Talk of The Villages Florida

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-   -   Cancelled by Preferred Care Partners (https://www.talkofthevillages.com/forums/medical-health-discussion-94/cancelled-preferred-care-partners-90095/)

ActsOfKindness 10-06-2013 05:41 PM

again not being argumentive here..but i will have to clarify something you just shared.this is important information...and people need to get l00% factual information..this is an important time of our lives open season with plans such as preferred care partners closing on us.
after the initial apppointment which again to reiterate is 3 to 5 months out to schedule if you are a new patient in the villages health care system(no one in the country which they are bragging....that they will be a role model for all of america..this health care system..does it take to see even a specialist that long ..months to go by for an appointment for a senior citizen) ..i was EXPLICITLY TOLD AT COLONY CARE ..one of the villages health care centers..set up rite now....that..if i need to see a same day appointment or a timely one....even after....the initial one...to wait so long for.
THAT A PA..WILL SEE ME.
hello? i dont need the villages health care system to see a PA
i can do that very nicely in any number of health plans or doctors offices perhaps.
that is ridiculous
please do not say..that after the initial appointment..you will be seen...by your primary care physician
that may NOT be the case..and people need to know this and be made aware of it now.
a PA is not the doctor
there are good PAs out there..but again to reiterate one more time!! you may not get into see your pcp..................even after getting established with the villages health care system..that is why they have an office staff of PA's in place.
forget that.
for the record i do not......see a doctor more than once a year..thank thank God...im blessed right now in life...but if i had an issue..i would not wait to see a pcp.....once im established and i mite as well just go to an urgent care center.
DOES ANYONE READING THESE POSTS KNOW IF THE NEW VILLAGES MEDICARE COMPLETE HMO OR REGIONAL COMPLETE PPO....WITH UNITED HEALTH even has an urgent care center..for us??????!! we have so many around the villages now which is a God send rather than waiting in hospital emergency room here in the villages....
but insofar as i know..and i cant find one provider directory online..for 2014 for either one of these plans....it seems you have to go in person or have an agent....to know what doctors are on board with the united health care plans for our area...
PUP physicians united..and other medicare advantage plans are right there online ...to view..and to also see the provider list for 2014.
YOU GOTTA MAKE INTELLIGENT DECISIONS PEOPLE.
IF YOU GO ON BOARD WITH UNITED HEALTH BEING PUSHED HERE IN THE VILLAGES MAKE SURE YOUR DOCTORS YOU HAD WITH PREFERRED CARE PARTNERS OR OTHER PLANS YOU WERE ON...ARE STILL INTACT WITH THESE PLANS.
THAT IS MOST IMPORTANT.
SOME OF US HAVE DOCTOR/PATIENT RELATIONSHIPS....THAT WE FOSTERED THROUGH PREFERRED CARE PARTNERS..THAT ARE NOT AVAILABLE WITH PERHAPS THE NEW VILLAGES MEDICARE COMPLETE HMO
IF THEY ARE ON BOARD THAT WILL BE WONDERFUL.
BUT AGAIN TO REITERATE THAT IS ANOTHER PROBLEM RITE NOW..
WE DONT KNOW.
WE ARE FLYING BLIND.
PERHAPS ON THE 15TH THEY WILL RELEASE THAT INFORMATION TO US...BEGGERS OUT THERE..THAT WANT TO KNOW IF OUR DOCTORS WE HAVE NOW ..ARE ON BOARD WITH THE HMO OR PPO THRU UNITED HEALTH IN THE VILLAGES
THANKS FOR READING THIS.

RVRoadie 10-07-2013 11:20 AM

Ok, here is my calculation of additional costs for my wife and I to switch to United Health Care medicare advantage program that is replacing our current Preferred Care Partners plan. These are based on what we actually received in 2013.

$2,399 - Part B premimum (loss of rebate, $99 each per month)
$750 - Vision benefits ($300 for glasses, free exam)
$402 - Dental (2 free exams each year)
$392 - Medicine (no copays on generic drugs)
$504 - Silver Sneakers (my wife goes to Curves)
$80 - Specialist copay (16 copays at $5 increase)
$200 - OTC products ($25 per quarter, each)

$4,727 - Total additional out of pocket costs to switch plans based on 2013 expenses.

