The Villages Health Care Program

[rxatkin]

We just got a call from The Villages Health Care telling us that The Villages Health Care System is no longer taking new patients with Medicare as primary insurance and Tricare For Life as secondary insurance. That's just gone into effect today. We just got off the phone with the call center supervisor. Anyone else in our situation? They have too many patients and not enough doctors. Good luck to us veterans and our spouses.

[Paper1]

We just got a call from The Villages Health Care telling us that The Villages Health Care System is no longer taking new patients with Medicare as primary insurance and Tricare For Life as secondary insurance. That's just gone into effect today. We just got off the phone with the call center supervisor. Anyone else in our situation? They have too many patients and not enough doctors. Good luck to us veterans and our spouses.

I'm not a veteran nor are we on medicare but also were told today to try back in January. I have BCBS

[Mudder]

Well as a member of Villages Health I am glad that they appear to be sticking to their original mission statement of each doctor having only 1200 patients. I do feel for those who are being phased out, I would be so upset to have to start the search again for new health care options. I feel your frustration, but feel happy for myself.

[nkrifats]

We just got a call from The Villages Health Care telling us that The Villages Health Care System is no longer taking new patients with Medicare as primary insurance and Tricare For Life as secondary insurance. That's just gone into effect today. We just got off the phone with the call center supervisor. Anyone else in our situation? They have too many patients and not enough doctors. Good luck to us veterans and our spouses.

I would assume that those of us already in the system are grandfathered in. At least I do hope so.

[graciegirl]

I would assume that those of us already in the system are grandfathered in. At least I do hope so.



You are very fortunate to have been accepted. I would love for us to be patients there. Unfortunately they have always only accepted certain kinds of insurance.


I have a feeling that this isn't a change, just their way of doing business and only certain kinds of insurance participate and are accepted.

[2BNTV]

I was at a UHC seminar and asked if it was part of TV HealthCare Network. I was informed that UHC is not part of TV HealthCare network, as I could go to any doctor I want.

Was I misinformed?

[jojo]

I was at a UHC seminar and asked if it was part of TV HealthCare Network. I was informed that UHC is not part of TV HealthCare network, as I could go to any doctor I want.

Was I misinformed?

We have UHC supplement insurance and go to Villages Health.

[Navy (SSBN 633)]

Medicare and Tricare for Life are still listed on their web site as acceptable insurances they accept.

[bimmertl]

There is still plenty of room for new patients if you sign up with United Health Care Medicare Advantage. It's the only Medicare Advantage plan accepted by The Villages Health network. (It's Medicare Advantage, not plain Medicare, a big difference)

Accepted Insurance by The Villages Health (http://www.thevillageshealth.com/insurance.php)

Two inserts in the Daily Sun already this week in addition to the weekly Sunday paper pages devoted to the product. Look at the brochure and see how many neighborhood meeting are being held from October 13 through December 3. It lists 52 different locations with multiple meetings at each location. In addition, you can walk into one of three UHC Medicare Stores located in the Villages. Based upon the numbers of meetings and unlimited access to sales personnel there is plenty of room for more patients in UHC Medicare Advantage.

As stated in the brochures, "United Healthcare pays royalty fees to Holding Company of the Villages, inc.". So there is always room for more patients as long as Morse makes a profit, otherwise SOL.

[golfing eagles]

There is still plenty of room for new patients if you sign up with United Health Care Medicare Advantage. It's the only Medicare Advantage plan accepted by The Villages Health network. (It's Medicare Advantage, not plain Medicare, a big difference)

Accepted Insurance by The Villages Health (http://www.thevillageshealth.com/insurance.php)

Two inserts in the Daily Sun already this week in addition to the weekly Sunday paper pages devoted to the product. Look at the brochure and see how many neighborhood meeting are being held from October 13 through December 3. It lists 52 different locations with multiple meetings at each location. In addition, you can walk into one of three UHC Medicare Stores located in the Villages. Based upon the numbers of meetings and unlimited access to sales personnel there is plenty of room for more patients in UHC Medicare Advantage.

As stated in the brochures, "United Healthcare pays royalty fees to Holding Company of the Villages, inc.". So there is always room for more patients as long as Morse makes a profit, otherwise SOL.

Is this TV Health trying to recruit more patients (which I doubt), or UHC trying to sell more medicare advantage policies prior to the open enrollment deadline (more likely). In the latter case, there is no guarantee of room for more patients at TV Health

[bimmertl]

Is this TV Health trying to recruit more patients (which I doubt), or UHC trying to sell more medicare advantage policies prior to the open enrollment deadline (more likely). In the latter case, there is no guarantee of room for more patients at TV Health

So why would UHC pay royalties to Holding Company of The Villages Inc if you enroll in their advantage plan if there isn't a tie in? UHC Medicare plan has no such arrangement.

Here's another interesting link to Villages Health. Doubt he took a pay cut.

After USF failure in the Villages, top official finds job there | Tampa Bay Times (http://www.tampabay.com/news/education/college/after-usf-failure-in-the-villages-top-official-finds-job-there/2217803)

Then he did this.

Ex-USF Physicians Group boss sues USF for $600,000 pay | TBO.com and The Tampa Tribune (http://www.tbo.com/news/crime/ex-usf-physicians-group-boss-sues-usf-for-600000-pay-20150518/)

[golfing eagles]

So why would UHC pay royalties to Holding Company of The Villages Inc if you enroll in their advantage plan if there isn't a tie in? UHC Medicare plan has no such arrangement.

Here's another interesting link to Villages Health. Doubt he took a pay cut.

After USF failure in the Villages, top official finds job there | Tampa Bay Times (http://www.tampabay.com/news/education/college/after-usf-failure-in-the-villages-top-official-finds-job-there/2217803)

Then he did this.

Ex-USF Physicians Group boss sues USF for $600,000 pay | TBO.com and The Tampa Tribune (http://www.tbo.com/news/crime/ex-usf-physicians-group-boss-sues-usf-for-600000-pay-20150518/)

I'm sure there is some sort of arrangement, after all, TV Health ONLY accepts UHC medicare advantage as their only advantage plan. However, UHC sells these policies to everyone who has other doctors as well, so they may be holding these meetings to enroll non TV Health patients as well, and the "royalties" are only for TV Health exclusivity.

[rpensabene]

There are several doctors outside of The Villages Health System that take the United Health Care Advantage Plans PPO & HMOs in the UHC network.

If you have the Medicare Complete Choice PPO you could go outside the network with higher copays. Make sure your doctor will file the claims for you.

The AARP Medicare Supplements insured by United HealthCare
are taken by any doctor who accepts Medicare Assignment.

[graciegirl]

So why would UHC pay royalties to Holding Company of The Villages Inc if you enroll in their advantage plan if there isn't a tie in? UHC Medicare plan has no such arrangement.

Here's another interesting link to Villages Health. Doubt he took a pay cut.

After USF failure in the Villages, top official finds job there | Tampa Bay Times (http://www.tampabay.com/news/education/college/after-usf-failure-in-the-villages-top-official-finds-job-there/2217803)

Then he did this.

Ex-USF Physicians Group boss sues USF for $600,000 pay | TBO.com and The Tampa Tribune (http://www.tbo.com/news/crime/ex-usf-physicians-group-boss-sues-usf-for-600000-pay-20150518/)



I don't understand what point you are trying to make.

[dbussone]

You are very fortunate to have been accepted. I would love for us to be patients there. Unfortunately they have always only accepted certain kinds of insurance.


I have a feeling that this isn't a change, just their way of doing business and only certain kinds of insurance participate and are accepted.


And I think it is safe to say that UHC products have priority consideration when it comes to acceptance by Villages Health.

[Schneil]

We are so disappointed in the healthcare program and restrictions. The advertising which sold us on TV while house hunting was and continues to be misleading. I particularly love the following advertisement that "health care is just a short golf cart ride away...." There is no disclaimer of: "only if you belong to UHC! Shame on the Morse family!

Copied from the Village Website:

An important part of a great retirement lifestyle is convenient access to wellness facilities and quality health care.

The Villages Health and USF HEALTH, a major academic health resource, are partnering to make The Villages America's Healthiest Hometown.

Staying healthy is easy in The Villages. Neighborhood fitness centers and health care facilities are located throughout The Villages -- just a golf car ride away. The Villages Healthcare Centers, The Villages Regional Hospital, Moffitt Cancer Center, VA outpatient clinic, senior living facilities, and a long term acute care hospital are all located here.

[Challenger]

We are so disappointed in the healthcare program and restrictions. The advertising which sold us on TV while house hunting was and continues to be misleading. I particularly love the following advertisement that "health care is just a short golf cart ride away...." There is no disclaimer of: "only if you belong to UHC! Shame on the Morse family!

Copied from the Village Website:

An important part of a great retirement lifestyle is convenient access to wellness facilities and quality health care.

The Villages Health and USF HEALTH, a major academic health resource, are partnering to make The Villages America's Healthiest Hometown.

Staying healthy is easy in The Villages. Neighborhood fitness centers and health care facilities are located throughout The Villages -- just a golf car ride away. The Villages Healthcare Centers, The Villages Regional Hospital, Moffitt Cancer Center, VA outpatient clinic, senior living facilities, and a long term acute care hospital are all located here.

My wife and I have been here five years. Both in our late seventies with a need for multiple health professionals including dermatology ,urology, dentistry, cardiology , and others . Have never had a moments problem accessing health care sine we moved here.

[CT514s]

We have UHC (not their Medicare Advantage) plan as our supplemental and are part of Villages Health Care. Had a long wait for our initial appointments, but no problems since then.

[villages07]

Back to the OPs post...I believe the main issue is that Villages Health does not have enough doctors. Are their hiring standards too high or are they just having trouble recruiting into this new concept, or just not paying enough in salary? Each center supposedly could support 8 doctors. Last I looked, Creekside/Sumter only had 5. If they had more docs, they could take on more patients. Dr Eagles....do you have an opinion on this?

[golfing eagles]

Back to the OPs post...I believe the main issue is that Villages Health does not have enough doctors. Are their hiring standards too high or are they just having trouble recruiting into this new concept, or just not paying enough in salary? Each center supposedly could support 8 doctors. Last I looked, Creekside/Sumter only had 5. If they had more docs, they could take on more patients. Dr Eagles....do you have an opinion on this?

Well, now that you mention it........

