[CritterLover]

Originally Posted by georgieporgie

The word is, The Villages are invested in UHC, and own part of the business.

They obviously have a close business relationship, but I do not believe there is ownership in either direction.

[NYGUY]

Originally Posted by CritterLover

Do you think TVH specialists are not top-notch or do I misunderstand?

No, you do not misunderstand. I don't think, in general, TVH specialists or other specialists, overall, in the area are top-notch. My theory is that it is very difficult to recruit the best and brightest along with their families to a rural area such as this. It's just my opinion, but I am sure it plays a roll.

[2BNTV]

Originally Posted by georgieporgie

Why isn't anybody talking about Florida Blue? They have Shands and Moffitt Center in their Advantage Plan Networks, both the HMO and Regional PPO. Besides, fyi, all the Villages Employees are on Blue Cross Blue Shield, Florida Blue, believe it or not!

I switched from Fl Blue, (HMO). That particular plan requires you to see your PCP first and then get a referral. I don't know about the PPO plan but I assume it's more than 104.90 per month.

The UHC plan had all of the specialists I was seeing without needing a referral. plus it was cheaper co-pay for the specialists.

I didn't see Shands and Moffit in my provider directory but if Shands and Moffit are your biggest concern, then Fl Blue, (PPO), is right for you. Maybe someone who has had UHC for a couple of years could weigh in, on whether they are in the UHC plan.

[Mudder]

With United Health, the Villages , you can always apply for a special exemption to see a specialist out of network if there is not one in this area or plan who can deal with your issue.
I have an appt with a special specialist in Boston where there is United Health. All I did was call her office and set the appt up, copy is $15.00. No problem.

[golfing eagles]

Originally Posted by NYGUY

No, you do not misunderstand. I don't think, in general, TVH specialists or other specialists, overall, in the area are top-notch. My theory is that it is very difficult to recruit the best and brightest along with their families to a rural area such as this. It's just my opinion, but I am sure it plays a roll.

You consider this a "rural" area?
Try central NY.

As far as recruiting goes, there are only so many of what you term "the best and the brightest"; they can't be everywhere. Fortunately, the difference between "average" and "best" is nowhere near as great as you probably believe. The main difficulty in recruiting is getting started--no one wants to be the only physician in a specialty in a given area---they end up being essentially "on call" all the time. Medicine has changed, doctors want a life outside of medicine. Once there are enough in a specialty, recruiting becomes easier. We had 7 physicians in our group in a city with 1/3 the population of TV, but were able to recruit 3 HS Valedictorians, the chief resident from SUNY Upstate and the chief resident from Univ. of Rochester., graduates of Univ. of Michigan and Georgetown Univ. The main reasons were that they knew exactly what to expect, and were only "on call" once a week.

[golfing eagles]

PS: TV Health recruited one of ours, so they're not doing too badly (no, not me)

[CritterLover]

I am a patient of TVH. My PCP and specialists are as top-notch as they come IMO. I can't imagine being treated better, personally or clinically, anywhere else.

[rexxfan]

Originally Posted by GordonL

My wife and I were also confused about medicare programs when we turned 65. Agents always seemed to have an agenda and created more confusion. Yes, UHC The Villages Advantage plan is a great deal with some caveats. It is a local HMO, so it is not the best for snowbirds. But you have emergency coverage anywhere in the US. You are restricted to doctors in the UHC network, but most people seem to be quite happy with the choices. If you have unique medical condition(s) you should check to see needed specialists are in network, otherwise consider a supplement plan rather than an Advantage plan.
Wife an I have been in 3 Advantage plans due to moves. We have been very pleased with all - Cigna, Humana and now UHC. Medical events have included cataract surgery, knee replacement surgery, hearing aid, dental care.

Regarding "not the best for snowbirds", I read something about a so-called "Passport" feature of UHC Medicare Advantage plans that enables members to receive non-emergency care outside their home area as long as there are in-network UHC providers in that area. Is this feature available on either of the two UHC MedicareAdvantage options available in TV? Here's an excerpt from the UHC webpage I found the information on:

UnitedHealth Passport® program – Get non-emergency care in certain areas within the United States for no additional monthly premium. You only pay the applicable co-pays according to your Evidence of Coverage. (UnitedHealth Passport is available on many, but not all, MedicareComplete plans insured through UnitedHealthcare. Note that emergency care is already covered worldwide on all plans.)
--
Bob C

[GordonL]

I was not aware of the Passport program and I thought emergency coverage was US only. I will be checking into both of those. Thanks for the heads up.