Fortunately, our old primary care doctor is willing to take us back. Not sure what plan we will go to, but $4,727 per year is too much to continue with The Villages Health System.

Villages PL 10-07-2013 04:10 PM

Pup
 
I called Physicians United Plan (PUP) today and requested information on their HMO health plan. Their toll free number is: 1-888-U-ASK-PUP

I made sure to ask for their booklet of providers. If you don't ask for it, you might not get it. And I think it will be important to actually call some of the providers to make sure they are participating in the plan.

They said I will get all the information in 7 to 10 days. Once I get it and read it I'll be glad to give my opinion of it.

Shirleevee 10-07-2013 05:11 PM

Quote:

Originally Posted by RVRoadie (Post 758264)
There are a number of Medicare Advantage plans available, however The Villages Health Care System doesn't take any of them except for United Health Care. So... "if you wan't to keep your doctor..." forget it unless you pay up to United Health Care.

from The Villages Healthcare site:


If you are eligible for Medicare, we want you to know that the only Medicare Advantage plans The Villages Health participates in are those offered by Preferred Care Partners and UnitedHealthcare®. UnitedHealthcare® Insurance Company is the same Medicare insurance provider that many Villagers already rely on for AARP® Medicare Plans.

We also accept most major health insurance plans.

Accountable Health Plan
AARP
Avmed
Blue Cross & Blue Shield

• Federal
• Blue Options
• Empire
• Health Options
• Preferred Patient Care
• Traditional

BCE Emergis
CCN
CCN/One Source
Champus/Tricare
ChampVA
Cigna
Coventry Health Care/First Health
Evolutions Healthcare
First Health
First Health Mail Handlers
GHI
Great West
Humana
Humana PPO
Interplan
Mail Handlers
MEDICARE
Multiplan
NALC
One Health Plan
Pacificare
Preferred Care Partners
Private Healthcare System/PHCS
Proamerica
Railroad Medicare
Southcare
Up & Up
United Healthcare

Most major Preferred Provider Organization Plans

gerryann 10-07-2013 05:32 PM

Quote:

Originally Posted by Shirleevee (Post 759436)
from The Villages Healthcare site:


If you are eligible for Medicare, we want you to know that the only Medicare Advantage plans The Villages Health participates in are those offered by Preferred Care Partners and UnitedHealthcare®. UnitedHealthcare® Insurance Company is the same Medicare insurance provider that many Villagers already rely on for AARP® Medicare Plans.

We also accept most major health insurance plans.

Accountable Health Plan
AARP
Avmed
Blue Cross & Blue Shield

• Federal
• Blue Options
• Empire
• Health Options
• Preferred Patient Care
• Traditional

BCE Emergis
CCN
CCN/One Source
Champus/Tricare
ChampVA
Cigna
Coventry Health Care/First Health
Evolutions Healthcare
First Health
First Health Mail Handlers
GHI
Great West
Humana
Humana PPO
Interplan
Mail Handlers
MEDICARE
Multiplan
NALC
One Health Plan
Pacificare
Preferred Care Partners
Private Healthcare System/PHCS
Proamerica
Railroad Medicare
Southcare
Up & Up
United Healthcare

Most major Preferred Provider Organization Plans

There are changes to this for 2014

gomoho 10-07-2013 07:49 PM

Does anyone else find it a little ironic that those supporting "Florida's Healthiest Hometown" aka United Health Care The Villages Medicare Advantage are the same group that has dropped silver sneakers (free gym membership)???

Bizdoc 10-08-2013 09:40 PM

Quote:

Originally Posted by gomoho (Post 759487)
Does anyone else find it a little ironic that those supporting "Florida's Healthiest Hometown" aka United Health Care The Villages Medicare Advantage are the same group that has dropped silver sneakers (free gym membership)???

Not at all. In order to hold down costs for the Medicare Advantage plan to a premium folks can live with, not everything can be paid for.

I see a really interesting trend that the same folks who want more benefits also want lower premiums. You have to pick one or the other. The costs have to be covered from somewhere. The plans that try to do both (like PCP) tend to lose a lot of money and go away.

gomoho 10-09-2013 05:55 AM

PCP only went away in our counties to make room for United Health Care - they are still alive and well in other parts of Florida.

ActsOfKindness 10-09-2013 11:30 PM

Quote:

Originally Posted by Dr Winston O Boogie jr (Post 756119)
So. bottom line is that we're going to have to pay $105 per month. That's a $105 increase in our premiums.

