Orlando Sentinel Article on Villages Health

[jane032657]

Health-care changes in The Villages leaves some scrambling for new doctors - Orlando Sentinel (http://www.orlandosentinel.com/health/os-villages-health-unitedhealth-medicare-20160811-story.html)

[Duppa]

This is an important issue that ought to be explored.

[RickeyD]

This is an important issue that ought to be explored.



The Florida attorney general would be the go to guy.

[rubicon]

follow the money. the article spoke of a pay for performance scenario. It would be interesting to see what agreement was made between United Health Care and TVHCS. It would be interesting to know why those over 65 must enroll in United Health Care. Can this be an age discrimination issue???? Ask an attorney..if you can find one that would go up against TVHCS. Don't bother with the local politicians they will just do a head fake

the law was changed so that insurance companies could not discriminate because of health pre-conditions (insurability) . so can they discriminate based on age?? Can they get around the age issue by claiming they are not discriminating all one has to do is sign up for United Health Care. Hmmmmmmmmmmm..and the beat goes on and the Daily Sun will publish another extensive and glowing article about the joys of The Villages Health Care system

Perhaps my opinion is all wet? I just wish if it is for the benefit of residents affected by this change and the community in general those responsibile for this decision step up and give us the reason we are all adults here.

[Carla B]

What they said in their letter of July 12: "Because our superior care best aligns with Medicare Advantage we have decided to no longer accept Original Medicare...."
What they meant: "Because we are losing a great deal of money, we have decided to no longer accept Original Medicare..."

I don't think it has to do with age discrimination; after all, physicians don't have to accept Medicare patients period.

I wonder if TVHS ever thought of turning their system into a concierge practice. It might be more palatable to the Original Medicare crowd or maybe even all patients to pay a yearly fee to join, with the provision of not being forced into an Advantage program.

[rubicon]

What they said in their letter of July 12: "Because our superior care best aligns with Medicare Advantage we have decided to no longer accept Original Medicare...."
What they meant: "Because we are losing a great deal of money, we have decided to no longer accept Original Medicare..."

I don't think it has to do with age discrimination; after all, physicians don't have to accept Medicare patients period.

I wonder if TVHS ever thought of turning their system into a concierge practice. It might be more palatable to the Original Medicare crowd or maybe even all patients to pay a yearly fee to join, with the provision of not being forced into an Advantage program.

CarlaB makes sense I forgot that doctors do turn down medicare because of their reduced payment and not the patients per se. some practices are accepting only cash, give the paperwork to patients and asking patients to get their benefits from their insurer. You could get sick just getting sick the way this insurance thing is turning out

[Jayhawk]

Did anyone actually READ the story?

"Also, what The Villages Health is doing is part of a growing trend, as the health care system moves away from a fee-for-service model toward one that pays for quality and performance, experts say."

"Over time, more and more Medicare beneficiaries will face similar choices to the Villagers,"


"I go every year to the Mayo Clinic and have them check me out, and I don't want to give up my right to that," Gott said. "This is not for me. I can't give up all those rights."

It boils down to CHOICE. And what any of us choose today may be different next year. That's the way the world works.

[2BNTV]

Did anyone actually READ the story?

"Also, what The Villages Health is doing is part of a growing trend, as the health care system moves away from a fee-for-service model toward one that pays for quality and performance, experts say."

"Over time, more and more Medicare beneficiaries will face similar choices to the Villagers,"


"I go every year to the Mayo Clinic and have them check me out, and I don't want to give up my right to that," Gott said. "This is not for me. I can't give up all those rights."

It boils down to CHOICE. And what any of us choose today may be different next year. That's the way the world works.

:agree: I read it.

Nothing new in the article for those who want to debate this issue. There are people who feel a limited choice of providers. They also feel they have been lied to. Don't understand this is a choice made by TVH to model health care, the way they think the new wave of medical care should be.

