Talk of The Villages Florida

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-   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/)

JwizChick 02-22-2022 09:16 AM

I have Traditional Medicare, Plan F (no longer available, but grandfathered in). Years ago, when The Villages switched to United Health Care and I was kicked out of The Villages Health, I asked a specialist I see for a referral to another Primary Care Physician. He was glad I wasn’t switching to Medicare Advantage. To quote him, “Please don’t switch to Advantage. They dictate what tests I can order for my patients. I have a patient right now that needs an MRI and they won’t let me order it for her.”

So Medicare Advantage is more than which doctors you see, it’s also about what tests and procedures you can have. To me, that means a disAdvantage!

allsport 02-22-2022 09:19 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.

DO NOT give up G for any advantage plan. The advantage plan gets rewarded for keeping you from care. The Village system is less than stellar. I had to go to their specialty clinic and they charged my insurance for a procedure I never had and they charged me for a well woman visit. I fought for 3 months to get it fixed. They also tried to make me pay in advance for an injection and charge me an actual visit for a shot. If I had not been a healthcare professional, I might never have figured out what they did.

loufromnewjersey 02-22-2022 09:40 AM

I have plan F and everything is covered with a $20 copay.
One example: my friend and I both had kidney stones the same year, went to the same urologist and had the same procedure. He has the advantage plan and his out of pocket cost was $800 vs my $20. The advantage plans work until you get sick.

Mrprez 02-22-2022 10:02 AM

Quote:

Originally Posted by loufromnewjersey (Post 2064547)
I have plan F and everything is covered with a $20 copay.
One example: my friend and I both had kidney stones the same year, went to the same urologist and had the same procedure. He has the advantage plan and his out of pocket cost was $800 vs my $20. The advantage plans work until you get sick.

Wrong. He is $1600 ahead of you. He also has a maximum out of pocket each year.

condomom22 02-22-2022 11:30 AM

Doctors/medical facilities that accept Medicare accept all Medigap (Supplemental) plans. Plenty of doctors accept Medicare in and around The Villages. And with Medicare + a Medigap plan you do not need referrals and are not restricted in using only physicians/hospitals/other medical facilities that are in your Advantage Plan. I have Medicare + Medigap Plan G and all I have had to pay for medical services is the annual Medicare Part B deductible. The Villages Health system requires one to be in certain Advantage Plans for using one of their primary care physicians; however, specialty doctors with The Villages Health do accept Medicare.

Mrprez 02-22-2022 12:08 PM

Quote:

Originally Posted by condomom22 (Post 2064592)
Doctors/medical facilities that accept Medicare accept all Medigap (Supplemental) plans. Plenty of doctors accept Medicare in and around The Villages. And with Medicare + a Medigap plan you do not need referrals and are not restricted in using only physicians/hospitals/other medical facilities that are in your Advantage Plan. I have Medicare + Medigap Plan G and all I have had to pay for medical services is the annual Medicare Part B deductible. The Villages Health system requires one to be in certain Advantage Plans for using one of their primary care physicians; however, specialty doctors with The Villages Health do accept Medicare.

Are you telling me you have no monthly premium? Plus, your Part B premium?

DrHitch 02-22-2022 12:13 PM

Medicare "Advantage" plans are a waste of money (in my humble opinion) because the dental and vision part of those plans are not worth the premiums. Better to self-pay.

Get regular Medicare with a part F or G supplemental. Then look for one that has "Silver Sneakers" to join a fitness place (eg Planet Fitness for free).

Those Advantage plans are all "private" and will steer you towards their own set of doctors and service providers and are very limited in travel especially outside the USA.... Plus somebody has to pay for all of their advertising Guess who??

rustyp 02-22-2022 12:29 PM

Quote:

Originally Posted by loufromnewjersey (Post 2064547)
I have plan F and everything is covered with a $20 copay.
One example: my friend and I both had kidney stones the same year, went to the same urologist and had the same procedure. He has the advantage plan and his out of pocket cost was $800 vs my $20. The advantage plans work until you get sick.

Quote:

Originally Posted by Mrprez (Post 2064558)
Wrong. He is $1600 ahead of you. He also has a maximum out of pocket each year.

Oh silly me I forgot the $200 month premium in the analysis.
I call this kind of logic Casino mathematics.

cindyfeh 02-22-2022 12:39 PM

If you are still n good health, you may consider “N”. The monthly premiums are less even with the copays. You can always change to “G” when you health issues increase.

Mrprez 02-22-2022 12:50 PM

Quote:

Originally Posted by rustyp (Post 2064610)
Oh silly me I forgot the $200 month premium in the analysis.
I call this kind of logic Casino mathematics.

Don’t forget about the Part D premium as well. Topping $400 a month even if you aren’t sick.

Mrprez 02-22-2022 12:54 PM

Quote:

Originally Posted by DrHitch (Post 2064603)
Medicare "Advantage" plans are a waste of money (in my humble opinion) because the dental and vision part of those plans are not worth the premiums. Better to self-pay.

Get regular Medicare with a part F or G supplemental. Then look for one that has "Silver Sneakers" to join a fitness place (eg Planet Fitness for free).

Those Advantage plans are all "private" and will steer you towards their own set of doctors and service providers and are very limited in travel especially outside the USA.... Plus somebody has to pay for all of their advertising Guess who??

I don’t pay any premiums. I have emergency world wide coverage. I don’t use the vision as I need to have my eyes checby an ophthalmologist. The hearing coverage is fine. My hearing aids were free and include 3 years of batteries. I want to be in a network, I like one stop shopping. Last thing I want to spend time on is looking for a doctor.

Mrprez 02-22-2022 12:55 PM

Quote:

Originally Posted by cindyfeh (Post 2064613)
If you are still n good health, you may consider “N”. The monthly premiums are less even with the copays. You can always change to “G” when you health issues increase.

And if you aren’t in good health you will never get one of these plans. They only want healthy people covered.

larcha 02-22-2022 01:05 PM

It is the clinics only. The hospitals accept all insurances including Medicare supplement plans.

Mrprez 02-22-2022 01:14 PM

Quote:

Originally Posted by larcha (Post 2064623)
It is the clinics only. The hospitals accept all insurances including Medicare supplement plans.

As do the specialists. Only primary care physician requires a Medicare Advantage plan.

Jack58033 02-22-2022 01:48 PM

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 have the advantage plan but want to see the best doctor in the country. You would be out of network right?


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