The first problem is national---The number of primary care doctors is shrinking rapidly. Currently there are a total of about 900,000 clinicians in the US, 624,000 are involved in direct patient care, and 209,000 are in primary care. Some estimates expect the total number to decrease by 250,000 in the next 5-7 years due to a variety of factors----early retirement, alternative careers , and medical careers that do not involve patient care.
Young physicians are trending towards specialty and sub-specialty care---as the technology develops and the body of knowledge expands exponentially, there is much more to know and new niches to fill. Primary care, in particular suffers because it is considered less "glamorous", overburdened by documentation and regulation, and to a certain degree is less lucrative.
As a result, recruiting is much more difficult all over. I don't know how the recruiting goes in TV Health---I believe they were originally aiming for 8 centers with 8 docs each, but they have taken a pause. I honestly don't know the reason but recruitment may be a part of it. Personally, I don't think hiring standards can ever be too high, but realism has to set in at some point. Yes, their goal is a fairly new concept, they want to build the best ACO possible, and this involves a lot of paperwork and regulation. This is why they try to limit patient profiles to 1250 patients/physician, have 1/2 hr follow up appts and 1 hr initial appts, which is about 1/2 of the national average.
I don't think salary is a huge factor. Those who are chasing dollars have already decided to go into specialty care, or avoid a medical career entirely and go to Wall Street--it's a lot easier to get a MBA than a MD. It appears the salaries offered at TV Health are about average for primary care, so they are competitive in their financial package.
I hope this answers some of your questions, IMHO.

[dbussone]

Well, now that you mention it........



The first problem is national---The number of primary care doctors is shrinking rapidly. Currently there are a total of about 900,000 clinicians in the US, 624,000 are involved in direct patient care, and 209,000 are in primary care. Some estimates expect the total number to decrease by 250,000 in the next 5-7 years due to a variety of factors----early retirement, alternative careers , and medical careers that do not involve patient care.

Young physicians are trending towards specialty and sub-specialty care---as the technology develops and the body of knowledge expands exponentially, there is much more to know and new niches to fill. Primary care, in particular suffers because it is considered less "glamorous", overburdened by documentation and regulation, and to a certain degree is less lucrative.

As a result, recruiting is much more difficult all over. I don't know how the recruiting goes in TV Health---I believe they were originally aiming for 8 centers with 8 docs each, but they have taken a pause. I honestly don't know the reason but recruitment may be a part of it. Personally, I don't think hiring standards can ever be too high, but realism has to set in at some point. Yes, their goal is a fairly new concept, they want to build the best ACO possible, and this involves a lot of paperwork and regulation. This is why they try to limit patient profiles to 1250 patients/physician, have 1/2 hr follow up appts and 1 hr initial appts, which is about 1/2 of the national average.

I don't think salary is a huge factor. Those who are chasing dollars have already decided to go into specialty care, or avoid a medical career entirely and go to Wall Street--it's a lot easier to get a MBA than a MD. It appears the salaries offered at TV Health are about average for primary care, so they are competitive in their financial package.

I hope this answers some of your questions, IMHO.


GE - I would add that the Feds also have a significant hand in this situation. Despite the fact that our country's population is growing, and the number of elderly is increasing, the Feds capped the number of residency positions in the late '90s. This is simply a matter of money. The Feds partially reimburse teaching hospitals for the cost of training physician so they capped the number of available slots to reduce future expenses. In essence there is an artificial choke point on the training of physicians regardless of current or future need IMO.

[golfing eagles]

GE - I would add that the Feds also have a significant hand in this situation. Despite the fact that our country's population is growing, and the number of elderly is increasing, the Feds capped the number of residency positions in the late '90s. This is simply a matter of money. The Feds partially reimburse teaching hospitals for the cost of training physician so they capped the number of available slots to reduce future expenses. In essence there is an artificial choke point on the training of physicians regardless of current or future need IMO.

The FEDS are a whole other chapter in this, but yes, they did cap residency support, but this was for specialty residencies while continuing to support primary care residencies. Of course, the flaw here was that 3 years of internal medicine is required prior to a specialty. They did change many specialty fellowships from 2 to 3 years, so the number of specialists finishing went down. I don't think there is much of a choke point---most residency programs cannot fill their slots with American graduates, hence the escalating need for patients to be "multi-lingual"
At the same time, IF Obamacare succeeds in bringing in 40 million new patients, the demand will be far greater

[NYGUY]

Before moving to The Villages, my PCP was the also the Chairman of the Department of Family Medicine at The University of South Florida. He always had students with him during office visits and we often discussed the difficulties of recruiting students to Family Medicine. He mentioned many of the same issues as GE has pointed out (compensation, practice costs, prestige, etc).

[dotti105]

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. WE are the ones who create the highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

[NYGUY]

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. WE are the ones who create the highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

You are absolutely correct!!!..:bigbow::bigbow:
Another instance of the tail wagging the dog!!!

[golfing eagles]

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

WE are the ones who create the My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

I too favor a single payer system, but with the caveat that the government is barred from administering its own program, otherwise, cost will go UP
Administrative costs for private insurance run 11-13%, government program insurance runs about 32%---which just goes to prove what we all already know---1 private sector worker can do as much as 3 government workers.
There will be those that go online and see numbers like medicare has a 5% administrative cost, but this is a fallacy. Medicare gets gov't office space, paid for in a different budget. They don't have billing and collection costs--that's in the IRS budget. They don't have mailing cost, office equipment cost, phone cost---I think the GSO covers that. They operate across state lines, which private insurance cannot do. When you add it all up from the different budgets, it comes to about 32%
And according to a BNA study, “Popular comparisons of Medicare and private group health plan ‘overhead’ costs wrongly compare only a part of administrative expenses related to the Medicare program to the whole of private sector administrative expenses for comparable large group health plans.” The report also says that Medicare’s costs for claims administration “are really about the same as claims administration costs in the private large group health plan market.” Moreover, some of Medicare’s general administration costs are expensed elsewhere in the federal budget, and others, like premium taxes, do not apply to the Medicare program. - See more at: Fact Check on Administrative Costs | AHIP Coverage (http://www.ahipcoverage.com/2013/04/11/fact-check-on-administrative-costs/#sthash.qNzpUclQ.dpuf)
Finally, the other downside: Your dad may have been correct about the insurance company "choke hold", but that would be traded in for a GOVERNMENT choke hold. I leave it to the reader to decide which is worse

[dbussone]

I too favor a single payer system, but with the caveat that the government is barred from administering its own program, otherwise, cost will go UP

Administrative costs for private insurance run 11-13%, government program insurance runs about 32%---which just goes to prove what we all already know---1 private sector worker can do as much as 3 government workers.

There will be those that go online and see numbers like medicare has a 5% administrative cost, but this is a fallacy. Medicare gets gov't office space, paid for in a different budget. They don't have billing and collection costs--that's in the IRS budget. They don't have mailing cost, office equipment cost, phone cost---I think the GSO covers that. They operate across state lines, which private insurance cannot do. When you add it all up from the different budgets, it comes to about 32%

And according to a BNA study, “Popular comparisons of Medicare and private group health plan ‘overhead’ costs wrongly compare only a part of administrative expenses related to the Medicare program to the whole of private sector administrative expenses for comparable large group health plans.” The report also says that Medicare’s costs for claims administration “are really about the same as claims administration costs in the private large group health plan market.” Moreover, some of Medicare’s general administration costs are expensed elsewhere in the federal budget, and others, like premium taxes, do not apply to the Medicare program. - See more at: Fact Check on Administrative Costs | AHIP Coverage (http://www.ahipcoverage.com/2013/04/11/fact-check-on-administrative-costs/#sthash.qNzpUclQ.dpuf)

Finally, the other downside: Your dad may have been correct about the insurance company "choke hold", but that would be traded in for a GOVERNMENT choke hold. I leave it to the reader to decide which is worse


If you want to know how the government runs things, just remember that the FDA allows up to 10% miscellaneous "material" in your hot dog. Think of ObamaCare as the same sort of production process.

[golfing eagles]

If you want to know how the government runs things, just remember that the FDA allows up to 10% miscellaneous "material" in your hot dog. Think of ObamaCare as the same sort of production process.

I hope they re-define that "10% miscellaneous" in light of terrorist attempts to acquire nuclear material!!!

[Avista]

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. WE are the ones who create the highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

Well said, Dotti!

[goodtimesintv]

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. WE are the ones who create the highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

The ACA and the feds have given more power and market share to the biggest insurers and United Healthcare-AARP than they have ever had!!

"These Medicare supplement insurance companies are the biggest of all the companies and most of them have been around the longest.

AARP– AARP is the largest and most recognized company for senior insurance. They are in every state and at the top of the food chain for all the Medicare supplement insurance companies. Find out more about an AARP Medicare supplement HERE.

Mutual of Omaha– Second only to AARP Mutual of Omaha is one of the most respected insurance companies in the U.S. They have made a big push to be a major competitor in the Medicare supplement market. Get more information on a Mutual of Omaha Medicare supplement HERE.

Humana – By forming a relationship with Wal-Mart for Medicare Part D, Humana has catapulted itself into a bigger part of the medigap market. Learn more about a Humana Medicare supplement HERE.

Gerber– Gerber made a huge splash when they entered the Medicare supplement market and moved quickly from the new guy to a major competitor. Get more information on a Gerber Medicare supplement HERE."

Medicare Supplement Insurance Companies - View Rates Online (http://www.medicaresupplementalinsurancequotes.com/medicare-supplement-insurance-companies/)

[JoMar]

We are so disappointed in the healthcare program and restrictions. The advertising which sold us on TV while house hunting was and continues to be misleading. I particularly love the following advertisement that "health care is just a short golf cart ride away...." There is no disclaimer of: "only if you belong to UHC! Shame on the Morse family!

Copied from the Village Website:

An important part of a great retirement lifestyle is convenient access to wellness facilities and quality health care.

The Villages Health and USF HEALTH, a major academic health resource, are partnering to make The Villages America's Healthiest Hometown.

Staying healthy is easy in The Villages. Neighborhood fitness centers and health care facilities are located throughout The Villages -- just a golf car ride away. The Villages Healthcare Centers, The Villages Regional Hospital, Moffitt Cancer Center, VA outpatient clinic, senior living facilities, and a long term acute care hospital are all located here.

First error is making decisions only based on what is on the internet. Second error is not talking to a real person to understand the "rules". Your sales person could have put you into the right place to call someone. You will get past this at some point and then you can just enjoy where you are.

[golfing eagles]

The ACA and the feds have given more power and market share to the biggest insurers and United Healthcare-AARP than they have ever had!!

"These Medicare supplement insurance companies are the biggest of all the companies and most of them have been around the longest.

AARP– AARP is the largest and most recognized company for senior insurance. They are in every state and at the top of the food chain for all the Medicare supplement insurance companies. Find out more about an AARP Medicare supplement HERE.

Mutual of Omaha– Second only to AARP Mutual of Omaha is one of the most respected insurance companies in the U.S. They have made a big push to be a major competitor in the Medicare supplement market. Get more information on a Mutual of Omaha Medicare supplement HERE.

Humana – By forming a relationship with Wal-Mart for Medicare Part D, Humana has catapulted itself into a bigger part of the medigap market. Learn more about a Humana Medicare supplement HERE.

Gerber– Gerber made a huge splash when they entered the Medicare supplement market and moved quickly from the new guy to a major competitor. Get more information on a Gerber Medicare supplement HERE."