I realize that it's about the money and TVH wanting to stay in business as they need to be making a profit. I also wish they could have found a way to include original Medicare with a supplement, as it so convenient for villagers, not having to change doctors.

"It is, what it is"!

[outlaw]

The Florida attorney general would be the go to guy.

Uh, I don't think she's going to ruffle this developer's feathers. Lot's of future political donations to be had.

[Villageswimmer]

:agree: I read it.

Nothing new in the article for those who want to debate this issue. There are people who feel a limited choice of providers. They also feel they have been lied to. Don't understand this is a choice made by TVH to model health care, the way they think the new wave of medical care should be.

I realize that it's about the money and TVH wanting to stay in business as they need to be making a profit. I also wish they could have found a way to include original Medicare with a supplement, as it so convenient for villagers, not having to change doctors.

"It is, what it is"!

Yes, the article is simply a rehash of what we've seen before, right down to people quoted.

To me, it's not so much the decision that was made but the poor way it was handled. Things are achangin. True. When Gary Morse was in charge, I think perhaps the same decision would have been made (they need to stay afloat financially) but I think it would have been handled with some sensitivity and honesty. For example, I still haven't received "the letter" since they were sent third class and not forwarded. This is a mistake that could have and should have been rectified. No doubt there are many people still not aware of this decision who are in for a big surprise when they return. Inexcusable.

Furthermore, to think that there are folks who made their home buying decisions, at least in part, based on access to TVH, is unconscionable and sad. No wonder they're upset! Not blaming sales agents. I have no doubt they didn't know the plan. Perhaps they should have. Or at least been directed not to pitch TVH since some changes were in the works.

So the result is a PR nightmare which could have been mitigated to some degree. :22yikes:

Just MHO.

[graciegirl]

Yes, the article is simply a rehash of what we've seen before, right down to people quoted.

To me, it's not so much the decision that was made but the poor way it was handled. Things are achangin. True. When Gary Morse was in charge, I think perhaps the same decision would have been made (they need to stay afloat financially) but I think it would have been handled with some sensitivity and honesty. For example, I still haven't received "the letter" since they were sent third class and not forwarded. This is a mistake that could have and should have been rectified. No doubt there are many people still not aware of this decision who are in for a big surprise when they return. Inexcusable.

Furthermore, to think that there are folks who made their home buying decisions, at least in part, based on access to TVH, is unconscionable and sad. No wonder they're upset! Not blaming sales agents. I have no doubt they didn't know the plan. Perhaps they should have. Or at least been directed not to pitch TVH since some changes were in the works.

So the result is a PR nightmare which could have been mitigated to some degree. :22yikes:

Just MHO.

Well said.

VERY well said.

[rubicon]

Did anyone actually READ the story?

"Also, what The Villages Health is doing is part of a growing trend, as the health care system moves away from a fee-for-service model toward one that pays for quality and performance, experts say."

"Over time, more and more Medicare beneficiaries will face similar choices to the Villagers,"


"I go every year to the Mayo Clinic and have them check me out, and I don't want to give up my right to that," Gott said. "This is not for me. I can't give up all those rights."

It boils down to CHOICE. And what any of us choose today may be different next year. That's the way the world works.

yea I posted about that yesterday and the question I had is that does this system mean that those over 65 have less a chance at meeting insurers performance expectations and so those 65 + are .more likely to get the boot. its one thing to fix a cold another to try and fix heart disease. I have read about much controversy about this performance system devised by the present Administration, the same Admin that gave us ACA

[Advogado]

My take on all this is that the Villages Health Care System is a for-profit operation run by the Developer. If the Developer feels that he needs to accept only United Health Advantage patients to maximize profits, fine. The Developer certainly has the right to do so, and there are alternative choices for the consumer.

