[paulascorpio]

Dr Raquet just came on in the Pinellas Health Care. He is originally from PA. I think he is great and so caring. I am disappointed because we will not have him after Dec 31 and need to find another primary care physician. I was so excited to find Dr Raquet only to have to lose him.

[RGump]

Depending on the plan you have I would check the network of providers. Remember: THERE ARE LOTS OF PHYSICIANS IN THE VILLAGES AREA AND LOTS ARE GOLF CART ACCESSIBLE.. Villagers have lots of choices even though it appears they may not.

[mrbgull]

WOW how did we all get here from once we started with the VCH program???? From the onset I was very happy with the program. I was COMPLETELY satisfied with my primary(DR Joe). I received my letter prior to going into Medicare and was rocked. Follow the money. This is wrong. What type of business plans thrives in by excluding such a large % of the population . Again sad. You have many choices. Do research and above all share whatever experiences you may have. We will all gain as we should.

[Paper1]

My wife and I both have Florian Gegaj from Florida Heart and Vascular. Very sharp young guy we both like.

[syber]

I just received my notice that because I am under age 65 and have original medicare because of disability that I can no longer see my doctor. My reply was that I also have my employer retiree healthplan with United Healthcare. They stated that even though they are in network with my employer coverage, they will disregard that United contract because I have original medicare. They went onto say that for those under age 65 who do not have Medicare and have my United plan, that those United Subscribers can stay. I asked if they will remove themselves from the network agreement with United and they said no. We will just not take United Subscribers with original medicare. My only choice is to accept the Advantage plan or drop my Original Medicare. This only affects people under age 65 who all have Medicare due to disability.

[champion6]

Originally Posted by syber

I just received my notice that because I am under age 65 and have original medicare because of disability that I can no longer see my doctor. My reply was that I also have my employer retiree health plan with United Healthcare. They stated that even though they are in network with my employer coverage, they will disregard that United contract because I have original medicare. They went onto say that for those under age 65 who do not have Medicare and have my United plan, that those United Subscribers can stay. I asked if they will remove themselves from the network agreement with United and they said no. We will just not take United Subscribers with original medicare. My only choice is to accept the Advantage plan or drop my Original Medicare. This only affects people under age 65 who all have Medicare due to disability.

You have another choice - keep your existing insurances and change to a PCP who will accept them. Many of us have done this recently. It's discouraging to have been put in this position, but it can have a successful and satisfying outcome.

[syber]

Right, have to change my primary doctor. Because I loose not only original medicare but also loose United Healthcare employer coverage if I stay. I guess I don't know how they can will stay in network with my employer united Healthcare policy, stay under a contract with my united healthcare policy and I am barred from using my employer coverage? This totally invalidates provider networks. I think the other issue here is truthfulness. Where a doctors say they are in network, then they should never say yes, we are in network with United Healthcare but not for you. So above all, the issue of honesty here is paramount. I do not want any doctor who does this.

[Villageswimmer]

Originally Posted by Paper1

My wife and I both have Florian Gegaj from Florida Heart and Vascular. Very sharp young guy we both like.

Agree. Met Dr. Gegaj Last week for new patient visit...very impressed.

[Villages Kahuna]

My wife and I were very happy to have chosen Villages Health when it was formed several years ago. They willingly accepted our health insurance--Medicare and AARP Plan F (for secondary insurance). We loved our doctors and their office environment was nothing short of luxurious.

After a couple of years they announced that any new patients would be required to forego Medicare and enroll in The Villages Health Medicare Advantage Plan. We were told not to worry, we were 'grandfathered' as far as insurance was concerned.

Then earlier this year, along with some 13,000-15,000 of their patients, we got a letter saying that our insurance would no longer be accepted. We would be required to enroll in their Medicare Advantage Plan or find another primary care physician after January 1, 2017. Along with the other thousands of their patients who were kicked out of their practice, we were enraged. We were also at a big disadvantage. As Villages Health grew with their aggressive marketing, they drove many of the primary care doctors in the area out of business. Now that some 15,000 patients were all looking for new doctors at the same time, many were no longer taking new patients.

The big disadvantage with The Villages Health Medicare Advantage Plan is a fairly narrow listing of doctors, specialists and other providers in their network. As an example, Moffitt Cancer Center, MD Anderson Cancer Center, Shands Medical Center and all the big hospitals in Orlando or elsewhere in the U.S. are not in their network. Many of their specialists will not treat pre-existing conditions. As an example, I have multiple artificial joints. If I needed a "revision" surgery, I would have to find an orthopedic surgeon to do it and pay the FULL cost of the surgery and hospitalization. Remember, when you choose The Villages Medicare Advantage Plan, you give up Medicare.

What it boils down to is that Villages Health cannot survive financially unless all their patients participate in their Medicare Advantage Plan. Their plan is wonderful if the patients are younger and healthy. It is not good at all if as you age you need specialized treatment or surgeries such as eye surgery, orthopedic surgery, cancer treatment, etc. They provide all of that treatment, but only through their very narrow list of local providers within their network.

Be forewarned. Be very careful before enrolling in Villages Health. Make sure you ask what your options would be should you need any specialized treatment. Will you be required to use one of their network specialists (yes)? Will you have forego consideration of doctors and providers that may have superior capabilities and reputations not in their network (also yes)?

Villages Health is an HMO with limited availability of specialized doctors and other medical providers. If you have pre-existing conditions or want the option to make your own choices for specialized care when needed, be very careful about choosing Villages Health for your primary medical care. We learned...but it was very much the hard way.

[Villages Kahuna]

Originally Posted by JoMar

I also heard there were a few thousand that were leaving....I dn't know how big a deal that is in the scheme of things. There are about 40 docs and if each has 1000 patients (they are capped at 1250) that's 40,000 patients. In addition, there are a bunch of new houses being built which will bring new customers. Will this initial change make a difference in care, I doubt it. Will they recover, I think so. We make decisioons on what works for us or we fear change and want to stay in our comfort zone. Do your homework....talk to Shine, or health health care professionals you trust, but those of us that live here have our agendas and tend to try and sway others to our agendas.

The general information available locally is that Villages Health notified about 13,00 to 15,000 of their patients that they would have to enroll in their Medicare Advantage Plan or leave. They expected that about 50% of those patients would make the switch.

As it appears to be turning out, only a very small percentage of the patients, maybe 5%, expelled have chosen to accept their HMO-based Advantage Plan and stay with Villages Health for their primary care. Clearly, they will have too many doctors and some will have to be laid off.

Doctors or any other business for that matter, work diligently for years to establish the trust and confidence of their patients and customers. With one financially-driven decision Villages Health destroyed that trust among thousands of Villagers, and their friends who by now are familiar with the story.