Primary Care Physician Recommendations

[kitkat1]

Hello! Any recommendations for a Primary Care Physician at The Villages? We were told to find one preferably before we move there! Thanks for any help.

[villagetinker]

First, checkout all of the discussions about the villages REQUIREMENT to use their ADVANTAGE plan. Once you have determined if you will be in the villages health system or not then you can look for the appropriate primary care doctor. There are several threads on this subject, key words, HEALTH, PCP, ADVANTAGE, and SHINE will give you a good start for searching. Please review your insurance options carefully. It appears that several thousand village health participants are leaving because of this recent change.
I am just trying to save you some trouble. Also, with villages health, you will experience a delay in your first visit (the welcome visit) and then and additional delay in getting to your PCP, not sure if you can setup any of this before you get here.
Hope this helps.

[JoMar]

I agree with villagetinker, first determine if you want to join the Villages Health Systen. If you do then you can go through them to find a Doc that works for you. Also, if you use their Advantage plan the wait to see the doc is not delayed. In the past, if you stayed with your plan and VHC accepted your plan you would experience the delay. I switched to VHC whey I arrived and had an appointment within a week. My wife brought her own plan and originally was delayed, until I joined then her delay was eliminated. If you decide to not go with VHC there are plenty of doctors outside TV and as Villagetinker stated, do the search and you will get all the information and confusion you will need.....lol.

[Avista]

We feel we are so fortunate to have The Villages Health Care. I would check out their web site. The Villages Health | America's Healthiest Hometown (http://www.thevillageshealth.com)
Depending where you will be living, select a center or possibly 2 that are near you. You can click on each physician to hear them say a few words. The docs are limited with the number of patients they serve, so may have to check and see who has some spots open. Pm me if any questions.

[villagetinker]

Just got a letter today from villages health, and it indicates that a large percentage of several thousand patients may be leaving, so this will have a significant impact on the villages health system. I am sure that they will have to let PCP doctors go, there will be lots of chaos and confusion.
OP, Please look over the insurance requirements, and carefully consider if you are looking at the Advantage plan, as you may not be able to go back to Medicare and a supplemental plan without a lot of grief or additional monthly payments. As I stated previously, you need to look at this very carefully, there are restrictions if you want to go back to Medicare. If you are confused, contact SHINE, as they will give you an unbiased review of what your options are.

VHS advantage plans works out for many people, especially if you are in good health, are a permanent resident, and can live with the limitations when you travel, if this does not fit your situation, it is probably not for you.
Hope this helps.
Send me a PM if you want to discuss further.

[rivaridger1]

Though much ballyhooed I found after two years neither the Village Health Care model or the physicians associated with it to be anything exceptional. The basic premise behind its existence is to keep you healthy. That is fine. They will talk to you spending more time then allocated in the traditional Primary Care Physician encounter. They will draw your blood twice each year and send it to an independent lab for testing. Most PCPs just write a lab order. More then a few of the physicians they employ are new to the area and do not know the specialists who have been practicing in it for years rendering referrals an iffy proposition. Yes, they employ some specialists, but they are few in number and hardly cover the entire basis of medical specialization. The model referred to earlier is to provide medical care to young, healthy active seniors. I honestly suggest you call the local hospitals and see if they have a referral recommendation protocol in place and might suggest some alternative PCPs, as well as the Villages Health Care. That is how I found two great specialists actually prior to finding a PCP. The big ones locally are The Villages Hospital and Leesburg Hospital. There are some other hospitals off campus as well, but not that far away.

And before someone else brings it up Villages Health Care no longer accepts my insurance since it is basic Medicare with a Supplement curiously enough provided by the same insurer that VHC now only accepts as a Medicare Advantage Plan provider. I did find another PCP outside the VHC system and am very confident with both his expertise and knowledge of the specialist community which services the area. Do your homework and keep in mind you will be subjected to a lot of propaganda associated with the VHC system emanating from the developer and in the local newspaper. Good alternatives do exist, you just have to do the research.

[Villageswimmer]

Just got a letter today from villages health, and it indicates that a large percentage of several thousand patients may be leaving, so this will have a significant impact on the villages health system. I am sure that they will have to let PCP doctors go, there will be lots of chaos and confusion.
OP, Please look over the insurance requirements, and carefully consider if you are looking at the Advantage plan, as you may not be able to go back to Medicare and a supplemental plan without a lot of grief or additional monthly payments. As I stated previously, you need to look at this very carefully, there are restrictions if you want to go back to Medicare. If you are confused, contact SHINE, as they will give you an unbiased review of what your options are.

