[Jayhawk]

Originally Posted by jdulej

Just fyi, it is still open enrollment. You might want to think about switching while you can (closes in December I think) or you will be locked in for a year. IMO it's important to have access to at least one of the top-level hospitals just in case.

Is Shands really that great or is that just perception? There are 489 reviews on Google and they average 3.2 * out of 5.0*

Just wondering.


UF Health Shands Cancer Hospital
3.2
489 Google reviews
Hospital in Gainesville, Florida

[biker1]

Really? The Villages is dictating which Drs. and hospitals you can go to? The reality is that you can only use The Villages Health PCPs if you have elected a UHC or Florida Blue Medicare Advantage Plan. You can use any PCP that is in the insurance providers' networks. You can go to The Villages Health Specialty Drs whether you have a Medicare Advantage Plan or not. Any network restrictions are from the insurance providers and has nothing to do with The Villages.

Originally Posted by Larchap49

Exactly, then find the top specialist within reasonable driving distance and take control of your own care. TV should not be dictating what Doctors or hospitals you can go to.

[Koapaka]

Might want to check and see what changes are in effect starting 1 Jan 2022 regarding the Villages Health Care for those of you that might want to take advantage of open season. I read something in the paper this past week that states some swap over to Humana from something else (did not pertain to us, so just glanced at it) but remember wondering how many people this might effect here in TV since so many use Villages Hospital System. If it would be a problem with your current plan, open season might be a chance to fix it vs being unpleasantly surprised come 1 Jan 2022.

[Topspinmo]

All of this is Insurance racketeering. What happens when you have lobbyists dictate who and what rules federal government applies. This should of been fixed when government took over health care coverage. It should be against law for any medical facility to refuse person because of their insurance plan. UHC good example.

[Joeint]

Originally Posted by Bridget Eichaker

That is why I prefer regular Medicare I can go anywhere.

Except The Villages Health.

[Rose Ann Vinci Igoe]

ok, I'm under the same health plan... I called United Health Care Customer Service. We ARE covered to Shands as of Oct 1, 2021. They looked it up under the Zip code. Also, even if any doctor or hospital is out of network, you can submit a request to have them. I have done this at different times and always got it approved.

[capecoralbill]

Originally Posted by Rose Ann Vinci Igoe

ok, I'm under the same health plan... I called United Health Care Customer Service. We ARE covered to Shands as of Oct 1, 2021. They looked it up under the Zip code. Also, even if any doctor or hospital is out of network, you can submit a request to have them. I have done this at different times and always got it approved.

First of all, get it in writing, do not trust a sales rep, unless he'll write it and sign it.

Secondly, I was in that situation, when i had UHC Villages Advantage plan, """any doctor or hospital is out of network, you can submit a request to have them""""
Think about it, when you are in extreme pain or disease I'll bet you won't feel like running around getting forms and writing letters to your Dr.'s office staff for an exception to their own policies. And even if you jump through all those hoops, there is no guarantee UHC will accept it, and you have just wasted several days or weeks.
Not much fun if you are dying or are having extreme pain, such as a kidney stone,
I switched to Original Medicate with Plan F right after that merry go round with UHC.
And dont forget, if you are on an Advantage plan for over 12 months, you will need togo through underwriting to be accepted back into an Medicare Supplement (Medigap) Original Plan

[Blackbird45]

I post before about going to an agent.
I was just sent a reminder about my appointment today.
"Please bring a list of medications, list of doctors and your Original Medicare Cards".

Now I'm not saying the posting of people's recommendations are not valid, what I'm saying find a pro who is not affiliated to one company, tell them what you need and have them lay out everything that is available to you and again if you don't like what they have to offer get up and walk out.

It's FREE

[twinklesweep]

This will be a long read, but IMO is extremely important!

Originally Posted by snhmhg

Because I am going on Medicare and a UH supplement plan F, I cannot see my primary at the Villages Health anymore. You have to have a Med Advantage plan, Villages requires it. I think Med plus the supplement F is the best way to go if you have health issues.

From my experience and that of a fair number of others, find a new primary who is independent of TV's Health program.

Originally Posted by rsmurano

IMO, the supplement plans (F, G, others) are the better way to go. My insurance broker told me last year these are the Cadillac plans (I have plan G). You can’t go to the villages health centers but from what I have heard, that’s a good thing.
Don’t take my word for this, do some checking yourself during the open period. I pay a small fee per month and have a small deductible (I think a couple hundred $$$ a year) but I don’t pay copays and can go anywhere where Medicare is accepted. The advantage plans you usually pay a copay for each visit, more restrictive on who you can see.

Don’t take my word for it either. I have heard the same about TV Health—that not going there is "a good thing." From what I've also been told, those who disagree are generally healthy, but inevitably as we grow older, it doesn't remain that way.

Originally Posted by esteelenov

I agree, I have plan F but I think it is no longer available. Plan G has taken its place.
Husband and I have both had to see specialists and have never had to pay a copay. Actually, we have never gotten a bill for any doctor or hospital. I have been hospitalized for kidney stones and husband has had operations and procedures (he has cancer).

They have honored grandfathering in the past. We have Plan J, which has not been offered for quite a few years. I once became ill while traveling overseas, and much to my surprise, my overseas medical bills were covered by Plan J (even though original Medicare would not even look at them).

Originally Posted by bonrich

I have Plan G, recently changed from F. We are primary in Florida and have a home in NYS. So, it was important to us to have a portable plan. We have United Health Care/AARP. Accepted anywhere the service accepts Medicare. Never a problem through the years of major health issues.

Yes absolutely! If original Medicare is accepted—and it is accepted virtually everywhere throughout the US—the Medicare Supplement automatically kicks in.

