Retired FDNY moving to Nocatee (Jacksonville, Melbourne: 2015, dermatologists, health insurance)

[Kerrijean]

Hi My husband and I are moving to Nocatee as soon as our house in Greenleaf is ready in the fall. Big changes but hoping for the best. Need help with Insurance Coverage that is best if you are a retired NYC fireman. I am also very interested in everything about Nocatee and the area.
I have three boys that are 10,8 and 6 and we are leaving Long Beach NY and hoping that we will find friends, great schools and safe streets.
Any feedback would be appreciated

[Acebab]

You will absolutely find kids, great schools and pretty safe streets here in Nocatee! Minor incidents do occur - such as car break in's to unlocked cars, but those type of things happen any and everywhere! For the most part, this is an area where kids can truly be kids. Riding bikes, walking to friends houses, etc. Greenleaf is crawling with kids and you will find that your boys know WAY more people than you do in about one weeks time! I live across the street in Austin Park, but have many friends in Greenleaf and it is a GREAT neighborhood. It has a great neighborhood spirit and everyone is very excited about the new school opening in the fall. The principal and vice principal are amazing and so far all the staff they have hired is experienced and enthusiastic. I can't wait for the new school to open!!! We have four kids - 12, soon to be 10, 7 and 4. Nocatee is a very eclectic area with people moving here from ALL over - it is one of the things I like most about the area. People are friendly and welcoming. Aside from the people, not too much else is here yet, but kind of like "Field of Dreams"...if you build it, they will come - just in reverse! The people are coming, we are just waiting for them to build "things" around us. That being said - I have no issues driving 15 minutes to get to the Mall, Home Depot or Target - I am here for the lifestyle - not the stores! If you are looking for a laid back, family friendly, outside time lifestyle, then you be very happy Nocatee!

I can't help you with insurance information - what type are you inquiring about....Homeowners???

[Kerrijean]

Thank you for the positive information. I am looking at what health care policy available to Retired Fireman from NYC I might want to enroll in as in NY we have GHI but I understand many doctors do not take it in Florida(more of a NY company) Enrollment is only a month or two a year and we are researching what other policies are taken.
We are leaving a beautiful beach that we walk to and have the best friends but unfortunately but since my husband is retired we simply do not need to pay these crazy taxes and live amongst these crowds. Excite to have my boys have safer streets to ride their bikes and skates on and a great school district.

[Robyn55]

Here's are lists of what Mayo takes:

Companies with Contracts with Mayo Clinic in Florida - Florida Patient and Visitor Guide - Mayo Clinic

Insurance plan contracts at Mayo Clinic in Jacksonville, Fla. - Florida Patient and Visitor Guide - Mayo Clinic

Here's a list for Baptist primary care:

Baptist Primary Care Insurance Information | Baptist Health | Jacksonville, FL

Note that Baptist isn't as integrated as Mayo in terms of billing (different Baptist providers may take/not take various insurance policies). But there are similar lists for all the Baptist providers on this website.

I don't know whether any of these links is up to date. Also - GHI isn't mentioned on any link above. I listed these 2 systems because I think Mayo is the best (at least for our needs) and Baptist is the closest to Nocatee. There are other systems in the metro area - like St. Vincents. Our metro area - like many - has seen a great deal of consolidation in terms of health care providers/systems over the years.

Obtaining decent individual health insurance policies can be problematic for middle aged and older people (until they go on Medicare) - not only here but in many parts of the US. The ACA has solved some problems (like pre-existing conditions issues) - but not all. Here in St. Johns County - we only had 2 companies willing to write ACA policies during the initial ACA sign-up. Florida Blue and - IIRC - Cigna (or it might have been Aetna). I looked at some of the offerings a while back - and they didn't seem all that great or all that inexpensive.

I don't know which companies will participate in the ACA in 2015. Although I'm fairly confident that Florida Blue will still be there. OTOH - Florida Blue - like many carriers - has tons of different insurance options - not all available through the ACA. And various providers may accept some policy flavors - but not others.

Overall - I'd explore Florida Blue first. I don't know if it's the best carrier - but it is the biggest. FWIW - my husband and I are both on Medicare now (which makes our lives easier). Robyn

[valentinb13]

I'd agree with Robyn - Florid Blue seems to be the biggest and most common carrier around here.

BTW - I have a buddy from Suffolk, retired FDNY who just had his house built here in Nocatee - he'll be moving down permanently next summer. I can try to find out if he has info on what he is doing regarding health care - if you want send me a message at valentinb13 at gmail dot com and I'll try to connect you two.

Good Luck with the move - you'll love it here!

[TravlerAtHeart]

Hi,
My Husband retired from NYPD and we are looking at the area. What I have found so far is some Dr's take GHI, NOT alot.
Atena is what works here. Hope this helps. I also thought that the city let you change if you have a life event like moving? You might want to check that out so you only need to pick up Atena when you move.

Good Luck!!

