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-   The Villages, Florida, General Discussion (https://www.talkofthevillages.com/forums/villages-florida-general-discussion-73/)
-   -   Preferred Care letter - have to change plans (https://www.talkofthevillages.com/forums/villages-florida-general-discussion-73/preferred-care-letter-have-change-plans-61292/)

Number 6 10-01-2012 12:06 PM

Think back to the passage of the Affordable Care Act. One piece of this legislation claims to have $716 billion in savings. This savings comes from three sources; cuts to Hospitals, Physicians and Medicare Advantage Plans. These Plans were receiving 114% of Medicare to care for their subscribers. This will be cut to 100%, essentially putting Medicare Advantage Plans out of business by 2014. Remember being told that this legislation will save money? Remember certain Senators claiming that they did not know what a Medicare Advantage Plan was? Yeah, sure.

janmcn 10-01-2012 01:05 PM

Quote:

Originally Posted by Number 6 (Post 562265)
Think back to the passage of the Affordable Care Act. One piece of this legislation claims to have $716 billion in savings. This savings comes from three sources; cuts to Hospitals, Physicians and Medicare Advantage Plans. These Plans were receiving 114% of Medicare to care for their subscribers. This will be cut to 100%, essentially putting Medicare Advantage Plans out of business by 2014. Remember being told that this legislation will save money? Remember certain Senators claiming that they did not know what a Medicare Advantage Plan was? Yeah, sure.

Do you really believe that the for-profit big business companies that provide Medicare Advantage Plans, such as Humana, United Health Care, Optimum, Coventry, CarePlus, etc, etc, are just going to get out of the Medicare Advantage Plans business, or will they learn to live within the 100% range? Perhaps some will do away with perks such as gym memberships, dental care, etc. to cut their costs.

NotGolfer 10-01-2012 01:22 PM

The *take* we're having at our house is that the Gold Plan is done. The new plan that was offered for diabetics, heart patients etc. is still in effect and another new plan is in the offering for PCP patients. So we can breathe a HUGE sigh (those who've been concerned) and make our appointments to go over the new coverage.

gomoho 10-01-2012 01:33 PM

Quote:

Originally Posted by janmcn (Post 562295)
Do you really believe that the for-profit big business companies that provide Medicare Advantage Plans, such as Humana, United Health Care, Optimum, Coventry, CarePlus, etc, etc, are just going to get out of the Medicare Advantage Plans business, or will they learn to live within the 100% range? Perhaps some will do away with perks such as gym memberships, dental care, etc. to cut their costs.

So what you are saying is the Affordable Health Care Program will eventually results in cuts in service to the consumer to cover the higher costs? Thought it was going to benefit seniors.

Avista 10-01-2012 01:47 PM

Attended a Preferred Care Partners meeting this morning. Will try to answer any questions. One good thing is we will get $99.90 back each month up from the $75 last year. No co-pay for primary care doc. Some co- pays have increased.

Number 6 10-01-2012 01:50 PM

Quote:

Originally Posted by janmcn (Post 562295)
Do you really believe that the for-profit big business companies that provide Medicare Advantage Plans, such as Humana, United Health Care, Optimum, Coventry, CarePlus, etc, etc, are just going to get out of the Medicare Advantage Plans business, or will they learn to live within the 100% range? Perhaps some will do away with perks such as gym memberships, dental care, etc. to cut their costs.

Yes. They will compete in the Medigap market. From a financial point of view, the managed care market has never really been a winner at anything close to 100%. It was initally set at 95% and those plans did not last long.

janmcn 10-01-2012 02:42 PM

Quote:

Originally Posted by gomoho (Post 562309)
So what you are saying is the Affordable Health Care Program will eventually results in cuts in service to the consumer to cover the higher costs? Thought it was going to benefit seniors.

The Affordable Health Care Act does help seniors by closing and eventually eliminating the doughnut hole that people have to pay for their prescriptions.

If Medicare Advantage Plans costs 14% more than basic Medicare, then they may have to cut back on some of their perks that Medicare doesn't cover; for instance health club memberships, eye glasses, dental care, etc. There are some MAP's that even pay for transportation to doctor appointments.

janmcn 10-01-2012 02:47 PM

Quote:

Originally Posted by janmcn (Post 562295)
Do you really believe that the for-profit big business companies that provide Medicare Advantage Plans, such as Humana, United Health Care, Optimum, Coventry, CarePlus, etc, etc, are just going to get out of the Medicare Advantage Plans business, or will they learn to live within the 100% range? Perhaps some will do away with perks such as gym memberships, dental care, etc. to cut their costs.

Quote:

Originally Posted by Number 6 (Post 562320)
Yes. They will compete in the Medigap market. From a financial point of view, the managed care market has never really been a winner at anything close to 100%. It was initally set at 95% and those plans did not last long.

Most of the companies listed, Humana, Optimum, etc are not in the Medigap market, so under your premise they will either go out of business or change their line of coverage.

gomoho 10-01-2012 02:55 PM

So Preferred Care is offering a very similair program - just remember you HAVE to enroll. Your c overage will not just carry over if you make no selection. You will default to basic medicare and lose big time.

merled 10-01-2012 10:21 PM

My friend and I got the letter and he went to the PCP office in the Villages today. They told him since they were bought out by United Health Care everyone will have to re-enrol starting Oct 15 thru Feb 28, 2013. Nothing much will change and you will still get the discounts you get now. They said that the letter is misleading because Medicare was the ones putting it together. So not to panic yet.

RVRoadie 10-01-2012 11:04 PM

The 14% premium for Medicare Advantage programs is true, but misleading. It does not take Medicare fraud into consideration for traditional Medicare, whereas Medicare Advantage plans have to absorbe any fraud that they allow.

EdV 10-02-2012 05:53 AM

Here’s a link to the Summary of Benefits for the new Preferred Care Providers Preferred Secure Option (HMO) which replaces this year’s Gold Plan. Copay amounts are shown starting on page 10/8.


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