Originally Posted by aldeana

If you have plan F that tells me you have freestanding Medicare with a Medigap (a supplemental policy-type F) and not an advantage plan. If you are not in an advantage plan, you don't have any network problems.

Absolutely true!

Originally Posted by Larchap49

Exactly why I have traditional Medicare and Humana plan F supplement. Go to any DR, any facility, anywhere in the USA. I pay the monthly premium and never another dime. I avoid all Villages facilities with their restrictive policies. One thing I won't let TV control is my health care. Their $0.00 premiums are not worth the restrictions on care centers, referrals, co-pays, wait times, etc. and when the UHC contract expires and it will expire, who will you get next. Again any DR any hospital anywhere except in TV. Why do you suppose TV restricts this when the top Doctors and hospitals in the country don't? I think their right to make another dollar goes too far when they dictate where you get your medical care.

The level of greed is shocking—and that is exactly what it is.... This is not to say that no one is pleased with TV Health, but wait until those persons start developing the inevitable issues that come with age.

Originally Posted by Zenmama18

Agree, my husband's 2 specialists do not take any Medicare Advantage plans, just traditional Medicare. Medicare Advantage is great if you're in generally good health, but if you have complex medical issues you may not have access to the best docs and facilities.

You think "may not"? More likely "will not" have access to what you determine is the best care for what you're dealing with. You have no such choices with TV Health or any other HMO or Advantage plan or whatever new names they come up with to counter what becomes the stigma of the existing names!

Originally Posted by WindyCityzen

Plan F is the Golden Ticket. Everyone takes it, no copays, no fuss/no muss. And once you’re in, never ever leave. You’re set for life.

Very true "no fuss/no muss." Your original Medicare automatically files the balance of your claims to the supplement, and the supplement then handles it from there. You do not have to deal with claim forms and such.


My two cents:

As far as supplement plans are concerned, Plan G is Plan G, spelled out by contract with Medicare. However, one insurance company may charge X dollars a month, while another company charges a considerably higher Y dollars a month. But the plans are by law identical! Many years ago, we "inherited" the plan that our employer had been paying for in our behalf, and we had always had a good relationship with its agent. When our employer quit the "health care for retirees" business and instead opted to pay retired employees a stipend, we went searching and discovered that that (again the identical) Plan J with a different company was a little over $100 difference in premium per month per person! Greed? So it appeared. When we went back to the formerly personable agent, his response bordered on nasty! We naturally changed companies!

Can an employer really opt out of health care for retirees? Evidently.... The only benefits that remain intact and cannot be touched were dental and vision (eyeglasses) coverage, and why? Because they were union-negotiated benefits!

We are constantly being enticed to sign on for an HMO or Advantage plan with so-called freebies—membership in a gym, free OTC drugstore supplies, coverage for prescription meds, zero premium (while the cost of original Medicare keeps going up), and more. But as pointed out above, with a supplemental plan there are zero deductibles and zero copays. Do an analysis of what one of these HMO or Advantage plans would cost you per year in contrast with no deductibles (including the $200 or however much it is nowadays each year for Medicare), and you might find it an eye-opener.

If you are relatively healthy, you may feel that financially there is a great advantage to an Advantage plan. But once you opt into one of these plans, it is extremely difficult to virtually impossible to be allowed to go back to original Medicare plus Medicare supplement.

And there are those of us who feel (nothing to document this ... yet) that when enough seniors are enticed into making this poor choice, the rest of us will then be told that the conventional original Medicare plus Medicare Supplement will no longer be available as of whatever the date will be. A profoundly scary thought!

[gatorbill1]

Originally Posted by Rose Ann Vinci Igoe

ok, I'm under the same health plan... I called United Health Care Customer Service. We ARE covered to Shands as of Oct 1, 2021. They looked it up under the Zip code. Also, even if any doctor or hospital is out of network, you can submit a request to have them. I have done this at different times and always got it approved.

When I call UHC they agreed Dr WAS in network, but financial office decided not to accept UHC TV

[curtmcgee]

Just called UHC The Villages Medicare Advantage HMO. Shands is now IN Network for us. Some doctors may not be, but the facility is. As a referral is not needed, a simple phone call to UHC (866-627-7806) to see if a specific doctor is covered is advised.

[Carla B]

My first exposure to an "Advantage" program was when a friend bought one way back in the 80's. He described how Humana used his Medicare premium and assumed his costs for the year from then on. Six months later they went bust. From that time on, numerous advantage plans failed. The insurance companies must have figured out how to make money from advantage plans over the years. It seemed that about the time Villages Health adopted the UHC Advantage model around 2016, the Federal Gov't. appeared to "bless" Advantage plans. Why not, as they shift the risk to the insurance companies.

Here's hoping the Gov't doesn't disown Original Medicare for us who still use it. I found out that we will save $400/yr by switching to Plan G from Plan F.

[Koapaka]

For those looking for help with this confusing mess of insurances and which is best for you once you are Medicare eligible, I understand that Craig Morrison is an excellent source in this area for helping you decide which option would best fit your individual needs. He offers free consultations to anyone requesting assistance. His number is 352-317-8992. It did not apply for us, but wanted to pass this on to anyone that it might help out. I do not know him, have never met him, but saw a video from one of the folks that do Villages Youtube segments.

[Rose Ann Vinci Igoe]

Originally Posted by jdulej

This is where it gets confusing. I have UnitedHealthcare The Villages Medicare Advantage 1 (HMO) and I have access to Shands in Gainsville. The OP listed a slightly different name (UHC The Villages HMO WellMed).

yup, I have it too, called customer service to reverify and YES WE ARE COVERED WITH SHANDS... AND I'M GOING FOR SURGERY THERE... SO yup

[wdst1]

Checked with my insurance agent and it is not true, misinformation being shared in a blog.