listen to the hype about advantage plans. Yes they may be more inexpensive but not the best choice if you want freedom of choice yourself. I have had plan G for 7 years - the only money outlay is the medicare deductible. All else has been paid for.

spinner1001 02-22-2022 07:30 AM

Quote:

Originally Posted by metoo21 (Post 2064307)
We would prefer to have Medigap G instead of any of the Advantage plans. Does anyone in The Villages have G? Is there an issue using it? We would just prefer to select our on doctors and facilities.

If you are already in a Medicare Advantage plan, you may have limitations in flipping over to a Medicare Supplement plan (e.g., Plan G) depending on personal circumstances. The devil is in the details.

SHINE, a Program run by a State of Florida agency, is a good way to educate yourself with unbiased insights.

mkjelenbaas 02-22-2022 07:48 AM

Quote:

Originally Posted by metoo21 (Post 2064307)
We would prefer to have Medigap G instead of any of the Advantage plans. Does anyone in The Villages have G? Is there an issue using it? We would just prefer to select our on doctors and facilities.

Don’t have one - thanks for asking.

Joanne19335 02-22-2022 07:48 AM

Quote:

Originally Posted by billethkid (Post 2064368)
If it is standard medicare plus a supplement then usually everything is covered....pick your own doctors/hospitals/no referrals required to go to specialists.
Some might say it costs more....all I know is we have not had to reach in our pocket for ANY procedures.....very major surgeries over the years.....100% covered.

Agree 100%. I have Aetna Medigap Plan N. Premiums are reasonable and everything is covered. I would never have an advantage plan.

TNLAKEPANDA 02-22-2022 08:03 AM

Yes we have the G plan and it’s great. You pay a monthly premium but there is no out of pocket or limitations or deductibles.

JoannMH 02-22-2022 08:07 AM

I have AARP plan G and have had no problems finding doctors within the villages. I worked for several years as an RN for a Medicare Advantage plan and everyone I worked with agreed that we would never get an advantage plan. We spent so much of our time helping our patients search for in network doctors and helping them understand their bills and what their financial responsibility was. It was confusing for us and very confusing for our patients. Plus every year it changed. If you qualify for Medicare Supplement.....I definitely think that is your best choice here in the villages. Also...from experience searching for doctors for my patients...I found that frequently the best doctors, specialists and hospitals did not accept an advantage plan.

toeser 02-22-2022 08:24 AM

Quote:

Originally Posted by bowlingal (Post 2064442)
I have traditional medicare and UHC as a supplement. My premiums are less than $200 per month and EVERYTHING is covered. No referrals. no co-pays, no deductibles. I can go to any doctor, hospital anywhere in the US. Yes, I can't use the Villages Healthcare for primary doctors, but I can for specialists. My total yearly payout is less than $2400. I bet your deductible, co-pays are more than that. Why wouldn't you get traditional medicare? make no sense to me.

Must be nice. I have Medicare plus the AARP UHC Supplement F + drug insurance. My premiums are $22,000 per year for my wife and I. That includes the portion for Medicare taken from my SS.

Rhonda West 02-22-2022 08:51 AM

Medicare with supplement
 
I just went through this with changing my mom over to straight Medicare with a supplement.

The Advantage Plan she had for years served her well UNTIL SHE GOT SICK! The dirty secret is that if you end up in rehab or need longer care than the ADVANTAGE plan has in their FINE print you are up a tree! My mom had a traumatic injury breaking her femur around an existing hip replacement. Her UHC Advantage plan issued a NOMNC - which is a termination of rehab coverage after 2 weeks! Short story is I learned that even though the Medicare guideline says you have 100 days in a rehab or nursing facility - UHC Advantage gives you 20 days and then they start sending you these notices!! We had to file appeals 6 different times to keep her in rehab without us having to be self pay. I can't even tell you what a pain in the @#$% this was!

I spoke with MANY medical professionals, facility professionals, social workers, nurses, and therapists and they ALL said there is NO advantage to an ADVANTAGE PLAN because Medicare gives them the power to dictate your coverage. With straight Medicare and a supplement Medicare allows the FACILITY that is treating you to determine when you are safe to go home within that 100 days!! What a novel idea!!

I disenrolled my mom from the Advantage Plan and enrolled her in supplement F with straight Medicare. "F" is the GOLDEN TICKET and is not available to all Medicare eligible individuals. With this combo we have received NO MORE "ousting notices" for my mom. She received 3 of those notices in the first 45 days she was in rehab before I made the switch back to straight Medicare and supplement F.

EVERY professional I spoke with told me they DO NOT recommend Advantage Plans for their aged relatives - that says a lot to me.

BTW - Moffit, SHANDS and Mayo Clinic ALL accept Advantage Plans - I know this first hand. Still easier to have straight Medicare with supplement.

metoo21 02-22-2022 09:01 AM

Quote:

Originally Posted by rsmurano (Post 2064464)
1 more thing, you can get a plan G from any state it doesn’t have to be from a florida insurance company. I save over $60 a month by keeping my out of state plan

So, are you a permanent resident of Florida? Have another home out of state? We would be permanent residents of FL with no other home. plan G in our current home state will be cheaper than in FL.

Jerseyborn 02-22-2022 09:15 AM

Quote:

Originally Posted by champion6 (Post 2064419)
The Villages Health is a group of clinics with primary care docs. They require specific Advantage plans for patients over age 65.

The hospitals in The Villages and Leesburg are owned by UFHealth. They accept Medicare and many more HMO & PPO insurance plans.

Attached is a list I created with primary care groups in/around The Villages. As far as I know, on this list The Villages Health is the only group that requires specific Advantage plans.

Thank you for sharing!

Lsepanske@aol.com 02-22-2022 09:15 AM

I have Plan G for last 3 years.....minimum deductible, highly recommend it. Had Plan F, expensive, no deductible.
Had Advantage Plans, cost me more in deductibles, limited in doctors, hospitals, etc.


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