VHS advantage plans works out for many people, especially if you are in good health, are a permanent resident, and can live with the limitations when you travel, if this does not fit your situation, it is probably not for you.
Hope this helps.
Send me a PM if you want to discuss further.


Could you possibly elaborate on the letter you received today? We're still up North and never received the original letter so I don't expect we'll get this one.

[JoMar]

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

[Archer_ID]

It is very simple. Come January 1, VHS will no longer accept Medicare plus supplements eve from United Health. You need to get The advantage plan from United Health. I have participated in advantage plans with all their associated costs and found supplemental insurance to be far easier and cheaper. So, apparently, have thousands of others.

[NYGUY]

Hello! Any recommendations for a Primary Care Physician at The Villages? We were told to find one preferably before we move there! Thanks for any help.

Slow down and head the advice provided by others to do your research. I am not sure who provided this advice or if they meant Physician's at The Villages Health, but it it is not at all necessary to make a decision before you move. There are lots of Primary Care Physicians in and around The Villages.

[goodtimesintv]

Hello! Any recommendations for a Primary Care Physician at The Villages? We were told to find one preferably before we move there! Thanks for any help.

Don't be needlessly scared (by Post #2) into assuming The Villages requires anybody to be in the primary-care (only) practice d.b.a. The Villages Health. (TVHealth will now only be accepting Medicare Advantage plans by United Healthcare and The Villages brands, plus private insurances for people who are not Medicare age or enrolled. More info on that practice and insurances accepted here: Accepted Insurance by The Villages Health (http://thevillageshealth.com/insurance.php) ).

A physician not in TVHealth that is consistently recommended is Felix Agbo. You'll see other good ones in the threads found here in this search results list:

https://www.talkofthevillages.com/forums/search.php?searchid=12705132

[villagetinker]

Could you possibly elaborate on the letter you received today? We're still up North and never received the original letter so I don't expect we'll get this one.

You are probably correct, these were bulk mailed and I do not think they are forwarded. The letter was essentially a follow-up, from the first letter. I do not have the exact text as I threw it away, and they just picked up the trash.

Maybe someone else can provide the text.

[2BNTV]

If you decide t get a UHC MA plan, I recommend Dr. Saul Rosenblum.

If you have another plan that is not accepted by TVH:
1. Dr. Florian Gegaj
2. Dr. Felix Agbo, (I have difficulty with my hearing, as he has an accent).

[villagetinker]

All, If you have additional questions, and did not get the second letter (or for that matter the first letter), please call villages health directly to see where you stand with you specific insurance, your age, and your situation. There appears to be different situations based on age, insurance, etc.
As mentioned above, please carefully investigate your insurance options, ask a lot of questions so that you get the appropriate coverage for your situation.
Hope this helps.

[kitkat1]

I have basic Medicare with BC/BS Carefirst as secondary. I am really happy with my coverage. So what you are saying is that there are PCP's outside of the VHC that will accept my insurance plan?

[paulascorpio]

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

[RGump]

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

[mrbgull]

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

[Paper1]

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

[syber]

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

[champion6]

I just received my notice that because I am under age 65 and have original medicare because of disability that I can no longer see my doctor. My reply was that I also have my employer retiree health plan with United Healthcare. They stated that even though they are in network with my employer coverage, they will disregard that United contract because I have original medicare. They went onto say that for those under age 65 who do not have Medicare and have my United plan, that those United Subscribers can stay. I asked if they will remove themselves from the network agreement with United and they said no. We will just not take United Subscribers with original medicare. My only choice is to accept the Advantage plan or drop my Original Medicare. This only affects people under age 65 who all have Medicare due to disability.You have another choice - keep your existing insurances and change to a PCP who will accept them. Many of us have done this recently. It's discouraging to have been put in this position, but it can have a successful and satisfying outcome.

[syber]

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

[Villageswimmer]

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


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

[Villages Kahuna]

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

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

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

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

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

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

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

[Villages Kahuna]

I also heard there were a few thousand that were leaving....I dn't know how big a deal that is in the scheme of things. There are about 40 docs and if each has 1000 patients (they are capped at 1250) that's 40,000 patients. In addition, there are a bunch of new houses being built which will bring new customers. Will this initial change make a difference in care, I doubt it. Will they recover, I think so. We make decisioons on what works for us or we fear change and want to stay in our comfort zone. Do your homework....talk to Shine, or health health care professionals you trust, but those of us that live here have our agendas and tend to try and sway others to our agendas.The general information available locally is that Villages Health notified about 13,00 to 15,000 of their patients that they would have to enroll in their Medicare Advantage Plan or leave. They expected that about 50% of those patients would make the switch.

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

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