Medicare Supplement Insurance Companies - View Rates Online (http://www.medicaresupplementalinsurancequotes.com/medicare-supplement-insurance-companies/)

Just how did you come to this conclusion? I have no love for the ACA, but in fairness, it has absolutely nothing to do with medicare or medicare supplemental policies. You then go on to list the 4 largest supplemental insurance companies, that had the overwhelming majority of market share both before and after ACA. The reason these companies have that market share is because CONSUMERS BUY them, not "the feds". They fill a niche, and therefore they sell their product. This may be the clearest example of the free market ay work in the whole mess

Even in the non-medicare market, about 12 million have signed up under ACA, but 7 million lost their coverage in the individual market, net gain = 5 million. In a country of 330 million, do you think this is a tremendous increase in market share? And you didn't think all the insurers have tremendous power over the care you receive both before after ACA?

[dotti105]

One of my big concerns with the huge monopoly type insurance companies who buy up their competition is the fact that they have a very large lobby which is an industry in and of itself. They are proud of the fact that they line the pockets of the house and senate members who are elected to represent OUR best interests. Our representatives are no longer representing us, they are representing the special interests who pay them well to do so.

Citizens United needs to be overturned and term limits in place before we will have elected officials who are willing to represent the citizens who voted them into office. $$ is running politics now, and big business supplies the big bucks. The insurance industry is one of the largest and most successful in getting laws drafted to their advantage.

When ACA came out with Insurance Companies in charge, we were guaranteed to have higher premiums, co-pays and less option for seeing the provider/specialist of our choice.

As they have put out the programs for 2016, there have been many changes and most are again in the favor of the insurance companies.

Our healthcare system, like our political system would be better run without the SuperPacs, and lobbyists who have the insidious power to determine our political future and the future of our healthcare, to a much greater degree than the citizens who elected those officials.

That is a recipe for disaster for all except the big boys with the big bucks.

[golfing eagles]

One of my big concerns with the huge monopoly type insurance companies who buy up their competition is the fact that they have a very large lobby which is an industry in and of itself. They are proud of the fact that they line the pockets of the house and senate members who are elected to represent OUR best interests. Our representatives are no longer representing us, they are representing the special interests who pay them well to do so.

Citizens United needs to be overturned and term limits in place before we will have elected officials who are willing to represent the citizens who voted them into office. $$ is running politics now, and big business supplies the big bucks. The insurance industry is one of the largest and most successful in getting laws drafted to their advantage.

When ACA came out with Insurance Companies in charge, we were guaranteed to have higher premiums, co-pays and less option for seeing the provider/specialist of our choice.

As they have put out the programs for 2016, there have been many changes and most are again in the favor of the insurance companies.

Our healthcare system, like our political system would be better run without the SuperPacs, and lobbyists who have the insidious power to determine our political future and the future of our healthcare, to a much greater degree than the citizens who elected those officials.

That is a recipe for disaster for all except the big boys with the big bucks.

While I would agree in principle that lobbies and superpacs diminish the influence of individual citizens with their elected representatives, I think there may be room for debate on your health insurance statements.
Here is a list, from CNN, of the top 10 lobbies in Wash DC:
The full list: Here are the publicly traded companies that have done the most direct lobbying since 2009, plus a bonus:

1. General Electric (GE): $134 million
2. AT&T: (T, Tech30) $91.2 million
3. Boeing Co (BA): $90.3 million
4. Northrop Grumman (NOC): $87.9 million
5. Comcast Corp (CMCSA): $86.4 million
6. Verizon Communications: (VZ, Tech30) $86.4 million
7. FedExCorp (FDX): $85.7 million
8. Exxon Mobil (XOM): $85 million
9. Lockheed Martin (LMT): $78.8 million
10. Pfizer (PFE): $77.8 million
...
16.Google (GOOG): $62.2 million
CNNMoney (New York) October 1, 2014: 11:36 AM ET

I don't see any insurers here

"When ACA came out with Insurance Companies in charge, we were guaranteed to have higher premiums, co-pays and less option for seeing the provider/specialist of our choice."

Actually, when ACA came out, period, with 40 million who for the most part could not pay their own premiums destined to enter the system, no exclusion for pre-existing conditions, and children up to 26 on their mommy's policy (and couch) who were not paying their own premiums, WE WERE GUARANTEED TO HAVE HIGHER PREMIUMS regardless of who was running it. The concept that the 3 TRILLION in cost over 10 years would be offset by more efficient care, EMRs and decreasing so called "fraud" was a joke from the beginning. So, as Obama exits next year and Obamacare gets fully implemented, hold on to your wallets. So far his $2000 saving/family has been a $5000 increase, not including higher deductibles, and will go up even further. If you think you are safe on medicare, NOT. Obamacare takes 550 billion from that program which already has financial problems, especially part B.
Remember, ACA had very little to do with health care reform and everything to do with being the largest tax increase and power grab by the federal government in our history. If they were serious about health care reform, the targets would have been pharmaceutical costs, tort reform, slashing regulation, and durable medical equipment costs---none of which were touched

[outlaw]

While I would agree in principle that lobbies and superpacs diminish the influence of individual citizens with their elected representatives, I think there may be room for debate on your health insurance statements.
Here is a list, from CNN, of the top 10 lobbies in Wash DC:
The full list: Here are the publicly traded companies that have done the most direct lobbying since 2009, plus a bonus:

1. General Electric (GE): $134 million
2. AT&T: (T, Tech30) $91.2 million
3. Boeing Co (BA): $90.3 million
4. Northrop Grumman (NOC): $87.9 million
5. Comcast Corp (CMCSA): $86.4 million
6. Verizon Communications: (VZ, Tech30) $86.4 million
7. FedExCorp (FDX): $85.7 million
8. Exxon Mobil (XOM): $85 million
9. Lockheed Martin (LMT): $78.8 million
10. Pfizer (PFE): $77.8 million
...
16.Google (GOOG): $62.2 million
CNNMoney (New York) October 1, 2014: 11:36 AM ET

I don't see any insurers here

"When ACA came out with Insurance Companies in charge, we were guaranteed to have higher premiums, co-pays and less option for seeing the provider/specialist of our choice."

Actually, when ACA came out, period, with 40 million who for the most part could not pay their own premiums destined to enter the system, no exclusion for pre-existing conditions, and children up to 26 on their mommy's policy (and couch) who were not paying their own premiums, WE WERE GUARANTEED TO HAVE HIGHER PREMIUMS regardless of who was running it. The concept that the 3 TRILLION in cost over 10 years would be offset by more efficient care, EMRs and decreasing so called "fraud" was a joke from the beginning. So, as Obama exits next year and Obamacare gets fully implemented, hold on to your wallets. So far his $2000 saving/family has been a $5000 increase, not including higher deductibles, and will go up even further. If you think you are safe on medicare, NOT. Obamacare takes 550 billion from that program which already has financial problems, especially part B.
Remember, ACA had very little to do with health care reform and everything to do with being the largest tax increase and power grab by the federal government in our history. If they were serious about health care reform, the targets would have been pharmaceutical costs, tort reform, slashing regulation, and durable medical equipment costs---none of which were touched

Ok Doc, now you're really making me sick. I thought you were supposed to first do no harm.

[golfing eagles]

Ok Doc, now you're really making me sick. I thought you were supposed to first do no harm.

How so?? Just posted some facts about insurance lobbies, health care costs, and the ACA. Yes, I might have done it differently, but for now it is what it is, so we should all understand it

[outlaw]

People blaming the insurance companies are going to be so disappointed when/if the US ever goes to universal single payer healthcare. If health insurance companies were getting so rich off of healthcare, why would investors own any other stocks? Why wouldn't health insurance companies dominate market capitalization? Why wouldn't the health insurance companies be the most expensive stocks? If you think it's difficult getting a doctor now. Wait until universal health care. Forget a knee replacement so you can continue playing golf or pickleball. That's what walking canes are for. Watch the new miracle drug line dry up because the government decides that the drug companies profit margin is too high and arbitrarily sets the price for these drugs. It's coming. Remember, you asked for it.

[outlaw]

How so?? Just posted some facts about insurance lobbies, health care costs, and the ACA. Yes, I might have done it differently, but for now it is what it is, so we should all understand it

Actually, I was kidding. I agree with your post. You see, your truthful explanation of the state of our health care system was so sad that it was making me sick...get it. You're a doctor; making me sick....get it. Knock knock. Anyone there?

[golfing eagles]

Actually, I was kidding. I agree with your post. You see, your truthful explanation of the state of our health care system was so sad that it was making me sick...get it. You're a doctor; making me sick....get it. Knock knock. Anyone there?

:bigbow:Way too early for me to get it

Primum non nocere

[outlaw]

:bigbow:Way too early for me to get it

Primum non nocere

I guess it would have been funnier if I would have posted in Latin.

[golfing eagles]

I guess it would have been funnier if I would have posted in Latin.

Way, way, way too early for THAT:a20:

[dotti105]

Golfing Eagles, I appreciate the negative information you have presented on the ACA and it's management by our mega insurance companies.

As I understand it, the US is one of the few developed nations that does not have a single payer system. Are they all wrong? I worked in the bay area with RNs from Canada who would not get US citizenship because they do not want to give up their excellent medial insurance in Canada. Why would that be?

While traveling in Australia, the people we met were all very happy with their universal health care.

No "death committees" in either country. Health care is considered a right in those countries as well as in the many other developed countries who rank above us in quality and outcomes.

I don't understand how that works. If universal health care is such a bad idea, why has it been so successful and well received in so many other nations? And why have we consistently ranked so low in outcomes?

Costs have increased dramatically during my years working as a RN, the pay....not so much. The Hospital corporations are flush with cash, HCA for example, (Governor Rick Scott's former "ATM card") where I worked for the last 10 years has made record profits year after year. Their hospitals are 12 of the top 25 in profits year after year.

Some one is making a lot of $$ on the back of the health care industry, it's healthcare providers, and patients alike.

Please enlighten me? No sarcasm intended. I really want to hear your reasoning for the situation here compared to the other 1st world countries.

I do enjoy your posts and respect your opinions.

[golfing eagles]

Golfing Eagles, I appreciate the negative information you have presented on the ACA and it's management by our mega insurance companies.

As I understand it, the US is one of the few developed nations that does not have a single payer system. Are they all wrong? I worked in the bay area with RNs from Canada who would not get US citizenship because they do not want to give up their excellent medial insurance in Canada. Why would that be?

While traveling in Australia, the people we met were all very happy with their universal health care.

No "death committees" in either country. Health care is considered a right in those countries as well as in the many other developed countries who rank above us in quality and outcomes.

I don't understand how that works. If universal health care is such a bad idea, why has it been so successful and well received in so many other nations? And why have we consistently ranked so low in outcomes?

Costs have increased dramatically during my years working as a RN, the
pay....not so much. The Hospital corporations are flush with cash, HCA for example, (Governor Rick Scott's former "ATM card") where I worked for the last 10 years has made record profits year after year. Their hospitals are 12 of the top 25 in profits year after year.

Some one is making a lot of $$ on the back of the health care industry, it's healthcare providers, and patients alike.

Please enlighten me? No sarcasm intended. I really want to hear your reasoning for the situation here compared to the other 1st world countries.

I do enjoy your posts and respect your opinions.

Wow, there's a lot in there, I could write a book! So I'll try to be short and answer point by point---but while I back this with facts, it is still only my opinion and I'm sure others will disagree.

