[JWish]

We just moved to The Villages from another state, and I just started in Medicare in December. All was set up for the other state as original Medicare, as I had researched Medicare extensively and heard lots of negatives about Advantage plans.

We are now working with a local Medicare insurance broker in The Villages, who is telling us that Advantage plans are totally different in Florida than the rest of the country, and that Villages Health is a different and amazing care system than normal care providers.

Sounds too good to be true as we would save a significant amount of money on a Florida Advantage plan, but I don’t want to fall for a sales pitch and regret it later.

Is this a different animal in Florida? Any challenges finding providers around The Villages for Advantage Plans? Any challenges finding providers accepting new patients? Does the UHC Advantage Plan travel provision really work? I’m hesitant to voluntarily join an HMO, but maybe the PPO version would be a better fit for a skeptic.

Looking for real-world experiences with it, especially from those who have been on it awhile.

Thanks for any feedback!

[BrianL99]

Originally Posted by JWish

We just moved to The Villages from another state, and I just started in Medicare in December. All was set up for the other state as original Medicare, as I had researched Medicare extensively and heard lots of negatives about Advantage plans.

We are now working with a local Medicare insurance broker in The Villages, who is telling us that Advantage plans are totally different in Florida than the rest of the country, and that Villages Health is a different and amazing care system than normal care providers.

Sounds too good to be true as we would save a significant amount of money on a Florida Advantage plan, but I don’t want to fall for a sales pitch and regret it later.

Is this a different animal in Florida? Any challenges finding providers around The Villages for Advantage Plans? Any challenges finding providers accepting new patients? Does the UHC Advantage Plan travel provision really work? I’m hesitant to voluntarily join an HMO, but maybe the PPO version would be a better fit for a skeptic.

Looking for real-world experiences with it, especially from those who have been on it awhile.

Thanks for any feedback!

Advantage plans are regulated by the government, just like every health care plan. They're the same all over the USA.

There are 1000's of posts on the subject, here on TOTV. Use the Search Tool and the keyword "Advantage" .... you'll be reading posts until early 2027.

[rjm1cc]

The advantage plans do different, just listen to the TV adv.
Look at this site and you can get free help in learning about the plans. SHINE - Home

[Dotneko]

I recommend chatting with SHINE.
We have been here 5 years and had Medicare Advantage with absolutely no issues.
I have a wonderful PCP at Lake Deaton, get into specialists quickly, have every 8 week infusions at zero cost to me (they are billed at 13,000 dollars to MA). I am quite happy so
far. Interestingly, I have FloridaBlue MA and my husband has United Health MA - we wanted to do real life comparisons of them. His is a bit better for dental and quarterly things like aspirin and bandaids, but his health is luckily good so we havent tested big ticket stuff with them.

[villagetinker]

Second vote for SHINE, they helped us avoid a very costly mistake, and their information is UNBIASED.
One of the big problems we had was that the specialist we wanted to see did NOT accept the advantage plans that The Villages Health System required, now this was several years ago, some there may have been some changes.
Remember, advantage plans are MANAGED care they decide for you, traditional Medicare you have a lot more say in your care.

[Sabella]

Originally Posted by villagetinker

Second vote for SHINE, they helped us avoid a very costly mistake, and their information is UNBIASED.
One of the big problems we had was that the specialist we wanted to see did NOT accept the advantage plans that The Villages Health System required, now this was several years ago, some there may have been some changes.
Remember, advantage plans are MANAGED care they decide for you, traditional Medicare you have a lot more say in your care.

I recently left an Aetna advantage plan PPO which was absolutely wonderful. There were no co-pays and It usually cost nothing. I went back to original Medicare because after doing research its not so wonderful - as you get older and you get sicker an advantage plan is gonna be limited as to what they will cover when compared to original Medicare. All the advantage plans are run by medical insurance companies with one objective to be extremely profitable and make more money.

[Blueblaze]

We tried Villages Health the first year. Not impressed. Severe doctor shortage and we needed months of notice to see a real doctor. Then they refused to admit me when their parking lot testing discovered that what I thought was allergies was actually Covid (for the 2nd time, after being vaccinated), and then refused to prescribe an antibiotic for the inevitable sinus infection (after I recovered from Covid a week later but took a month to test negative).

Our original doctor isn't even there anymore, anyway. But if you want to use them, no choice -- you have to get your insurance from United, which I also discovered when I switched to Humana the 2nd year, after both Humana and Villages told me they would be available, and then discovered that the greatly restricted HMO plan they accepted wasn't the PPO I'd chosen.

So the next year, we switched back to United and then couldn't find a real doctor in Villages Health who was taking new patients anywhere within a 45 minute drive from my home (even though there's a Villages Health clinic just outside my "village").

This year, I discovered Humana's "Give back" plans, which return $150/mo per patient of our Social Security check's medicare payments. The specialist copay is higher ($45), but for $300/month, I can afford to see a lot of specialists. However, the real reason I switched was that Moffit Cancer Center in Tampa is in-network, unlike any other advantage plan I looked at. Not that either of us have Cancer, but I had a scare a couple of years ago, and Moffit is one of the best in the country.

