Retired Military moving to Villages....Healthcare info needed...Please?

[Troy8432]

My wife (59) and I (54) are making preparations to move to the Villages in spring/summer 2020. We were there in October on a lifestyle visit and are returning in February to gather more information. We really enjoyed our visit and have pretty much made the decision to move from our current location in Northern Virginia. Among all the many items that need careful consideration, healthcare is pretty darn important. Especially, since we are starting to notice an increase in annoying minor medical issues that need attention. I am retired USAF and 60% VA disabled and she spent a few years in the Army many years ago herself. Admittedly, and rather ashamedly, I have never given much thought to healthcare insurance because there was always something else that was more important to be concerned about. When I was Active Duty we used military medical and since I retired in 2004, we've used Tricare Prime. Although it hasn't exactly been free like the recruiter promised me back in 1984 ("give us 20 years and you'll never pay a dime"), getting an ear infection or sore throat fixed by my doctor around the corner has been pretty simple.

During my feeble attempts to do health insurance research near The Villages, I've discovered that either I am an idiot or just overwhelmed by the difficulty in getting accurate non-conflicting information. It really is rather humbling because although I can solve extremely complex network communications engineering puzzles, I can't seem to figure out what to do regarding our future healthcare insurance. As such, I am reaching out the kind and knowledgeable folks in the Villages for advice, recommendations, points of contacts, useful information websites, personal experiences, etc...

So here is what I know. Tricare Prime is not available around The Villages, but Tricare Standard is. There is also something called Tricare extra. Don't know what that is, but it might be something to consider if I could find information about it. I also think there might be Tricare supplements to other insurance packages that are available. I just don't understand them. Although free, Tricare standard can be tricky, because you need to compare what Tricare will cover against what a doctor charges before you get care or you risk paying significantly out of pocket. I also know that I can get 100% care at the VA Clinic, but my wife cannot and I don't know how busy the VA Clinic at The Villages can be. I've considered simply walking into The Villages medical center while I am there in February and just talking to an administrator, but I really would like to hear from some of my future Villager neighbors. Any information would be useful, thank you in advance.

[600th Photo Sq]

My wife (59) and I (54) are making preparations to move to the Villages in spring/summer 2020. We were there in October on a lifestyle visit and are returning in February to gather more information. We really enjoyed our visit and have pretty much made the decision to move from our current location in Northern Virginia. Among all the many items that need careful consideration, healthcare is pretty darn important. Especially, since we are starting to notice an increase in annoying minor medical issues that need attention. I am retired USAF and 60% VA disabled and she spent a few years in the Army many years ago herself. Admittedly, and rather ashamedly, I have never given much thought to healthcare insurance because there was always something else that was more important to be concerned about. When I was Active Duty we used military medical and since I retired in 2004, we've used Tricare Prime. Although it hasn't exactly been free like the recruiter promised me back in 1984 ("give us 20 years and you'll never pay a dime"), getting an ear infection or sore throat fixed by my doctor around the corner has been pretty simple.

During my feeble attempts to do health insurance research near The Villages, I've discovered that either I am an idiot or just overwhelmed by the difficulty in getting accurate non-conflicting information. It really is rather humbling because although I can solve extremely complex network communications engineering puzzles, I can't seem to figure out what to do regarding our future healthcare insurance. As such, I am reaching out the kind and knowledgeable folks in the Villages for advice, recommendations, points of contacts, useful information websites, personal experiences, etc...

So here is what I know. Tricare Prime is not available around The Villages, but Tricare Standard is. There is also something called Tricare extra. Don't know what that is, but it might be something to consider if I could find information about it. I also think there might be Tricare supplements to other insurance packages that are available. I just don't understand them. Although free, Tricare standard can be tricky, because you need to compare what Tricare will cover against what a doctor charges before you get care or you risk paying significantly out of pocket. I also know that I can get 100% care at the VA Clinic, but my wife cannot and I don't know how busy the VA Clinic at The Villages can be. I've considered simply walking into The Villages medical center while I am there in February and just talking to an administrator, but I really would like to hear from some of my future Villager neighbors. Any information would be useful, thank you in advance.