Golfing Eagles, I appreciate the negative information you have presented on the ACA and it's management by our mega insurance companies.

Actually, I believe the only negative part (that I mentioned) was the cost and how it was misrepresented as well as the lack of scope in addressing the true problems in healthcare

As I understand it, the US is one of the few developed nations that does not have a single payer system. Are they all wrong? I worked in the bay area with RNs from Canada who would not get US citizenship because they do not want to give up their excellent medial insurance in Canada. Why would that be?

I guess the tongue in cheek answers would be yes, and dementia. However, part of the problem is comparing apples and oranges. At the risk of the ire of the right, I would have developed a single payer system in the US as well, but I just wouldn't let our government run it. There is a big difference between how our government works and that of Luxembourg. What "works" there might not work here for a whole array of reasons, more on that later. As far as the Canadian system being "excellent", for some things it is. They are very good at preventative care, prenatal care, immunizations and simple problems. I assume your nurse friends never had a serious problem. They might think differently if they needed an MRI or open heart surgery, as they got sicker and sicker on a long waiting list. Seattle, Detroit, Buffalo, Albany, and to a certain extent Boston has a thriving business providing advanced care to Canadians who cross the border to utilize these services

While traveling in Australia, the people we met were all very happy with their universal health care.

Again, they tend to be happy as long as they don't get seriously ill.

No "death committees" in either country. Health care is considered a right in those countries as well as in the many other developed countries who rank above us in quality and outcomes.

I think "death committees" was a fear tactic of Sarah Palin and the far right. But you can only pay for universal health care either by higher taxes or rationing. European socialist republics do it with a little of both, something that Americans probably would not stand for.

I don't understand how that works. If universal health care is such a bad idea, why has it been so successful and well received in so many other nations? And why have we consistently ranked so low in outcomes?

Now here is the real fallacy with the arguments we hear all the time in the media. How successful is it, really. In Scandinavia, their 80% income tax is "well received"? And just ask the Greeks how it is working out for them. Italy, Spain, Portugal and Ireland are right on the same precipice. But more importantly, let's take a close look at the "low rank" of the US in health care
These so called rankings are generally based on life expectancy---the CIA World Fact Book ranks the US 43rd in this category. However, life expectancy to a large degree is a function of infant mortality, which the CIA ranks the US 57th in. But why? Almost every other country reporting infant mortality only counts live births after 34 weeks, some 36 weeks. We count every live birth---25 weeks, botched abortions, miscarriages--as long as the baby took 1 breath, we count it, therefore skewing the statistics.
There is also probably a genetic component to life expectancy as well. Japan is #1 or 2 on all the lists. The following is not racist, repeat that to all liberals, NOT RACIST, but fact--40 of the 42 lowest life expectancy countries are in Africa (the other 2 are Haiti and Afghanistan). Yes--- war, poverty, HIV and other disease and starvation are huge factors, but I wonder if some genetics is at play as well, as noted below
Even within the US, there is a large variation from state to state---from 81.3 years down to 75.0. Guess which state is #1----Hawaii, coincidentally a state with a high percentage of Japanese DNA. Which state is #50?---Mississippi, which in addition to some poverty and lack of access to care has a high percentage of African DNA (again, to liberals, fact, NOT RACIST)
Now let's look at the criteria by which the WHO rank the US system 37th in the world:
The rankings are based on an index of five factors:[2]
Health (50%) : disability-adjusted life expectancy
Overall or average : 25%
Distribution or equality : 25%

Responsiveness (25%) : speed of service, protection of privacy, and quality of amenities
Overall or average : 12.5%

Distribution or equality : 12.5%

Fair financial contribution : 25%


So, you can see how ridiculous this ranking is---every statistical factor works against the US and works in favor of small, genetically demographically homogenous populations that all pay high taxes.

I prefer the following test of the quality of the US health system:
When world leaders, royalty and billionaires get really sick, do they flock to NY City and Boston, or do they flock to "Luxembourg"?

Costs have increased dramatically during my years working as a RN, the
pay....not so much. The Hospital corporations are flush with cash, HCA for example, (Governor Rick Scott's former "ATM card") where I worked for the last 10 years has made record profits year after year. Their hospitals are 12 of the top 25 in profits year after year.

Some one is making a lot of $$ on the back of the health care industry, it's healthcare providers, and patients alike.


Well, it certainly wasn't me! But the last figures I saw 4 years ago showed 78% of all US hospitals were in the red. And doctors only account for 9% of every health care dollar. And if it's the "mega insurance companies", let's all go out and buy Humana stock. Remember, it's possible to take in tremendous amounts of money and still lose--just look at the federal budget!!

Well, "that's all folks":024: My arm is tired:1rotfl:

[bimmertl]

We just got a call from The Villages Health Care telling us that The Villages Health Care System is no longer taking new patients with Medicare as primary insurance and Tricare For Life as secondary insurance. That's just gone into effect today. We just got off the phone with the call center supervisor. Anyone else in our situation? They have too many patients and not enough doctors. Good luck to us veterans and our spouses.

Be sure to read the article in todays Daily Sun on page C1 title Villages Health Takes An Important Step . It states "Effective immediately the grassroots health care organization (Villages Health) will accept only United Healthcare Medicare Advantage plans for new patients."

So yes, there is room for new patients as long as you belong to the only Medicare Advantage plan that pays commissions to Morse. Nobody else can get in.

So don't believe the BS about Villages Health having to many patients. There's plenty of room if Morse gets a cut.

[dbussone]

Be sure to read the article in todays Daily Sun on page C1 title Villages Health Takes An Important Step . It states "Effective immediately the grassroots health care organization (Villages Health) will accept only United Healthcare Medicare Advantage plans for new patients."

So yes, there is room for new patients as long as you belong to the only Medicare Advantage plan that pays commissions to Morse. Nobody else can get in.

So don't believe the BS about Villages Health having to many patients. There's plenty of room if Morse gets a cut.

You didn't need a program to see this coming. In fact I will predict that the developer's exit strategy for the so called health system ultimately involves a sale to UHC.

[trichard]

You are so right! It is all about the money. The villages health is a great concept that is sucking a lot of red. The developer has been subsidizing the operation into the millions each month. I believe they thought Unitedhealthcare's MA program would grow substantially with the association with the villages. That did not happen so the anticipated payer mix did not generate the projected capitated payment revenues. This move positions the system for a stock buyout. Stock is held by management and physicians. The most likely buyer is United Health Care. Meanwhile, where will the original Medicare patients go? A smart move for a quality primary care group would to set up shop adjacent to the villages.

[NYGUY]

You didn't need a program to see this coming. In fact I will predict that the developer's exit strategy for the so called health system ultimately involves a sale to UHC.

That is a reasonable prediction!!

[Villageswimmer]

You are so right! It is all about the money. The villages health is a great concept that is sucking a lot of red. The developer has been subsidizing the operation into the millions each month. I believe they thought Unitedhealthcare's MA program would grow substantially with the association with the villages. That did not happen so the anticipated payer mix did not generate the projected capitated payment revenues. This move positions the system for a stock buyout. Stock is held by management and physicians. The most likely buyer is United Health Care. Meanwhile, where will the original Medicare patients go? A smart move for a quality primary care group would to set up shop adjacent to the villages.


Not disputing this post, but what is the source of this info?

[dbussone]

That is a reasonable prediction!!


Thank you!

[outlaw]

Whatever happens, I'm sure it will be in our best interest.

[NYGUY]

Whatever happens, I'm sure it will be in our best interest.

:1rotfl::1rotfl:

[deemelvin1@gmail.com]

I'm interested to know how our veterans feel about the article in the paper today announcing changes to The Villages Health. This includes that they will will no longer be accepting new patients covered by military healthcare (Tricare to include Tricare for Life/Medicare). I called to verify this was correct and was told it is. I personally feel this is just another example of groups paying lip service to supporting our troops when, in fact, they do not.

[trichard]

Not disputing this post, but what is the source of this info?

One of the docs.

[nkrifats]

I'm interested to know how our veterans feel about the article in the paper today announcing changes to The Villages Health. This includes that they will will no longer be accepting new patients covered by military healthcare (Tricare to include Tricare for Life/Medicare). I called to verify this was correct and was told it is. I personally feel this is just another example of groups paying lip service to supporting our troops when, in fact, they do not.

Villages Health is not only ones doing this walgreens is a prime example, they will not fill a prescription if you are using Tricare. Villages Health cut off others also. What about them? They made a business decision.. II don't feel that they are paying lip service. I have run into same situation when company I worked for switched plans and my DR did not accept new plan. The Village Health did keep those already enrolled. A point to consider.

[Navy (SSBN 633)]

I am retired Navy and granfathered in "for now"..but feel certainly feel the change is kind of a slap in the face to our VETS!!!

[Fredwms]

Does the hospital accept Medicare & Tricare for Life? Also, my Medicare advantage plan is through Humana. Does the hospital accept Humana?
:shrug:

[dbussone]

Does the hospital accept Medicare & Tricare for Life? Also, my Medicare advantage plan is through Humana. Does the hospital accept Humana?

:shrug:


I would recommend you call their business office. Most likely they do. However, the $ you pay out of pocket may not be what you expect. That depends on the specific contract the hospital has with each provider.

Medicare tells the hospital what it will pay. Humana is a different story though.

[Challenger]

Does the hospital accept Medicare & Tricare for Life? Also, my Medicare advantage plan is through Humana. Does the hospital accept Humana?
:shrug:

If you have Medicare and Tricare for Life, why are you paying Humana premiums? Just wondering!!!

[liliana42]

As of today, The Villages Health is no longer accepting new regular medicare patients--only UHC medicare advantage ones. And I was told by the billing department that even though this applies to new patients only, they are sending letters to let current patients know that this will be applying to them as well (though I don't know when the cutoff date is).

[jrandall]

One of my big concerns with the huge monopoly type insurance companies who buy up their competition is the fact that they have a very large lobby which is an industry in and of itself. They are proud of the fact that they line the pockets of the house and senate members who are elected to represent OUR best interests. Our representatives are no longer representing us, they are representing the special interests who pay them well to do so.

Citizens United needs to be overturned and term limits in place before we will have elected officials who are willing to represent the citizens who voted them into office. $$ is running politics now, and big business supplies the big bucks. The insurance industry is one of the largest and most successful in getting laws drafted to their advantage.

When ACA came out with Insurance Companies in charge, we were guaranteed to have higher premiums, co-pays and less option for seeing the provider/specialist of our choice.

As they have put out the programs for 2016, there have been many changes and most are again in the favor of the insurance companies.

Our healthcare system, like our political system would be better run without the SuperPacs, and lobbyists who have the insidious power to determine our political future and the future of our healthcare, to a much greater degree than the citizens who elected those officials.

That is a recipe for disaster for all except the big boys with the big bucks.

Ft

So very and sadly true!

[rxatkin]

You are very fortunate to have been accepted. I would love for us to be patients there. Unfortunately they have always only accepted certain kinds of insurance.