However, my criticism of the whole operation is the way the Developer's Daily Sun, from the very beginning, has characterized the Villages Health Care System in advertisements disguised as news. The Daily Sun has constantly described the system as some kind of Marcus Welby, altruistic effort to make The Villages "Florida's Healthiest Home Town"-- rather than accurately describing the System for what it is: another Developer for-profit business.

By the way, I think that the System is probably the wave of the future-- for better or worse. I just would like to see a little truth in advertising on the part of the Developer and the Daily Sun.

[Villageswimmer]

My take on all this is that the Villages Health Care System is a for-profit operation run by the Developer. ...

However, my criticism of the whole operation is the way the Developer's Daily Sun, from the very beginning, has characterized the Villages Health Care System in advertisements disguised as news. The Daily Sun has constantly described the system as some kind of Marcus Welby, altruistic effort to make The Villages "Florida's Healthiest Home Town"-- rather than accurately describing the System for what it is: another Developer for-profit business...


...right, part of the dishonesty alluded to in my post. Why lie when you can tell the truth? There's no shame in a for-profit business.

The Marcus Welby stuff couldn't have been more condescending IMO.

[Mikeod]

The VHS system as originally configured was not sustainable. Long appointment times and limited panel size significantly reduced reimbursements under traditional medicare, even with supplements, which do not benefit the provider as much as the patient. As a result, the developer agreed to directly support the system for a period of time, which has expired. Also, using the reimbursement system makes it difficult to budget, since income will fluctuate, reimbursements be denied/appealed/delayed. Thus VHS is faced with the choice of closing, or increasing income/decreasing expenses. With MA plans, VHS will get guaranteed income per MA member and the ability to manage services/expenses with more certainty of funds. Would you rather they closed down? How would that have lessened the problem?

Why choose only one MA plan? Well, upon initiating the VHS, there was a connection between UHC and VHS that must have benefited both VHS and the developer. Perhaps that relationship had some limitations that precluded other MA plans being accepted by VHS.

Why is the Marcus Welby thing considered a lie? Those who have had VHS spoke highly of the time they had available with their doctor. And how a lot of services were available in house. I remember seeing my PCMD and told I needed to get labs and an X-ray done. Told to go over there for the labs, and over there for the X-ray. Then hope like crazy the results got back to him. Contrast that to those who needed those services within VHS and just walked down the corridor to get them done. When I was with VHS and needed an X-ray, I was walked to the X-ray, had it done, then back to the doctor's room and had him read it right there at the same visit. I think that is what has meant by the Marcus Welby comment.

Now, where I have difficulty with "the letter" is the place where they made it sound as if the prime motivator to the change was a concern for better outcomes. This was, as stated by many before me, a business decision. Improve revenue or close. It would have gone over better if they had owned up to the fact that they had hoped to keep all the members, but, if they wanted to continue the mode of practice (long appointment time, limited panels, in-house services, etc.), they had to improve revenue flow. Making it sound as if this was other than that certainly angered and frustrated many.

[Garden guru]

Yes, the article is simply a rehash of what we've seen before, right down to people quoted.

To me, it's not so much the decision that was made but the poor way it was handled. Things are achangin. True. When Gary Morse was in charge, I think perhaps the same decision would have been made (they need to stay afloat financially) but I think it would have been handled with some sensitivity and honesty. For example, I still haven't received "the letter" since they were sent third class and not forwarded. This is a mistake that could have and should have been rectified. No doubt there are many people still not aware of this decision who are in for a big surprise when they return. Inexcusable.

Furthermore, to think that there are folks who made their home buying decisions, at least in part, based on access to TVH, is unconscionable and sad. No wonder they're upset! Not blaming sales agents. I have no doubt they didn't know the plan. Perhaps they should have. Or at least been directed not to pitch TVH since some changes were in the works.

So the result is a PR nightmare which could have been mitigated to some degree. :22yikes:

Just MHO.