[blueash]

Originally Posted by NYGUY

No, you do not misunderstand. I don't think, in general, TVH specialists or other specialists, overall, in the area are top-notch. My theory is that it is very difficult to recruit the best and brightest along with their families to a rural area such as this. It's just my opinion, but I am sure it plays a roll.

The patient profile of a doctor here is going to be reasonably healthy senior citizen, period. Very few doctors want to have a practice of managing our demographic unless they are in geriatrics and enjoy it. Family doctors are trained to treat all ages and spend a little time training in elder care. They would want to see kids, teens, young adults... Specialists may expect to see fewer young people but most can expect good continuity and to be able to manage their patients. We, as patients, often have another set of doctors "back home" and many seem to leave the area when an illness worsens. Combine this with a severe lack of younger adults and kids for the doctor's family social life, and yes it is harder to get doctors to come here other than those into geriatrics and those nearer retirement age themselves.

[golfing eagles]

Originally Posted by blueash

The patient profile of a doctor here is going to be reasonably healthy senior citizen, period. Very few doctors want to have a practice of managing our demographic unless they are in geriatrics and enjoy it. Family doctors are trained to treat all ages and spend a little time training in elder care. They would want to see kids, teens, young adults... Specialists may expect to see fewer young people but most can expect good continuity and to be able to manage their patients. We, as patients, often have another set of doctors "back home" and many seem to leave the area when an illness worsens. Combine this with a severe lack of younger adults and kids for the doctor's family social life, and yes it is harder to get doctors to come here other than those into geriatrics and those nearer retirement age themselves.

Well, that's interesting. Do you really think the demographics of a primary care practice here is different than anywhere else, PERIOD? And your insight into what type of patient a doctor wants to see is based on what? The average age of a patient in my NY practice was probably about 45-50, but the average age of the patients that actually came to be seen was in the 70's. Pediatricians want to see kids, that's obvious. Gynecologists want to see women, oncologists want to treat cancer. Family practitioners will see who they want. Specialists want to do procedures. I very much doubt "demographics" in TV has a lot to do with recruiting.

[CritterLover]

Originally Posted by blueash

The patient profile of a doctor here is going to be reasonably healthy senior citizen, period. Very few doctors want to have a practice of managing our demographic unless they are in geriatrics and enjoy it. Family doctors are trained to treat all ages and spend a little time training in elder care. They would want to see kids, teens, young adults... Specialists may expect to see fewer young people but most can expect good continuity and to be able to manage their patients. We, as patients, often have another set of doctors "back home" and many seem to leave the area when an illness worsens. Combine this with a severe lack of younger adults and kids for the doctor's family social life, and yes it is harder to get doctors to come here other than those into geriatrics and those nearer retirement age themselves.

I'm fairly certain that in TV, they fully understand the demographics.

[rexxfan]

Originally Posted by GordonL

I was not aware of the Passport program and I thought emergency coverage was US only. I will be checking into both of those. Thanks for the heads up.

This is where I found that for what its worth:

https://www.uhcmedicaresolutions.com...r-support.html
--
Bob C

[Bonnevie]

there's actually a course at Lifelong Learning on understanding Medicare and the various add on plans.

[goodtimesintv]

Originally Posted by georgieporgie

The word is, The Villages are invested in UHC, and own part of the business.

We are all "invested in" the UHC-AARP bed partnership via the federal bedroom:

"“AARP lobbied for the new health care law and now it stands to profit, lawmakers charged Wednesday as they called for the IRS to investigate whether the powerful interest group deserves to keep its federal tax exemption.

“Three veteran representatives released a report that estimates the seniors lobby could make an additional $1 billion over 10 years on health insurance plans whose sales are expected to pick up under the new law. They also questioned seven-figure compensation for some AARP executives.”

Among the key findings from the Ways & Means Committee report are:

As a result of the new health care law, the Administration estimates more than seven million seniors will lose their current Medicare Advantage plans, resulting in a massive migration of seniors to Medigap plans. AARP is the nation’s leading provider of Medigap plans and has a contract in which AARP financially gains for every additional Medigap enrollee.

Based on low, mid and high-range estimates, AARP stands to financially gain, over and above the millions of dollars they currently receive from United, between $55 million and $166 million in 2014 alone as a result of new Medigap enrollees stemming from the health care law’s cuts to MA, which AARP strongly endorsed.

Under the mid-range estimate and under their current contract, AARP’s financial gain from the health care law could exceed $1 billion during the next 10 years. This is because AARP will see their royalty payments increase as seniors are forced out of MA plans and buy AARP Medigap plans instead.

- See more at: AARP Profits from ACA at the Expense of American Seniors, New Report Shows | Speaker.gov