I have a feeling that this isn't a change, just their way of doing business and only certain kinds of insurance participate and are accepted.
I got into the program about two weeks ago. My wife had to wait until she was Medicare eligible and they called her to tell her she couldn't participate now. It is a definite change in the program as outlined in The Daily Sun today. Of course, they left out the part of excluding Medicare and Tricare For Life as primary and secondary payers. Another knife in the back of Veterans and their families.

[rxatkin]

Medicare and Tricare for Life are still listed on their web site as acceptable insurances they accept.
Believe me, try to do it now. Their web site is probably changed by now.

[rxatkin]

There is still plenty of room for new patients if you sign up with United Health Care Medicare Advantage. It's the only Medicare Advantage plan accepted by The Villages Health network. (It's Medicare Advantage, not plain Medicare, a big difference)

Accepted Insurance by The Villages Health (http://www.thevillageshealth.com/insurance.php)

Two inserts in the Daily Sun already this week in addition to the weekly Sunday paper pages devoted to the product. Look at the brochure and see how many neighborhood meeting are being held from October 13 through December 3. It lists 52 different locations with multiple meetings at each location. In addition, you can walk into one of three UHC Medicare Stores located in the Villages. Based upon the numbers of meetings and unlimited access to sales personnel there is plenty of room for more patients in UHC Medicare Advantage.

As stated in the brochures, "United Healthcare pays royalty fees to Holding Company of the Villages, inc.". So there is always room for more patients as long as Morse makes a profit, otherwise SOL.
You got it!

[rxatkin]

Be sure to read the article in todays Daily Sun on page C1 title Villages Health Takes An Important Step . It states "Effective immediately the grassroots health care organization (Villages Health) will accept only United Healthcare Medicare Advantage plans for new patients."

So yes, there is room for new patients as long as you belong to the only Medicare Advantage plan that pays commissions to Morse. Nobody else can get in.

So don't believe the BS about Villages Health having to many patients. There's plenty of room if Morse gets a cut.
That's pretty much it in a nutshell!

[rxatkin]

I'm interested to know how our veterans feel about the article in the paper today announcing changes to The Villages Health. This includes that they will will no longer be accepting new patients covered by military healthcare (Tricare to include Tricare for Life/Medicare). I called to verify this was correct and was told it is. I personally feel this is just another example of groups paying lip service to supporting our troops when, in fact, they do not.
That's the way this Air Force retiree sees it as well.

[sirknor]

I'm happy with UHC.

[outlaw]

This is what is referred to as "turning the screws".

[golfing eagles]

This is what is referred to as "turning the screws".

Perhaps. Or perhaps it has to with federal regulation pertaining to ACOs. Just as the federal regulators have decided that 80% of homeowners have to be over 55 to qualify as an adult community, there MAY be a regulation requiring a certain percentage of enrollees in an ACO have a medicare advantage plan. As TV Health aims to be an ACO, they may need to meet a requirement. I don't know if it is true, but certainly possible.

[dbussone]

Perhaps. Or perhaps it has to with federal regulation pertaining to ACOs. Just as the federal regulators have decided that 80% of homeowners have to be over 55 to qualify as an adult community, there MAY be a regulation requiring a certain percentage of enrollees in an ACO have a medicare advantage plan. As TV Health aims to be an ACO, they may need to meet a requirement. I don't know if it is true, but certainly possible.


GE - I'm not certain about that either. The Feds announced their plan to eliminate Advantage plans over the next several years.

[Navy (SSBN 633)]

Believe me, try to do it now. Their web site is probably changed by now.

you are correct..web site changed....Retired Military booted...ugh

[dillywho]

I prefer to choose my own doctors.....not have them chosen for me. No, thank you.

As for not taking military insurance, not good at all. These people devoted themselves to taking care of us, protecting our freedoms, etc. and this is how they are repaid? Yes, they were protecting the very freedom that VHC is exercising, but that doesn't make it right.

[graciegirl]

...

[golfing eagles]

I prefer to choose my own doctors.....not have them chosen for me. No, thank you.

As for not taking military insurance, not good at all. These people devoted themselves to taking care of us, protecting our freedoms, etc. and this is how they are repaid? Yes, they were protecting the very freedom that VHC is exercising, but that doesn't make it right.

Do you know if they are just no longer taking NEW patients with Tricare or also ditching existing patients. It looks as though they are not taking ANY new patients other than UHC Villages Medicare Advantage, but they sent us a letter stating not to worry, they are keeping us with our existing insurance (not Tricare)

[JoMar]

you are correct..web site changed....Retired Military booted...ugh

I don't see this as Vets being booted, rather than the plans being booted. I know many retired vets that are in the health system but they have acceptable plans. Some posts seem to suggest that the Villages Health Care is the only provider that does not accept Tricare and that is false, there are many providers that do not accept Tricare. Why? Seems the "negotiated rate" that Tricare is looking for is below the minimums the provider can accept. I suspect that VHC has made a business decision with UHC that is in it's best interests while Tricare and other health care plan providers try to do the same thing in negotiating rates. As a vet, I understand that I am not entitled to stuff but that if the government or other businesses provides opportunities I have a choice to take advantage of it or not. Health care providers run a business and they have every right and an obligation to run their business's in a profitable profile. VHC made a decision on what works in their interests and decided to get in bed with UHC. You as an individual made a decision on what works in your interest and decided to get in bed with Tricare. Since there are other doctors and providers in the area that do accept medicare and tricare you can still receive services.

[Challenger]

I don't see this as Vets being booted, rather than the plans being booted. I know many retired vets that are in the health system but they have acceptable plans. Some posts seem to suggest that the Villages Health Care is the only provider that does not accept Tricare and that is false, there are many providers that do not accept Tricare. Why? Seems the "negotiated rate" that Tricare is looking for is below the minimums the provider can accept. I suspect that VHC has made a business decision with UHC that is in it's best interests while Tricare and other health care plan providers try to do the same thing in negotiating rates. As a vet, I understand that I am not entitled to stuff but that if the government or other businesses provides opportunities I have a choice to take advantage of it or not. Health care providers run a business and they have every right and an obligation to run their business's in a profitable profile. VHC made a decision on what works in their interests and decided to get in bed with UHC. You as an individual made a decision on what works in your interest and decided to get in bed with Tricare. Since there are other doctors and providers in the area that do accept medicare and tricare you can still receive services.

makes sense to me!!!

[PTennismom0202]

We have only lived in The Villages 2 years but have already had 3 PCPs leave. I qualify for TV Health based on my insurance coverage, but my husband doesn't. We have not had good experiences with specialists. The hospital doesn't have a good patient experience score from Medicare.

https://www.medicare.gov/hospitalcompare/profile.html#profTab=1&ID=100290&Distn=6.0&dist=50&loc=32159&lat=28.9177956&lng=-81.8879884

We are seriously considering leaving TV because we can't rely on getting good health care here.

[Fredwms]

If you have Medicare and Tricare for Life, why are you paying Humana premiums? Just wondering!!!

My fiancé's ex was a Navy captain and she qualified for Tricare under their 20/20 program (20 years in service and 20 years married). I personally have Humana Advantage under Medicare as I am not military and not eligible for Tricare.

[Radioman41]

I'm not sure what Villages Health was thinking when establishing this new policy. There are many retired federal employees moving to The Villages. I doubt if they will give up, or suspend their federal health plan (fep ~ very often Blue Cross) for Medicare Advantage in order to join Villages Health. With Medicare A & B along with fep insurance, a retired federal employee can get medical care almost anywhere if necessary.

[ekdk92]

This policy means the Villages Health is not available to anyone under age 65.

Doesn't seem to fit the needs of a 55 and over community.

[Mikeod]

This policy means the Villages Health is not available to anyone under age 65.

Doesn't seem to fit the needs of a 55 and over community.
No, it just means medicare eligible members are restricted to one advantage plan. If you don't want or aren't eligible for that plan, you must look elsewhere for service.

[golfing eagles]

This policy means the Villages Health is not available to anyone under age 65.

Doesn't seem to fit the needs of a 55 and over community.

I don't think it is clear from this thread that TV Health is closed to anyone under 65. If it is, it is a poor business decision in the long run. From a practical point of view, sign up an 18 year old and you may have a patient for the next 80 or 90 years. Sign up a 99 year old and ........

[bimmertl]

I don't think it is clear from this thread that TV Health is closed to anyone under 65. If it is, it is a poor business decision in the long run. From a practical point of view, sign up an 18 year old and you may have a patient for the next 80 or 90 years. Sign up a 99 year old and ........

The policy is that new patients must enroll in UHC Medicare Advantage to be accepted in the Villages system, you can't do that unless you qualify for Medicare so you have to be 65. Where is the grey area?

[golfing eagles]

The policy is that new patients must enroll in UHC Medicare Advantage to be accepted in the Villages system, you can't do that unless you qualify for Medicare so you have to be 65. Where is the grey area?

The grey area is whether the policy applies to ALL new patients or all new patients that are medicare eligible.
Most medical practices actively seek younger patients with private insurance, some will not take anymore medicare patients, so to close a large practice to all but those over 65 with UHC MA is somewhat counterproductive. Do you know for a FACT that they are not taking anyone under 65??

[NYGUY]

The grey area is whether the policy applies to ALL new patients or all new patients that are medicare eligible.
Most medical practices actively seek younger patients with private insurance, some will not take anymore medicare patients, so to close a large practice to all but those over 65 with UHC MA is somewhat counterproductive. Do you know for a FACT that they are not taking anyone under 65??

I thought it was very clear that NO NEW patients will be accepted unless they have a UHC Medicare Advantage Plan (that would be their Advantage HMO or PPO). I believe that means you have to be at least 65 or have qualified under the SS disability provisions)

[golfing eagles]

I thought it was very clear that NO NEW patients will be accepted unless they have a UHC Medicare Advantage Plan (that would be their Advantage HMO or PPO). I believe that means you have to be at least 65 or have qualified under the SS disability provisions)

And from their update web page:

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 UnitedHealthcare®.
•UnitedHealthcare® The Villages® MedicareComplete® (HMO)
•AARP® MedicareComplete Choice® (Regional PPO)

Please note the first word---IF. So I still think it's unclear, I'm sure it will be made more clear in the coming days

[memason]

Not sure this is all accurate.....My wife and I are not 65 yet and we both go to The Villages Health Care. We just recently signed up and have initial appointments in May, although I have already been to the audiologist there a few times.

They have no problems with our insurance carrier...

[outlaw]

Not sure this is all accurate.....My wife and I are not 65 yet and we both go to The Villages Health Care. We just recently signed up and have initial appointments in May, although I have already been to the audiologist there a few times.

They have no problems with our insurance carrier...

Same here....but, when you reach 65 and are eligible for medicare, they may tell you that you have to go on UHC medicare advantage versus medicare. Pluses and minuses for both types. I have already received an email that tells me to get with them to "discuss" insurance options when I reach medicare eligibility.

[golfing eagles]

Same here....but, when you reach 65 and are eligible for medicare, they may tell you that you have to go on UHC medicare advantage versus medicare. Pluses and minuses for both types. I have already received an email that tells me to get with them to "discuss" insurance options when I reach medicare eligibility.

