Talk of The Villages Florida - View Single Post - Received my The Villages Health notice last week
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Old 02-02-2016, 07:26 PM
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villagetinker villagetinker is offline
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Here is my take on the situation;
First, if you read the recent article in the Daily Sun, it actually noted there were 12 (yes twelve) specialists in the system. Think about this, anyone who needs more care then the PC, will be referred to a specialist, if they are "limited to 1250 patients", guess what LONG wait times, etc. Unfortunately my wife sees 3 to4 specialists, what a mess.
No add it the news release a few months ago that United Health Care (sound familiar) is LOSING several hundred MILLION dollars on these SUPPLEMENT programs.

Here is my take:
1. If UHC goes out of the SUPPLEMENT programs TVHC will need to scramble to "fix" their system, my guess they will need to open it to all of the ADAVANTAGE plans.
2. TVHC sees the handwriting on the wall, and changes their stance (we can only hope.)
3. UHC, goes from a FREE (aka zero monthly cost) type of program to a monthly charge program. I actually think this is the most likely outcome. UHC and TVHC would be able to keep the original program will all of the goodies, and charge a suitable monthly charge to make up for the losses.

NOW, here are the potential CONTINUING problems:
Due to the lack of specialists, you may end up with an OUT OF NETWORK doctor, guess what, better have a really healthy checkbook.
If you go to a hospital other then TVRH, you may find additional OUT OF NETWORK charges on your bill.
Due to the lack of specialists, you may need to go outside the TVHC network to get a LOCAL specialist, guess what, they will NOT accept the United Health Care insurance card, carry a big check book....

For all of the above reason, we converted from the existing advantage plan to a supplemental plan. Yes, we have a monthly premium, but yes we are covered by ANY DOCTOR that accepts Medicare, yes we are covered at ANY HOSPITAL that accepts Medicare.

Please look over your options carefully, contact SHINE:
SHINE - Home
Florida Department of Elder Affairs' SHINE Program
1-800-963-5337
for an UNBIASED assessment of your situation.

Hope this helps, and please do not shoot the messenger.
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Pennsylvania, for 60+ years, most recently, Allentown, now TV.