I agree completely. The whole decision showed absolutely no respect for residents who took access to TVH into account, when deciding whether to move here. Even now, the official Villages Health website does not say that original Medicare will soon not be accepted. It simply says: "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®." Accepted Insurance by The Villages Health (http://www.thevillageshealth.com/insurance.php) Obviously, that statement is quite true, but any mention of what the policy will soon be for those with original Medicare is completely absent from their website. Prospective residents are STILL being kept in the dark. And why would a prospective resident think to ask? The idea that a retirement community of over 100,000 would not accept Medicare and yet advertise itself as "America's Healthiest Hometown" is ludicrous. Talk about unconscionable!

[looneycat]

there are plenty of non affiliated doctors here to go to. the villages system is not for me. i require too many specialists and shands hospital. while i could be in the villages system i would then be responsible for 20% of the hospital costs. also the villages health is big on seeing PAs in lieu of mds. i won't see a PA in place of a doctor. nope standard medicare plus a supplement works fine for me.

[graciegirl]

there are plenty of non affiliated doctors here to go to. the villages system is not for me. i require too many specialists and shands hospital. while i could be in the villages system i would then be responsible for 20% of the hospital costs. also the villages health is big on seeing PAs in lieu of mds. i won't see a PA in place of a doctor. nope standard medicare plus a supplement works fine for me.

Our Aetna was not accepted and that could be a good thing for us too for the reasons you just stated.

I like valid reasons like you just gave in any kind of debate, rather than emotional ones that I am skeptical of. I remember people saying that one of the reasons that they moved here was because of the herd of buffalo being present to view and to feed. I thought that very hard to understand.

[goodtimesintv]

When, when, WHEN will you guys look at the true incentives for the whole darn nation of seniors to be forced into Medicare Advantage plans??


Obamacare Was Supposed To Kill Medicare Advantage. It Only Made It Stronger

Marilyn Tavenner is about to make an unprecedented move: From head of Medicare, to the nation’s top lobbyist for private insurers — in just six months.

Tavenner will succeed Karen Ignagni as the CEO of America’s Heath Insurance Plans, the New York Times reported on Wednesday. Tavenner had served as the administrator of CMS for more than three years, where she was responsible for Medicare, Medicaid, and much of Obamacare’s implementation.

Critics immediately seized on the merry-go-round of Washington — how another top White House official has found a job with the lobbyists she used to negotiate with.

“Is there a revolving-door emoji?” NPR’s Jacob Goldstein ruefully tweeted.

But I think there’s a very telling line, buried near the bottom of the Times‘ 798-word story.

“Asked about her priorities, Mr. Tavenner said she wanted to protect Medicare Advantage, the program under which private insurers manage care for more than 30 percent of the 55 million beneficiaries of Medicare.”

There’s a reason why private insurers care so much about Medicare Advantage: It’s arguably their hottest market right now...."

Forbes Welcome (http://www.forbes.com/sites/dandiamond/2015/07/15/obamacare-was-supposed-to-kill-medicare-advantage-it-only-made-it-stronger/#43e49e227ee1)

.

[goodtimesintv]

......

[rubicon]

Yes, the article is simply a rehash of what we've seen before, right down to people quoted.

To me, it's not so much the decision that was made but the poor way it was handled. Things are achangin. True. When Gary Morse was in charge, I think perhaps the same decision would have been made (they need to stay afloat financially) but I think it would have been handled with some sensitivity and honesty. For example, I still haven't received "the letter" since they were sent third class and not forwarded. This is a mistake that could have and should have been rectified. No doubt there are many people still not aware of this decision who are in for a big surprise when they return. Inexcusable.

Furthermore, to think that there are folks who made their home buying decisions, at least in part, based on access to TVH, is unconscionable and sad. No wonder they're upset! Not blaming sales agents. I have no doubt they didn't know the plan. Perhaps they should have. Or at least been directed not to pitch TVH since some changes were in the works.