I'm under 65 with BC/BS My wife is over 65 with traditional medicare/UHC supplemental. We both signed up last week

[outlaw]

I'm under 65 with BC/BS My wife is over 65 with traditional medicare/UHC supplemental. We both signed up last week

The big question is whether TVH will force you to convert to UHC medicare advantage versus medicare with supplemental. If your wife just signed up with medicare and supplemental, that is a good sign. But, it may just be a misread by me. They still may force you onto medicare advantage versus medicare with supplemental. The wording on the website is very clever. If you try to check on "accepted insurance", the website will take you to the medicare advantage plan statement. You can't find "accepted" supplemental insurance or any other insurance for that matter. Just the medicare advantage statement. Very suspicious, imo.

[outlaw]

I'm under 65 with BC/BS My wife is over 65 with traditional medicare/UHC supplemental. We both signed up last week

Look for the infamous email. You will get it.

[memason]

Same here....but, when you reach 65 and are eligible for medicare, they may tell you that you have to go on UHC medicare advantage versus medicare. Pluses and minuses for both types. I have already received an email that tells me to get with them to "discuss" insurance options when I reach medicare eligibility.

ok....this makes sense to me now. We already have UHC for our insurance, from my employer. Once we hit 65, we'll have to make some decisions on supplemental carriers.

[scrapple]

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. WE are the ones who create the highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

I wish there was a "like" button!

[golfing eagles]

Look for the infamous email. You will get it.

If this is their intention, they better send it before Dec 7

[NYGUY]

And from their update web page:

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 UnitedHealthcare®.
•UnitedHealthcare® The Villages® MedicareComplete® (HMO)
•AARP® MedicareComplete Choice® (Regional PPO)

Please note the first word---IF. So I still think it's unclear, I'm sure it will be made more clear in the coming days

Yah, I agree GE, the IF makes you wonder. My reading says it's just clever wording (and if that is it, trust takes a hit), but, we shall see.

[outlaw]

If this is their intention, they better send it before Dec 7

Why dec 7?

[golfing eagles]

Why dec 7?

Medicare open enrollment deadline for 2016

[FromDC]

READ the following article. It is dated September 2014, but it is oh so relevant for today. The article talks about the Villages Advantage Plan as being a revenue generator:

**University of South Florida backed out from running the specialty care clinic due to lower than expected sales of the Plan.

**The business model relied on getting enough patients enrolled in the Plan. Only 6,000 enrolled, but they needed 20,000 enrolled the first year.

USF pulls out of its $4 million specialty care clinic at the Villages | Tampa Bay Times (http://www.tampabay.com/news/health/usf-pulls-out-of-its-4-million-specialty-care-clinic-at-the-villages/2198191)

If you want to enroll in this Advantage Plan because of Villages Health, go ahead. You will be helping their income stream. You will only read accolades in the local paper and hear accolades from sales people. Consider visiting a SHINE representative and have nonbiased dialog to find out what insurance is best for your situation.

I would not consider selecting a plan that restricts me and limits me to such a narrow range of doctors and services while boosting revenue.

[Garden guru]

READ the following article. It is dated September 2014, but it is oh so relevant for today. The article talks about the Villages Advantage Plan as being a revenue generator:

**University of South Florida backed out from running the specialty care clinic due to lower than expected sales of the Plan.

**The business model relied on getting enough patients enrolled in the Plan. Only 6,000 enrolled, but they needed 20,000 enrolled the first year.

USF pulls out of its $4 million specialty care clinic at the Villages | Tampa Bay Times (http://www.tampabay.com/news/health/usf-pulls-out-of-its-4-million-specialty-care-clinic-at-the-villages/2198191)

If you want to enroll in this Advantage Plan because of Villages Health, go ahead. You will be helping their income stream. You will only read accolades in the local paper and hear accolades from sales people. Consider visiting a SHINE representative and have nonbiased dialog to find out what insurance is best for your situation.

I would not consider selecting a plan that restricts me and limits me to such a narrow range of doctors and services while boosting revenue.
The statistics in the article really speak for themselves. If they need 20,000 people to enroll in the plan to make the finances work out, they're fighting an uphill battle. First of all, no snowbirds are going to join; they want a health care plan that will allow them to get medical care wherever they happen to be all year long, not just when they're here in TV. That right there eliminates half of TV population. Secondly, many residents in the northern sections of TV have lived there for years, and in some cases decades, and are already well established with other medical groups and other doctors around the area. Unless they're unhappy with those doctors, they're not going to have any interest in breaking all of those ties and starting over again with new Villages doctors. That means that TV Health is forced to try to get 20,000 permanent residents who have only recently arrived to fill their 20,000 person quota. However, most of those newbies are Baby Boomers who have only recently retired and have been in the trenches fighting managed care battles with their private insurance companies for several decades now. They’re not gullible, inexperienced folks who are going to be easily fooled into choosing a Medicare plan that's clearly not in their best interests.

How all of this is tied up in the financial bottom line of the whole Villages "Marcus Welby Neighborhood Clinics", I have no idea, but considering how coercive TV has decided to become about the matter, I can’t help but wonder if their whole health care system house of cards is in serious danger of collapsing.

[Mikeod]

Th First of all, no snowbirds are going to join; they want a health care plan that will allow them to get medical care wherever they happen to be all year long, not just when they're here in TV. That right there eliminates half of TV population.

I think that enrollment in the UHC Advantage plan does not restrict a person to services only with the Villages Health Plan and can be used with network providers in their summer/home area as well. The Villages Health Plan is saying the UHC plans are the only ones they will accept. You are not contracting directly with them, only with UHC.

[outlaw]

READ the following article. It is dated September 2014, but it is oh so relevant for today. The article talks about the Villages Advantage Plan as being a revenue generator:

**University of South Florida backed out from running the specialty care clinic due to lower than expected sales of the Plan.

**The business model relied on getting enough patients enrolled in the Plan. Only 6,000 enrolled, but they needed 20,000 enrolled the first year.

USF pulls out of its $4 million specialty care clinic at the Villages | Tampa Bay Times (http://www.tampabay.com/news/health/usf-pulls-out-of-its-4-million-specialty-care-clinic-at-the-villages/2198191)

If you want to enroll in this Advantage Plan because of Villages Health, go ahead. You will be helping their income stream. You will only read accolades in the local paper and hear accolades from sales people. Consider visiting a SHINE representative and have nonbiased dialog to find out what insurance is best for your situation.

I would not consider selecting a plan that restricts me and limits me to such a narrow range of doctors and services while boosting revenue.


I think that is the issue. I look at Medicare Advantage as an HMO construct versus Medicare plus supplement as non-HMO, opening up the number of specialists to virtually the whole medical field.

[LynnWM158]

I would assume that those of us already in the system are grandfathered in. At least I do hope so.
Those of us already in the system are grandfathered in with whatever insurance we currently have
. Medicare Advantage pays the provider a higher percentage that regular Medicare, and supposedly costs the insurer less in premiums. Hope this helps.

[graciegirl]

:bigbow:Way too early for me to get it

Primum non nocere


I didn't get it either. Je ne compris pas.

[golfing eagles]

I didn't get it either. Je ne compris pas.

Latin in Hippocratic oath---"First do no harm"

[outlaw]

ok....this makes sense to me now. We already have UHC for our insurance, from my employer. Once we hit 65, we'll have to make some decisions on supplemental carriers.

The point is you may not have a choice. If you stay with TVH, you may be required to go with medicare advantage, which is not medicare plus supplemental.

[gomoho]

I think that enrollment in the UHC Advantage plan does not restrict a person to services only with the Villages Health Plan and can be used with network providers in their summer/home area as well. The Villages Health Plan is saying the UHC plans are the only ones they will accept. You are not contracting directly with them, only with UHC.

You need to speak with someone at one of the United Health Care offices as you have an incorrect idea of how an Advantage plan works. You can only see the doctors in your network for that plan (limited geographically) unless you are on vacation and have an emergency. A Medicare supplement allows you to see any doctor, anywhere that accepts medicare.

[Carla B]

///

[dotti105]

The Medicare Advantage Plan through The Villages, written by United Health Care does offer coverage in most other states. The only state we may have an issue in in Ca. as we have family there. If we need to be seen while there we may not have coverage.

For us, the states in which we would need coverage are all "in Network" except for Ca. The United Health Care offices can show you exactly where you will and will not be covered.

[graciegirl]

Latin in Hippocratic oath---"First do no harm"



Got that part Doc, I took Latin. It's the post that you responded to that I didn't get.


All Gaul is divided into three parts.

[outlaw]

Vos may exsisto profundus.

[golfing eagles]

Got that part Doc, I took Latin. It's the post that you responded to that I didn't get.


All Gaul is divided into three parts.

It may help to re-read posts #34-39. The responder to my post regarding insurance said is was making him sick. But it was a tongue in cheek statement that he actually agreed with me, it was the whole mess that was making him sick. I didn't catch on at first, too subtle for early morning

[FromDC]

The Medicare Advantage Plan through The Villages, written by United Health Care does offer coverage in most other states. The only state we may have an issue in in Ca. as we have family there. If we need to be seen while there we may not have coverage.

For us, the states in which we would need coverage are all "in Network" except for Ca. The United Health Care offices can show you exactly where you will and will not be covered.

Are you saying The United Healthcare The Villages Medicare Complete 1 (HMO) is nationwide where you can visit almost any doctor? It is quite the opposite. An HMO is structured to have a very limited number of in-network providers. If you have an HMO plan and you become sick and need urgent care outside the network area, the plan will probably cover your emergency situation. If you have an HMO and you want an elective procedure done outside the network, you will probably pay the whole amount out of pocket. If you favor some of your doctors “from back home”, you better talk to your plan provider to see if they will or won't cover your elective care. I used the word 'probably' a lot, because using an out-of-network provider gets you into a gray area of who will pay for what. If you read the Plan summary, it is quite vague too.

Enter your zipcode on the Medicare.gov website. You will access the Advantage Plans you are allowed to sign up for. Stay on that website and do a columnar comparison of the original Medicare plan and the Advantage Plans you are interested in. Shop around, compare benefits, check out the providers, and costs.

Go see a SHINE volunteer representative and they will give you non-biased information and will guide you to your best options. Also, there is a great class at the Life Long Learning College that provides great information: Understanding Original Medicare and Medicare Options.

Do some homework and just don't hop in the golf cart and have an insurance agent tell you what is best for you. I guess I should mention that you should do this homework every year. Plans change and your health changes.

[golfing eagles]

Are you saying The United Healthcare The Villages Medicare Complete 1 (HMO) is nationwide where you can visit almost any doctor? It is quite the opposite. An HMO is structured to have a very limited number of in-network providers. If you have an HMO plan and you become sick and need urgent care outside the network area, the plan will probably cover your emergency situation. If you have an HMO and you want an elective procedure done outside the network, you will probably pay the whole amount out of pocket. If you favor some of your doctors “from back home”, you better talk to your plan provider to see if they will or won't cover your elective care. I used the word 'probably' a lot, because using an out-of-network provider gets you into a gray area of who will pay for what. If you read the Plan summary, it is quite vague too.