[Walkingonsunshine]

Hey Kerrijean & Traveleratheart, I am also approaching retirement from NYC Dept of Education. I currently have GHI. As you probably know, GHI is so widely accepted in NY that I am concerned about coverage when I'm finally living full time in Durbin Crossing. I will look into the Aetna coverage and if I find out anything interesting I will private message the both of you.

[Ditto23]

Hi, I am the guy valentinb13 was referring to. I am Retired FDNY and have purchased a home in Greenleaf Village. The Topic that you are all discussing is a big concern for me also. Currently I have Empire HMO New York. I know NYC Retirees in Nocatee that have told me that finding Doctors that accept GHI is very difficult. NYC offers Empire EPO, but it is rather expensive for a family plan and I did not see it listed on Robyn's lists for Mayo or Baptist. I also did not see the Aetna HMO plan. If you could keep me in the loop on what you find, I'd appreciate it. In the meantime I'll be researching this also. Thanks.

[Robyn55]

Originally Posted by Ditto23

Hi, I am the guy valentinb13 was referring to. I am Retired FDNY and have purchased a home in Greenleaf Village. The Topic that you are all discussing is a big concern for me also. Currently I have Empire HMO New York. I know NYC Retirees in Nocatee that have told me that finding Doctors that accept GHI is very difficult. NYC offers Empire EPO, but it is rather expensive for a family plan and I did not see it listed on Robyn's lists for Mayo or Baptist. I also did not see the Aetna HMO plan. If you could keep me in the loop on what you find, I'd appreciate it. In the meantime I'll be researching this also. Thanks.

Mayo doesn't accept any Medicare HMO plans. And doesn't accept most non-Medicare HMO plans:

Mayo Clinic contracts do not include Medicare Advantage Plans HMO, Medicaid (HMO) Managed Care Programs or any Commercial HMO products that are not specified below. This information is updated periodically and is subject to change. This list is not meant to be all inclusive, please check with your health plan to verify coverage.

Insurance plan contracts at Mayo Clinic in Jacksonville, Fla. - Florida Patient and Visitor Guide - Mayo Clinic

I don't know about other providers. But - in general these days - no matter where you are and whether or not you're on Medicare - you're better off avoiding HMOs. And sticking with a good PPO. Because the providers who are willing to be part of HMO networks is declining. And many HMO policies have poor or no coverage if you go out-of-network. Robyn

[TravlerAtHeart]

Hi,

We are not on Medicare, and have many, hopefully, healthy years before we get there. My husband is a retired NYC Sergeant, and I am quoting the amounts of insurance and deductibles based on that. What I have found so far:

You can not go out of network with Aetna. Aetna docfind will let you search who is covered by town and specialty. It does seem extensive around the Jacksonville area. But we have no children, and since NYC does not have a plus one plan, we would have to pay the $608.00 family rate per month. The benefit is, FL law states that if you have an HMO and are admitted to the hospital in an emergency, you can not be balanced billed.

GHI is very limited in this area especially when it comes to things like orthopedics, and dermatologists. We do not have children so I do not know about pediatricians. You can probably find a family Dr. in the area, and if you are willing to travel, there seems to be specialists down around Melbourne and Ocala.

My experience with hospitals in south Florida with the combo of GHI and Blue Cross is as follows:

Blue cross covers the hospital, the tests, and the medications in the hospital after the deductible. ( I think is was $300.00). The Drs you need to read those tests are not covered unless they are GHI Drs. Which means the radiologist, pathologist, and the anesthesiologist are not covered. This came as a surprise to me, since my surgery was scheduled with a GHI Dr, and I had to go to the hospital two days before my surgery to pay the deductible and speak with someone about my insurance and pre-op testing. Nobody explained that they balance bill in FL, which means that if the doctor is not in your plan, they bill you the entire amount.

GHI reimburses you at 60% of “reasonable and customary” rates after your $200.00 deductible. That is not what the Dr bills you, it is what GHI deems as “reasonable and customary”. You are responsible for the rest. If you do speak with the Dr's they will usually discount the balance, but maybe not. We also have the high option rider that pays an “enhanced' reimbursement, what ever that means.

The union (SBA) also offers a catastrophic reimbursement after $2000.00. You should check with your respective unions for something like that. Also remember that there is a $3000.00 Public Safety officer tax deduction if you decide to take one of the pay plans.

I have also checked out some of the Obama-care plans. I really don't see the value, I have not spoken to any insurance agents, but from what I researched, there are some issues about the fact that the union offers you health care, so you may not be eligible for a subsidy. I am not sure how there deductibles work, if it is out of pocket dollars, or reasonable and customary dollars. I do know the rules about these policies change regularly, so if you are considering this you should look into as close to your moving as possible.

If you don't have an emergency, you can negotiate with a Dr. It seems even with a $200.00 GHI and the $300.00 Blue Cross deductible, even with balanced billing, if you are relatively healthy, and can find a good family Dr. close by, you might be better off traveling or negotiating for any specialist. We are considering this, with Atena as a backup if needed for long term illness.