There is a Tricare web site that will help you along with various telephone numbers for your particular circumstance.

Since you are retired military both you and your wife should be able to get medical help.

[seoulbrooks]

My wife is using Tricare Standard without a problem around the Villages. Since I am older I have Medicare and Tricare. Her providers have only charged minimum co-pays above what Tricare has paid. You can get a supplement but remember some supplements cost more than the care limit ($3000). We just keep a care fund of $3,000.00 set aside each year incase she should need serious care. Using Medicare and Tricare for life I pay nothing for my care here. Good luck on your move.

[LuvtheVillages]

Before I reached Medicare age, I used Tricare Standard and a supplement. All the military support organizations offer a supplement - ask whatever org you already belong to. The plans are all very similar. I think mine was with MOAA.

When you are 65, Medicare and Tricare for Life are all you need.

Be careful of Villages Health. They only accept Advantage plans and will want you to enroll in theirs. Do not give up your Tricare, there are consequences down the road if you should try to switch back. There are many, many doctors and clinics here apart from Villages Health.

I don't understand your statement about a doctor charging more than Tricare Standard covers. If the doc accepts Tricare (and they all do) then they accept that as full payment. Your only obligation is the co-pay (unless you have the supplement.)

[Dan9871]

We have a couple of neighbors who are retired military with a disability. They both use Villages Health and the VA. There is a VA outpatient clinic in the Villages. Both are satisfied with the arrangement. For somethings, they prefer going to their primary care provider in Villages Health and for others, they go to the VA clinic. As far as I know, neither had to give up their Tricare to use Villages Health.

But in the end, there are many choices for health care here in The Villages.

The Villages Health (https://thevillageshealth.com/tricare-for-life/)

[JoMar]

Before I reached Medicare age, I used Tricare Standard and a supplement. All the military support organizations offer a supplement - ask whatever org you already belong to. The plans are all very similar. I think mine was with MOAA.

When you are 65, Medicare and Tricare for Life are all you need.

Be careful of Villages Health. They only accept Advantage plans and will want you to enroll in theirs. Do not give up your Tricare, there are consequences down the road if you should try to switch back. There are many, many doctors and clinics here apart from Villages Health.

I don't understand your statement about a doctor charging more than Tricare Standard covers. If the doc accepts Tricare (and they all do) then they accept that as full payment. Your only obligation is the co-pay (unless you have the supplement.)

Not sure that is correct....we have neighbors that have Tricare for Life and are the Villages Health Care. They were never asked to switch to an Advantage Plan.

[villagetinker]

Troy8432, first thank you and your wife for your service. Now I believe SHINE SHINE - Home (http://www.floridashine.org/) may be able to help you. The link will take you to the home page, on there you can click the contact us button for additional info. Many if not all of the Villages Health SPECIALISTS accept outside insurance, the Villages Health system and primary care doctors ONLY accept 3 or 4 advantage plans, and the advantage plans are generally not accepted (or on a very limited basis) for doctors and specialists outside the villages. We were in the villages health plan and had some problems with the advantage plans and were able to switch back to regular medicare and supplemental plans.
Since you mentioned some recent medical concerns I would be very careful about changing plans. You are wise to look into this, hope the link to SHINE helps, we have found them to be very useful, and their info is UNBIASED.

[Sparty6971]

The OP has two issues really. First, being in their 50s still they are probably not Medicare eligible nor Tricare for Life. That does make it necessary for careful study. Then, when a military retiree reaches age 65 and becomes eligible for Medicare and are enrolled in Tricare for Life, it becomes easier. My wife and I are above that transition age, have Standard Medicare and Tricare for Life for medical and drug coverage. The Villages Health System does indeed accept that medical insurance combination and has for a few years. Before then however, we just had Tricare Standard (I think that was the name back then) and it was a little more difficult to find doctors but certainly not impossible; and, no the Villages Health System did not accept that for medical coverage. I caution the OP about enrolling in some of the Medicare Advantage plans when you get to that point; some of them include the drug coverage which can mess up your Tricare drug coverage. As someone said, do not give up your Tricare coverages - once surrendered, it's very difficult if not impossible to get them back.