Enter your zipcode on the Medicare.gov website. You will access the Advantage Plans you are allowed to sign up for. Stay on that website and do a columnar comparison of the original Medicare plan and the Advantage Plans you are interested in. Shop around, compare benefits, check out the providers, and costs.

Go see a SHINE volunteer representative and they will give you non-biased information and will guide you to your best options. Also, there is a great class at the Life Long Learning College that provides great information: Understanding Original Medicare and Medicare Options.

Do some homework and just don't hop in the golf cart and have an insurance agent tell you what is best for you. I guess I should mention that you should do this homework every year. Plans change and your health changes.

I agree. UHC offers 4 MA plans in Florida, the Villages MA 1 & 2 are both HMOs. The other 2 are PPOs. TV health only takes the HMO. So I would double and triple check the coverage network and participating providers. The concept of an HMO written with TV in mind would have nationwide coverage is questionable at best.

[FromDC]

I agree. UHC offers 4 MA plans in Florida, the Villages MA 1 & 2 are both HMOs. The other 2 are PPOs. TV health only takes the HMO. So I would double and triple check the coverage network and participating providers. The concept of an HMO written with TV in mind would have nationwide coverage is questionable at best.

I have spent over half an hour looking for the full provider directory for the United Healthcare The Villages Medicare Complete 1 (HMO) plan. I have not been able to locate such a directory. I want to see ALL the in-network providers (doctors, hospitals, specialty care services, etc.) and where they are physically located. On the UHC website, you can only enter an individual doctor name, group, facility, etc. to see if they participate in the Complete 1 plan.

Reviewing this type of complete directory should be a prerequisite before signing up for the plan. Could UHC let us know where we could find such a directory online?

[NYGUY]

....UHC offers 4 MA plans in Florida, the Villages MA 1 & 2 are both HMOs. The other 2 are PPOs. TV health only takes the HMO.

Not quite right Doc. The Villages Health now only accepts United Healthcare Medicare Advantage Plans and UHC's PPO's are Medicare Advantage Plans. I have a HUC Medicare Advantage PPO and have my email from TVH saying my insurance will continue to be accepted by TVH.

I might add, that in my opinion, UHC's PPO's are a much better option than UHC HMO's if a larger network of physicians (both primary and specialists) are important to someone as well as not requiring referrals in all cases.

[golfing eagles]

Not quite right Doc. The Villages Health now only accepts United Healthcare Medicare Advantage Plans and UHC's PPO's are Medicare Advantage Plans. I have a HUC Medicare Advantage PPO and have my email from TVH saying my insurance will continue to be accepted by TVH.

I might add, that in my opinion, UHC's PPO's are a much better option than UHC HMO's if a larger network of physicians (both primary and specialists) are important to someone as well as not requiring referrals in all cases.

Looks like you are correct
From TV website:

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 UnitedHealthcare®.
•UnitedHealthcare® The Villages® MedicareComplete® (HMO)
•AARP® MedicareComplete Choice® (Regional PPO)

my bad, I think I picked it up from other posts--should have checked myself

[outlaw]

Yesterday, I called three different people connected to TVH. My concern is that, although I am a patient with TVH, I am not yet 65 (God that sounds old, doesn't it?). I asked, when I became eligible for medicare, if I would be required to sign up for Med Adv, or would I be allowed to go with medicare plus supplemental. Two people said they didn't know. One person said yes. So, I still am not sure what will happen when I turn 65. And I guess, this whole thing with TVH going to UHC Med Adv is so new that the employees really don't know.

[FromDC]

Yesterday, I called three different people connected to TVH. My concern is that, although I am a patient with TVH, I am not yet 65 (God that sounds old, doesn't it?). I asked, when I became eligible for medicare, if I would be required to sign up for Med Adv, or would I be allowed to go with medicare plus supplemental. Two people said they didn't know. One person said yes. So, I still am not sure what will happen when I turn 65. And I guess, this whole thing with TVH going to UHC Med Adv is so new that the employees really don't know.

I am in the same boat as you. My primary care doctor is with the Villages Health and I am under 65. We can only wait and see what happens.

The doctors, in the front office, strive to make the patients well. The business people, in the back office, strive to make sure the finances are well. As mentioned in my Post #97, the Villages Health business needs to promote selling their Advantage Plan. This is one part of their business model. Sell, sell, sell. Starting immediately, any new patients are required to buy the Advantage Plan. Eventually, the business people will reevaluate to see if they need to bring more people into the Advantage plan. They may target new Medicare eligible folks (like you and me) and/or say that everyone needs to buy the Advantage Plan.

I have a road map of where I want to go with my Medicare sign-up even though I am not 65. Joining Villages Health was easy when I first moved down here, but I don't have any loyalty to them. There are many physicians that take original Medicare and isn't it a better idea to have choices?

[CFrance]

If you have a supplemental plan, anybody who takes Medicare must accept your supplemental (Medigap) plan. Don't see how they can get around that at TVH since it's the law.

Medigap works with the exact same network as Medicare. So you don't have to check the network if they accept Medicare.

https://www.senior65.com/medicare/article/which-doctors-accept-medigap

[FromDC]

If you have a supplemental plan, anybody who takes Medicare must accept your supplemental (Medigap) plan. Don't see how they can get around that at TVH since it's the law.

Medigap works with the exact same network as Medicare. So you don't have to check the network if they accept Medicare.

https://www.senior65.com/medicare/article/which-doctors-accept-medigap

I liked the link you referenced. Yes, if a doctor accepts Medicare assignment, he will take your Medicare supplement. Medicare pays 80% and supplement pays 20%. The Villages Health will still process those claims as in the past for existing patients.

The Villages Health has opted to only accept their 2 Advantage Plans for new patients. This is their business decision to do this.

Any doctor can accept Medicare and then drop out of Medicare assignments at any time. This is similar to doctors participating and then not participating as an in-network provider. Also, the Villages Health can drop the Advantage Plan if they wish. It is their decision, but there is no law violation.

I wish someone from Villages Health or UnitedHealthcare would participate in this discussion.

[NYGUY]

If you have a supplemental plan, anybody who takes Medicare must accept your supplemental (Medigap) plan. Don't see how they can get around that at TVH since it's the law.

They get around it by not accepting Medicare for new patients. They can accept Medicare Advantage Plans (in their case, only UHC) and not accept Medicare.

[massapequa girl]

Don't worry, there are many doctors OUSIDE OF THE VILLAGE HEALTH CARE SYSTEM, who accept BC/BS and Medicare. My advice, don't give up what you have, once you do, you can't get back into the BC/BS systems. The doctors outside of the Village Health care are better than what they are "selling" in the Villages.

[Boomer]

Yesterday, I called three different people connected to TVH. My concern is that, although I am a patient with TVH, I am not yet 65 (God that sounds old, doesn't it?). I asked, when I became eligible for medicare, if I would be required to sign up for Med Adv, or would I be allowed to go with medicare plus supplemental. Two people said they didn't know. One person said yes. So, I still am not sure what will happen when I turn 65. And I guess, this whole thing with TVH going to UHC Med Adv is so new that the employees really don't know.


There was a guy in a TVH booth at the square so I asked him......

Me: Will TVH take Medicare as the primary and a Plan F Supplement?

Booth Guy: Not for new patients.

Me: But it is a UHC Plan F Supplement.

Booth Guy: Won't take it for new patients.

Me: Really?

Booth Guy: UHC Advantage Plan is the only one accepted for new patients.

(Yeah. I know. I asked the guy the same question 3 different ways. That is because I find this appalling on so many levels and I was hoping I was not hearing him right.)

-- So Plan F supplements are out for new patients. And I guess it is true that any other Medicare plan would be, too, including those plans that many Villagers have in place as a retiree benefit from their careers. But I did not ask about those. I think I know the answer. Hope I am wrong......

wow......Talk about the company store.......

[CFrance]

If they don't take Plan F, then they can't take Medicare. So I guess the way they get around that is by saying no to new patients. I don't know how they can take Medicare for some new patients but not for others. I would love to hear an professional's opinion on this.

[outlaw]

If they don't take Plan F, then they can't take Medicare. So I guess the way they get around that is by saying no to new patients. I don't know how they can take Medicare for some new patients but not for others. I would love to hear an professional's opinion on this.

Why is that?

What they are saying is that new patients have to sign up for medicare part c, which is a medicare advantage plan.

[memason]

I have a retiree plan from my former employer and it is accepted, but I'm not on Medicare yet... The retiree plan also happens to be a UHC PPO plan

[outlaw]

I have a retiree plan from my former employer and it is accepted, but I'm not on Medicare yet... The retiree plan also happens to be a UHC PPO plan

Based on what I was told, I think you will be OK. Nor sure, though.

[CFrance]

Why is that?

What they are saying is that new patients have to sign up for medicare part c, which is a medicare advantage plan.
Because by law Plan F is accepted anywhere in the country that Medicare is. They are getting around that somehow. I would like to know how.

[NYGUY]

....I think I know the answer. Hope I am wrong......

You are not wrong!!

[NYGUY]

Because by law Plan F is accepted anywhere in the country that Medicare is. They are getting around that somehow. I would like to know how.

I thought that was already answered....They will no longer accept Medicare if you are a new patient!!!....which part of that are you having trouble with?? Or are you just not happy about it?

[CFrance]

I thought that was already answered....They will no longer accept Medicare if you are a new patient!!!....which part of that are you having trouble with?? Or are you just not happy about it?
See post #9. And stop screaming.

[NYGUY]

See post #9. And stop screaming.

No....and post #9 doesn't say anything about them accepting "Medicare". CF, Send me a PM so I can try to explain.

[outlaw]

I thought that was already answered....They will no longer accept Medicare if you are a new patient!!!....which part of that are you having trouble with?? Or are you just not happy about it?

I think they will still accept medicare. But you will have to enroll in medicare part c (med adv plan), as opposed to using a supplemental insurance.

[golfing eagles]

Because by law Plan F is accepted anywhere in the country that Medicare is. They are getting around that somehow. I would like to know how.

Very easy---a physicians office does not have to accept any insurance or patient they do not want to. They can apply a different rule to NEW patients. As long as they are consistent with existing patients, they have the prerogative to change the rules for new patients. We do this all the time, usually when an insurer drops reimbursement to a ridiculous low level. We don't like dropping patients we have had for 30 years, although some practices do, so we just don't accept any new patients with that insurance. Medicaid is a prime example. We take no new Medicaid, but have kept existing patients who already have it---if for no other reason than life circumstances can change
Hope that answers your question

[Boomer]

............

[outlaw]

I have seen Advantage Plans described as "replacements" for Medicare. I also found something that said when you sign up for Plan C (aka an Advantage Plan) you "leave" what they call Original Medicare. -- If that wording is correct, it looks like therein could lie the loophole. (I will try to find that source and cite it later. It was not the .gov site though. It was one of those sites with explanations.)