Whatever you do, be sure to select a PPO, not an HMO. If something goes wrong and you need to hire the best, you don't want to be stuck paying the whole thing out of your own pocket.

[rjm1cc]

I think the PPO suggestion is good. The question is what coverage do you have when you travel around the US.

[lpkruege1]

Originally Posted by JWish

We just moved to The Villages from another state, and I just started in Medicare in December. All was set up for the other state as original Medicare, as I had researched Medicare extensively and heard lots of negatives about Advantage plans.

We are now working with a local Medicare insurance broker in The Villages, who is telling us that Advantage plans are totally different in Florida than the rest of the country, and that Villages Health is a different and amazing care system than normal care providers.

Sounds too good to be true as we would save a significant amount of money on a Florida Advantage plan, but I don’t want to fall for a sales pitch and regret it later.

Is this a different animal in Florida? Any challenges finding providers around The Villages for Advantage Plans? Any challenges finding providers accepting new patients? Does the UHC Advantage Plan travel provision really work? I’m hesitant to voluntarily join an HMO, but maybe the PPO version would be a better fit for a skeptic.

Looking for real-world experiences with it, especially from those who have been on it awhile.

Thanks for any feedback!

Watch the travel side of it. What's covered, where, at what percentage. Is international travel covered? Do you snow bird? I found most of my seasonal doctors were not on the plan. I went with a medigap policy. It cost me more a month but I get quality care from anyone excepting medicare. Just saying.

[Rzepecki]

SHINE - Home
SHINE can help you find the plan that will work best for your needs. Unbiased information; they are not insurance agents.

[elle123]

Originally Posted by rjm1cc

I think the PPO suggestion is good. The question is what coverage do you have when you travel around the US.

To be precise it's Medicare "Disadvantage" not Advantage.🤑

[rsmurano]

Advantage plans are not governed by Medicare, far from it. Advantage plans suck, ran by insurance companies, and these companies will do anything they can to save money for themselves rather than give you care your dr prescribed.

Don’t believe me, then why doesn’t Medicare require authorization for a procedure but an advantage plan does? Because, close to 70% of the time an advantage plan will refuse doing the service your dr prescribed whereas Medicare doesn’t require authorization? Because when the insurance company refuses service they save money. Don’t believe me, google it and you will see Congress has been working on this fraudulent practice for many years. The insurance companies hope that the patient will get tired of fighting the insurance company and give up.

Google why hospitals are refusing patients with advantage plans. More and more hospitals are adding themselves to the list.

Go out and get a good supplement plan and you will get the work your dr requested without any headaches

[Ptmcbriz]

We have our Advantage plan through my husband’s retirement union in California. It’s Anthem Blue Cross Blue Shield Medicare Advantage. Even though it’s a California based plan it’s nationwide. The Villages Health bills Florida Anthem BCBS and they in turn bill California Anthem BCBS. We love it. We have never been turned down for anything and they have covered everything except very minimal copays ($5 office visit). So you can have Advantage plans from anywhere if they are Nationwide.

[Janie123]

Originally Posted by JWish

We just moved to The Villages from another state, and I just started in Medicare in December. All was set up for the other state as original Medicare, as I had researched Medicare extensively and heard lots of negatives about Advantage plans.

We are now working with a local Medicare insurance broker in The Villages, who is telling us that Advantage plans are totally different in Florida than the rest of the country, and that Villages Health is a different and amazing care system than normal care providers.

Sounds too good to be true as we would save a significant amount of money on a Florida Advantage plan, but I don’t want to fall for a sales pitch and regret it later.

Is this a different animal in Florida? Any challenges finding providers around The Villages for Advantage Plans? Any challenges finding providers accepting new patients? Does the UHC Advantage Plan travel provision really work? I’m hesitant to voluntarily join an HMO, but maybe the PPO version would be a better fit for a skeptic.

Looking for real-world experiences with it, especially from those who have been on it awhile.

Thanks for any feedback!

I have not heard of any doctor or hospital no longer accepting a supplemental plan, but it seems like every year, hospitals and practices are dropping Advantage plans left and right. Currently the Mayo Clinic in Jax is not accepting any advantage plans and Moffitt in Tampa is not accepting certain advantage plans. We have a pancreatic cancer survivor via the Mayo Clinic. Treatment went from August thru April. I can’t imagine what we would have done when they stopped mid treatment.

The survivor was exceptionally healthy and one day, she got very bad indigestion, two days later, a tumor was found in her pancreas. Two weeks later chemo was started.

I will never roll the dice on healthcare. Today we both have a Cigna Supplemental G plan that is accepted everywhere.

[coleprice]

When turning 65 and signing up for Medicare, consider a Medicare SUPPLEMENT Plan G or Plan F rather than an Advantage Plan. Medicare Supplement plans cost more, but they are far more comprehensive. Plus, more Doctors accept Supplement Plans and they can save you money if you're hospitalized. For more information, check out medicare school.com or call them at 833-833-3661.