So the result is a PR nightmare which could have been mitigated to some degree. :22yikes:

Just MHO.

villageswimmer: Ask those residents who were members of the Wellness Center, especially those using the indoor pool if Gary Morse handled that business transaction with sensitivity. Ask the residents who were upset that the bison disappeared if that situation was handled with sensitivity by Gary Morse. Ask the residents who bought at the height of the home market if Gary Morse handled selling of homes with sensitivity. Ask residents if those securing bridge loans from citizens received that sensitivity
Point of fact I had more than ample funds to qualify for a loan and so they stopped asking about my finances after leaning of two accounts. Yet when i sent them my 20% down payment much to my surprise and chagrin that sensitivity company owned by Gary Morse demanded to know where that 20% came from. I asked if they thought I was a terrorist...and the beat goes on

I am not complaining because i know its all about business I just want to clarify the sensitive point

and by the way i paid the full amount before the loan came due and they still grabbed me for a full months payment so i paid expenses never used the loan and they still made a handsome profit

Cést la vie

[rubicon]

My take on all this is that the Villages Health Care System is a for-profit operation run by the Developer. If the Developer feels that he needs to accept only United Health Advantage patients to maximize profits, fine. The Developer certainly has the right to do so, and there are alternative choices for the consumer.

However, my criticism of the whole operation is the way the Developer's Daily Sun, from the very beginning, has characterized the Villages Health Care System in advertisements disguised as news. The Daily Sun has constantly described the system as some kind of Marcus Welby, altruistic effort to make The Villages "Florida's Healthiest Home Town"-- rather than accurately describing the System for what it is: another Developer for-profit business.

By the way, I think that the System is probably the wave of the future-- for better or worse. I just would like to see a little truth in advertising on the part of the Developer and the Daily Sun.

Its exactly my mind set. ACA was a disaster before the ink dried because it ignored underwriting as Washington also did with the housing market. I was an insurance guy and did my share of criticisms to my superiors but underwriting as to insurance banks and mortgage companies is critical

The only way ACA can survive is to have everyone insured. the authors of ACA knew this and planned on it because they really wanted a one payer situation (ie government control of 1/6th the economy. I am a fierce opponent of central planning.

[villagetinker]

I started a new thread on the NLRN survey results, they are very interesting., and we have their attention.

[outlaw]

Although this TVH bait and switch scheme is hurting a lot of villagers, at least they may now wake up to reality. Koolaid may taste good, but it is not necessarily good for you.

[graciegirl]

Although this TVH bait and switch scheme is hurting a lot of villagers, at least they may now wake up to reality. Koolaid may taste good, but it is not necessarily good for you.

You know, how people say things is the secret to many things..........................


If you like I can explain, again.

Most people who are happy here don't like to have someone say they are naïve and have made a bad decision.

Nowhere is everything perfect.

I think this healthcare system was meant to help people and to make a profit too, but it hasn't been successful. I think the poster who is himself an M.D. explained it better than most.

And Rubicon, you who say that corporations "don't have feelings" are angry they weren't "sensitive". I don't know if they are a bunch of fools and thieves, but they sure give us the opportunity to live like millionaires, all of us.

I don't drink liquor and I don't drink Kool-Aid either, Outlaw. And we weren't allowed into The Villages Healthcare system in the beginning so we have had no dealings with it but know many who thought it was good, until they quit accepting their insurance.

[Chi-Town]

What they said in their letter of July 12: "Because our superior care best aligns with Medicare Advantage we have decided to no longer accept Original Medicare...."
What they meant: "Because we are losing a great deal of money, we have decided to no longer accept Original Medicare..."

I don't think it has to do with age discrimination; after all, physicians don't have to accept Medicare patients period.

I wonder if TVHS ever thought of turning their system into a concierge practice. It might be more palatable to the Original Medicare crowd or maybe even all patients to pay a yearly fee to join, with the provision of not being forced into an Advantage program.

I always thought the path was being laid for a concierge practice. Especially in the beginning.