I do not see how holders of Plan F who have found that those plans have worked for them with hospitalizations, etc -- or snowbirds -- or those who have good Medicare supplement coverage as a retiree benefit -- or those who will pay for choice -- will switch to this Advantage Plan. But I guess the pool is so big here that TV figures they eventually can hold all the cards.

I do realize that premium cost is often the main consideration. And I think there may be other coverages available within an Advantage Plan. But what are they saying about out-of-pocket limits? -- I know people who are going with this plan and, of course, I hope it serves them well. We each must decide what works best for us.

You know......whether a supplement or an advantage plan, the stockholders in a huge insurance company own a piece of every patient. -- and before I get bashed because somebody thinks I am bashing the market, that is so not true. I like to stock-pick, but I do not want to own a piece of patients. Whoops.....I digress....

So anyway, I remain appalled at this move by TV to shut out those new patients who do not buy their insurance plan. -- Appalled but not surprised. What's next? Priority seating in the waiting room?

I think I better just stop typing and go get some coffee.....maybe then this little song I keep singing in my head will stop.......It's all about the profit, 'bout the profit, not medicine.....all about the profit, 'bout the profit, not medicine.......

Boomer

Here's the way it was explained to me by a UHC rep. When you choose medicare c, you also sign up for medicare b. You still send your medicare b premium ($105 for most people) to the government. The government sends the medicare c insurance company about $10,000 per patient per year. It is up to the insurance company to manage the healthcare for each of those patients without anymore money from the government. So the insurance company can adjust coverage, copays, doctors in network, etc. You still are enrolled in medicare.

[jojo]

I just came from the UHC office and was told that indeed the Villages Health System will not accept United Health Care Supplement (or any supplement) for new patients although they will for current patients. When queried about providers having to accept supplements if they accept Medicare they said it was because Medicare Advantage is a replacement for Medicare. ugh.

[looneycat]

We are so disappointed in the healthcare program and restrictions. The advertising which sold us on TV while house hunting was and continues to be misleading. I particularly love the following advertisement that "health care is just a short golf cart ride away...." There is no disclaimer of: "only if you belong to UHC! Shame on the Morse family!

Copied from the Village Website:

An important part of a great retirement lifestyle is convenient access to wellness facilities and quality health care.

The Villages Health and USF HEALTH, a major academic health resource, are partnering to make The Villages America's Healthiest Hometown.

Staying healthy is easy in The Villages. Neighborhood fitness centers and health care facilities are located throughout The Villages -- just a golf car ride away. The Villages Healthcare Centers, The Villages Regional Hospital, Moffitt Cancer Center, VA outpatient clinic, senior living facilities, and a long term acute care hospital are all located here.

actually it is accurate as there are plenty of doctors in and around TV who are not part of vhc. they were all dropped by UHC if they were not part of the villages health care system. I certainly don't expect the villages health care system to take care of me, I take care of me and my medical choices. personally I have the aarp/uhc supplement. an advantage plan is out of the question as I have occasional hospital visits that would be financially crippling if I were on an advantage plan.

[TheVillageChicken]

My fiancé's ex was a Navy captain and she qualified for Tricare under their 20/20 program (20 years in service and 20 years married). I personally have Humana Advantage under Medicare as I am not military and not eligible for Tricare.

Actually the program is 20/20/20 and she will lose the benefit when you marry her.

[TV MAN]

Loonycat why do you think that you would lose coverage under advantage vs aarp suplemnetal ??

"I have the aarp/uhc supplement. an advantage plan is out of the question as I have occasional hospital visits that would be financially crippling if I were on an advantage plan."

[golfing eagles]

actually it is accurate as there are plenty of doctors in and around TV who are not part of vhc. they were all dropped by UHC if they were not part of the villages health care system. I certainly don't expect the villages health care system to take care of me, I take care of me and my medical choices. personally I have the aarp/uhc supplement. an advantage plan is out of the question as I have occasional hospital visits that would be financially crippling if I were on an advantage plan.

If I may give some advice----re-read the advantage plans thru UHC and look at the plan details, use the link thru TV Health page.

If I'm reading correctly, plan 1 has an out of pocket max of $4500 with 0 premium, and plan 2 has a max of $1900 with an $85/mo. premium= $1020/year
Assuming you will be paying about $178/ mo. UHC supp. and $51/ mo. part D in 2016, that's $229x12= $2748/yr.
So, with plan 1, your exposure would be $1752/ year.
If you know you will exceed $2748 in out of pocket costs, then with plan 2 you'll have $1020 in premium and a max of $1900, = $2920, or exposure over your current cost of $172/yr. The prescription co-pays look identical in the advantage and supp. plans.

If I'm reading it right......

[outlaw]

If I may give some advice----re-read the advantage plans thru UHC and look at the plan details, use the link thru TV Health page.

If I'm reading correctly, plan 1 has an out of pocket max of $4500 with 0 premium, and plan 2 has a max of $1900 with an $85/mo. premium= $1020/year
Assuming you will be paying about $178/ mo. UHC supp. and $51/ mo. part D in 2016, that's $229x12= $2748/yr.
So, with plan 1, your exposure would be $1752/ year.
If you know you will exceed $2748 in out of pocket costs, then with plan 2 you'll have $1020 in premium and a max of $1900, = $2920, or exposure over your current cost of $172/yr. The prescription co-pays look identical in the advantage and supp. plans.

If I'm reading it right......

Based on discussions with a UHC rep, I believe you still have to pay for your medicare part b, which is $105 per person. So that would add another $1260 per year.

[waynegbrown]

Nov 9, 2015. We are enrolled with The Villages Health, using Medicare and Tricare For Life. The Villages Health sent us a letter telling us they will continue to care for their existing 1700 patients covered by this combination, but will no longer accept new patients so covered. TVH suggested we get an insurance checkup with UHC Medicare Store at Sumter Landing and consider adding UHC Medicare Advantage coverage since there may be no cost additional benefits available such as dental, vision and hearing aids. We have an appointment to hear their pitch.
To clarify one issue, I believe UHC Advantage does not require you get your care from The Villages Health, but the only Medicare Advantage program accepted by
TVH is UHC.

[looneycat]

$4500 out of pocket for COVERED services. As the villages hospital twice sent me elsewhere because of prior health issues I would be outside covered services in Shands and financially impacted beyond $4500. If a UHC Villages rep can tell me differently i would listen, looking for facts not opinions.

[PTennismom0202]

I've started with The Villages Healthcare for primary care a few months prior to my 65th birthday. They (The Villages Healthcare) told me good thing I got in before I was 65, because I'll be grandfathered in without United Healthcare Medicare Advantage when I hit Medicare age. Today I got the call -- 1 month before I am Medicare eligible. They changed their policy. They will not allow me to stay in the practice unless I change from Medicare B + Tricare for Life to a United Healthcare Medical Advantage plan + Tricare for Life. I stand to have a poorer Rx benefit and limit my provider choices if I do as they want. Don't think I'll do it. It's hard to find PCPs around here -- there seems to be a revolving door for them.

[NYGUY]

I've started with The Villages Healthcare for primary care a few months prior to my 65th birthday. They (The Villages Healthcare) told me good thing I got in before I was 65, because I'll be grandfathered in without United Healthcare Medicare Advantage when I hit Medicare age. Today I got the call -- 1 month before I am Medicare eligible. They changed their policy. They will not allow me to stay in the practice unless I change from Medicare B + Tricare for Life to a United Healthcare Medical Advantage plan + Tricare for Life. I stand to have a poorer Rx benefit and limit my provider choices if I do as they want. Don't think I'll do it. It's hard to find PCPs around here -- there seems to be a revolving door for them.

Oh, what a tangled web we weave when first we practice to deceive..:ohdear:

[outlaw]

I've started with The Villages Healthcare for primary care a few months prior to my 65th birthday. They (The Villages Healthcare) told me good thing I got in before I was 65, because I'll be grandfathered in without United Healthcare Medicare Advantage when I hit Medicare age. Today I got the call -- 1 month before I am Medicare eligible. They changed their policy. They will not allow me to stay in the practice unless I change from Medicare B + Tricare for Life to a United Healthcare Medical Advantage plan + Tricare for Life. I stand to have a poorer Rx benefit and limit my provider choices if I do as they want. Don't think I'll do it. It's hard to find PCPs around here -- there seems to be a revolving door for them.

Sounds like the hammer just dropped. So much for TV Healthcare. It's HMO or hit the road.

[JoMar]

Sounds like the hammer just dropped. So much for TV Healthcare. It's HMO or hit the road.

Not only HMO.....also PPO. Both are plans under the AARP United Healthcare plans.

[jamougel]

We are new to the Villages, and went looking for a primary care physician, kept reading about the Villages Health, so we went to make an appointment. We were told the woman that was to interview us was at lunch, so we were told she would get back to us within 24 to 48 hours. She did call, the next morning, only to inform us they accept nothing but Medicare advantage plans. One, they should have told us that when we went for the appointment, two, that should be in all their advertisements and brochures. Seems to me with TV being almost all medicare, doctors should accept all national supplemental plans....just my opinion. Never ever thought finding a doctor in the Villages would be so problamatic

[dbussone]

We are new to the Villages, and went looking for a primary care physician, kept reading about the Villages Health, so we went to make an appointment. We were told the woman that was to interview us was at lunch, so we were told she would get back to us within 24 to 48 hours. She did call, the next morning, only to inform us they accept nothing but Medicare advantage plans. One, they should have told us that when we went for the appointment, two, that should be in all their advertisements and brochures. Seems to me with TV being almost all medicare, doctors should accept all national supplemental plans....just my opinion. Never ever thought finding a doctor in the Villages would be so problamatic



Call Angel Tafur, MD if you are looking for a highly competent primary care physician. My wife and I both worked in healthcare before retiring, and both are very pleased.

His office number is: (352) 350-6241

[PTennismom0202]

I have Tricare for Life and was invited to leave in January before my 65th birthday. I think this has been in place for quite some time. This is a concierge practice.

[skyc6]

Does anyone know if United Health Care The Villages, which has a Dental part to it, has dental coverage for services other than preventive work? I know it covers exams, xrays, and cleanings, from dentists in the network. What I am asking is what if you need a root canal or a filling? Is there coverage for that?

[SKIMAN]

my neighbor who works for the villages health care system says this deal puts $16 million it the the pockets who ever made this deal..so much for Marcus Welbey heath care... welcome to the real world........

[CritterLover]

my neighbor who works for the villages health care system says this deal puts $16 million it the the pockets who ever made this deal..so much for Marcus Welbey heath care... welcome to the real world........

I so respect and appreciate those who are trying to remain objective and who have something reasonable, rational, or factual to add to this discussion, and anything else is just irresponsible.

[Polar Bear]

my neighbor who works for the villages health care system says this deal puts $16 million it the the pockets who ever made this deal..so much for Marcus Welbey heath care... welcome to the real world........

Oooh...your neighbor said...
I so respect and appreciate those who are trying to remain objective and who have something reasonable, rational, or factual to add to this discussion, and anything else is just irresponsible.

Agree.