MY husbands doctors and my urgent care center which saved my life, 441 urgent care, are not i believe on the new villages health medicare advantage program ...either one, i believe there are two .one is hmo the other ppo....and we love our doctors...and dont want to change. in addition..the rebate really helped us on our fixed income. we are not one of the more wealthier villagers living here in alligator land , so having said that. i spent the greater part of 2 days..48 hours almost non stop on the computer researching medicare advantage plans for our area. it is true...that freedom gives back a rebate of i believe 72$ or 74$ and so does optium...but both those plans YOU MUST be a special needs person.. have a heart condition. diabetes i forgot the other criteria. to receive the rebate on your part b premium taken out of your social security check every month. it is also true....that....there are more doctors on board with the united health plans..however..the villages health care centers will be unbelievably impacted with so many new patients and not enough doctors. i decided because pcp is accepted with them..rite now i still have it until january to go on board with one of their pcp primary care physicians. guess what i had to wait over 3 months to get to see dr carla noel so please...even though there are more doctors in network doesnt mean you will get in to see them in a prompt timely manner. and not wind up with a PA instead sigh. that is the villages h ealth care system they are ranting and raving about here..which is overkill in my humble opinion. the only MEDICARE advantage program i found..is PUP..rewards hmo with the plan number 024. i could not find one agent to sign me up...its enrollment in the mail. which im very uncomfortable with but the rebate without any criteria..meaning just straight up and down...rebate..like preferred care had for the past two years....IS 90$ which is not too shabby. the doctors are the same as we have with preferred care INCLUDING the urgent care centers. now having typed all of this..a neighbor of a neighbor gave us the name of an independent agent we are seeing tomorrow....to try to sign up for PUP rewards hmo. if it works out..i will be thrilled and relieved and have some peace of mind. i only need one doctor...one hospital , one urgent care center. insofar as specialists..they are out there even on pup rewards. if you or anyone is interested in pup ..please go to the website...askpup.com
everything is explained there.including who the doctors are in sumter or marion countys. i hope i can sign up...with the agent tomorrow....if you wish to speak to me further, i dont usually go on the forum alot. i was here...and answering alot of posts earlier..but usually i let months slip by and i forget to come back to this forum. my email is flowerpower55@gmail.com . good luck to everyone who needs to switch plans..make an intelligent decision.....and dont go by hype or fear. God bless all.

gadaboutgal 10-13-2013 02:24 PM

Quote:

Originally Posted by Bizdoc (Post 760054)
Not at all. In order to hold down costs for the Medicare Advantage plan to a premium folks can live with, not everything can be paid for.

I see a really interesting trend that the same folks who want more benefits also want lower premiums. You have to pick one or the other. The costs have to be covered from somewhere. The plans that try to do both (like PCP) tend to lose a lot of money and go away.

Well said. I couldn't agree with you more.

rubicon 10-13-2013 03:25 PM

IMHO the main impetus for all the movement by insurance companies and medical providers is due to the uncertainty/concern related to implementation of the Affordable Health Care Act.

I you subscribe to the adage that the pat is prologue to the future then you can say with a certainty that the Villages Lake-Sumter, Inc. (Developer) will maximize profits under the Villages Health Care Alliances

As an example when owned The Wellness Center he charged roughly $39.00 per month. If you wanted to go to a group class it cost between $45.00 to ^5.00 per month. I took two classes at a cost of $110 a month.

MVP stepped in and kept the rates below the national averages and that included group classes.

I have been associated with the Munroe Health Care System for six years and have been pleased with both doctors and staff and its hospital

DEWRDW 10-14-2013 07:08 AM

I can see why the seminars for Freedom Health and Optimum are full in and around TV - the Medicare Advantage Plan (HMO) with United Health Care that is taken by the Villages Health Care System does not provide the benefits that we were used to with PCP - the web site for United Health Care Village Plan with regard to the drug benefit is massive - I think it is over 300 pages - after scrolling down many of them, I still didn't find our meds so I am just writing them down and taking them to a meeting - this way, I will know the cost - I don't want any surprises! I think we all have to look at the status of our health and what plan meets our needs - as someone noted this new advantage plan may not be for everyone since benefits have been eliminated!


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