[bimmertl]

Been in VHC the since the beginning. Started with Family Docs of Belleview which became VHC. Never has a problem with docs at VHC. Only problem I had was the fact if your read the BS you were led to believe that you received some type of exceptional care with UCH Medicare Advantage. Having had two docs at VHC, one retired, I doubt either one of them knew what insurance provider I had. I have no doubt they provided the same level of care regardless of your insurance so I don't buy the exceptional care nonsense with UHC Advantage. Had some recent minor medical problems got great treatment once again.

Can't find any fault with VHC docs or treatment. Not interested in"Morse Care" so moving on to other providers. Great experience with VHC and the docs while it lasted.

[outlaw]

You know, how people say things is the secret to many things..........................


If you like I can explain, again.

Most people who are happy here don't like to have someone say they are naïve and have made a bad decision.

Nowhere is everything perfect.

I think this healthcare system was meant to help people and to make a profit too, but it hasn't been successful. I think the poster who is himself an M.D. explained it better than most.

And Rubicon, you who say that corporations "don't have feelings" are angry they weren't "sensitive". I don't know if they are a bunch of fools and thieves, but they sure give us the opportunity to live like millionaires, all of us.

I don't drink liquor and I don't drink Kool-Aid either, Outlaw. And we weren't allowed into The Villages Healthcare system in the beginning so we have had no dealings with it but know many who thought it was good, until they quit accepting their insurance.

I was duped by TVH. There. I said it. I don't expect you to ever understand/accept that TVH acted unethically in the way they strung me and many others along, until they dumped us. There are ways to conduct business that is fair and above board, and TVH did not choose the high road on this one.

[villagetinker]

Interesting point, the Villages Health SPECIALISTS appear to be SEPERATE from the VHC. I stumbled on to this when I went in for an appointment with a specialist, and they wanted a follow-up. When I asked about the insurance I was told no problem I could continue to use them as they accept ALL insurances. So the bottom line all we lost, was our PCP, and access to the patient portal.

[Villageswimmer]

Interesting point, the Villages Health SPECIALISTS appear to be SEPERATE from the VHC. I stumbled on to this when I went in for an appointment with a specialist, and they wanted a follow-up. When I asked about the insurance I was told no problem I could continue to use them as they accept ALL insurances. So the bottom line all we lost, was our PCP, and access to the patient portal.


Thanks for your post. Very good info for a lot of folks, I'm sure. This is the first time I've heard this. This is huge!

TVH should include this in their marketing or a DS article. I think it will soften the blow significantly. :BigApplause:

Are the specialists referred to as "associates" or "associated" with TVH? I think I saw that terminology somewhere. Maybe on TVH website?

In any case, this little known fact should make a lot of folks happy.

[Kkbart4@gmail.com]

I'm so confused. If I have Medicare and United healthcare supplemental plan, can I go to a doc in the villages? I'm new to all this!

[graciegirl]

I'm so confused. If I have Medicare and United healthcare supplemental plan, can I go to a doc in the villages? I'm new to all this!

There are many doctors in The Villages that were here before The Villages tried to institute something really nice here that apparently isn't working out. We have a PCP, a dermatologist, a gastroenterologist, an endocrinologist and a foot doctor and they are accessed in the ordinary way and they take the usual kinds of insurance.

[Villageswimmer]

villageswimmer: Ask those residents who were members of the Wellness Center, especially those using the indoor pool if Gary Morse handled that business transaction with sensitivity. Ask the residents who were upset that the bison disappeared if that situation was handled with sensitivity by Gary Morse. Ask the residents who bought at the height of the home market if Gary Morse handled selling of homes with sensitivity. Ask residents if those securing bridge loans from citizens received that sensitivity
Point of fact I had more than ample funds to qualify for a loan and so they stopped asking about my finances after leaning of two accounts. Yet when i sent them my 20% down payment much to my surprise and chagrin that sensitivity company owned by Gary Morse demanded to know where that 20% came from. I asked if they thought I was a terrorist...and the beat goes on

I am not complaining because i know its all about business I just want to clarify the sensitive point

and by the way i paid the full amount before the loan came due and they still grabbed me for a full months payment so i paid expenses never used the loan and they still made a handsome profit

Cést la vie


You, obviously, have far more history with TV than I. I heard about the old Wellness Center for the first time a couple of days ago and know nothing of the bison. Maybe my comments were more emotional than factual. I don't know. I started coming down in 2010 and bought in 2012. My history is limited. Still, though, I feel like things are changing in a lot of ways and it's kind of sad. Maybe it's me. I still love TV and wouldn't live anywhere else. I feel like you're very upset and I apologize if my post contributed to that.

[Carla B]

I'm so confused. If I have Medicare and United healthcare supplemental plan, can I go to a doc in the villages? I'm new to all this!

With any supplemental plan, i.e., "A," "C", "F" etc., you will not be allowed to see a salaried doctor in The Villages' Health System after December 31, 2016. That doesn't mean you can't find primary care physicians located in The Villages who have their own practices. There are many of them.

[goodtimesintv]

The future of Medicare tied to Medicare Advantage growth, experts say

As government program costs are expected to balloon, insurers hope to carve out more of that business.

A surging interest in Medicare Advantage among the retirement-aged population and the fast-consolidating ranks of private payers has some experts asking whether the program might be the future of Medicare overall.

As it stands, one in three Medicare beneficiaries, about 18 million people, are already enrolled in Medicare Advantage and those numbers are only expected to climb as 10,000 baby boomers a day turn age 65.

While all Americans become eligible for Medicare at 65 years old, allowing insurance companies to take on that risk as managers of those benefits is attractive to consumers because these programs often come with lower out-of-pocket expenses and extra coverage beyond what is just covered in Part A and Part B of Medicare. Also, federal subsidies mean some beneficiaries pay no premium.

And despite federal cuts in payment rates in April, the Medicare Advantage program continues to grow.

"We view Medicare Advantage as an increasingly favorable and critical business for health insurers in the medium term," said Standard & Poor's analysts James Sung in a recent report.

"It remains the largest and most advanced retail market in the country.".......

The future of Medicare tied to Medicare Advantage growth, experts say | Healthcare Finance News (http://www.healthcarefinancenews.com/news/future-medicare-tied-medicare-advantage-growth-experts-say)

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[VApeople]

I'm so confused. If I have Medicare and United healthcare supplemental plan, can I go to a doc in the villages? I'm new to all this!

We just got here three months ago.

Start checking with doctors to see if they will accept your insurance. Do not just make phone calls. Visit the doctor's office or hospital IN PERSON to get your answers.

The Villages Health Care system has some beautiful new buildings with the friendly Villages logo on them, but we were very surprised to find that they would not accept our insurance.

After checking around, we found some doctors and hospitals that would take our insurance. I had a physical exam and had a basil cell skin cancer removed, and I was very pleased with the treatment I received.

[PTennismom0202]

It has been suggested that this is a concierge practice. In a way it is. Instead of paying your annual concierge fee of $1000-$4000, you join a specific Medicare Advantage program. It can also be viewed as a group model HMO a la Kaiser Permanente. The Villages Health provides the doctors (Permanente Medical Group, in an exclusive arrangement) and United Healthcare provides the insurance (the Kaiser Foundation Health Plan piece). Any way you look at it, those of us who are not free or who would lose a lot to opt for the United Healthcare products that The Villages Health will accept are not going to be able to use The Villages Health primary care. This is the only NCQA Level 3 (the top level) Patient Centered Medical Home in this area. That's too bad because Patient Centered Medical Homes are awesome. NCQA > Programs > Recognition > Practices > PCMH Evidence (http://www.ncqa.org/programs/recognition/practices/pcmh-evidence)