The suggestion to talk with SHINE is a great one. And of course access the Tricare web site as well. Don't wait too long as you don't want to get into a panic mode when the decision must be made. The time from mid-50s to "retired" age goes by quickly.

[Dan9871]

T, and the advantage plans are generally not accepted (or on a very limited basis) for doctors and specialists outside the villages. .

We have the Villages Health plan and have not had any problem with specialists outside of Villages Health accepting it.

[kansasr]

If a health provider accepts Medicare they must, by law, accept Tricare. You'll be hard pressed to find someone serving the Villages who does not accept Medicare. When we first moved here, I was on Tricare standard until moving to Medicare/Tricare for Life. I had no problems during that period and my Tricare co-pays were not a problem.

[AnneS]

The Villages Health Care is the very best They accept. Medicare & Tricare, thus u have no copay you do have to sign up. Just call them

[eeroger]

My husband is retired army & we moved from NOVA. The Villages Health accepted my BC/BS Fed and Tricare until we turned 65 last year. Then we had to choose an Advantage plan or leave. We left because we did not want to choose a restricted plan. My husband uses a combination of private doc & the VA. I use a private doc. Look into a Tricare supplemental plan. Many organizations offer them such as MOAA, USAA, etc. I agree with other readers - do not switch to an Advantage plan.

[rmd2]

Don't switch from your Tricare to The Villages Advantage Plan. When they first started the Advantage plan I looked into it and they said I would have to switch from my Federal Blue Cross Blue Shield to The Villages Advantage Plan. The Villages Health Care Advantage person said I could try it out and if I didn't like it I could always go back to my Federal plan. This was false. Once you leave your Federal Plans or your Tricare you will NOT be able to switch back! The Federal Plans are the best.

[sterlingcnslts]

If you have tri-care prime, as I do, nothing really changes here in the Villages. Almost every doctor excepts it. You share will be the same as it is now. When you start drawing medicare the 2 of them will pay almost everything. The VA clinic here is pretty good except the wait for appointments is a bit slow. I no longer use it because you can not get in quickly for a routine cold or pain, etc.

[Lblueocala]

My husband is retired military with 60% disability. He gets his care at the VA clinic here at the villages on county road 42. It is a large clinic with most services. Be sure to have copies of you medical records, DD214, VA ID card, etc with you. I had tricare prime with MOAA as my secondary in Kansas. They have tricare standard and extra down here, but you should have MOAA as a secondary. Tricare standard and extra are like Medicare they pay the same rate as Medicare to the doctors. So when you get here you need to fine a doctor that is in the tricare network. That means they have signed a contract with the government that they will accept what the government will pay them just like Medicare. Tricare pays 80% of your bill and you pay 20 or 25% depending on if you have standard or extra. I think standard you pay no premium for it and extra you do, I’m not sure, I haven’t read the new coverage for 2020, only Medicare as I now have Medicare and tricare for life. MOAA will cover the 20% out of pocket you would pay. When you start looking for a doctor the villages healthcare does not take tricare or regular Medicare they want you to sign up for their network that limits you to only their doctors.Never give up you Medicare and tricare for life when you reach age 65. It means the difference between being locked in to a limited number of doctors or being able to go to any doctor in the country. I have had no problem finding doctors for all my healthcare here. You need to ask the doctors office if they accept Tricare and do the billing for you, not have you pay up front and then you have to fill out the paperwork and get reimbursed from tricare. MOAA you will have to submit paperwork for visits, they are very good about helping you, I had their coverage from 2000 till July 1, 2019, and liked them. If you go to a doctor or urgent care that is not in the tricare network you are responsible for that bill, so know before you go. If it is a true emergency and you end up in the ER you need to let Tricare know it in a certain time frame and it will be covered if the hospital is not a tricare contractor.

[Lblueocala]

I also have my husband as a patient with the civilian doctor I see as a backup to the VA. He got a real bad cough and I sent him to a urgent care for the chest X-ray and the antibiotic prescription he ended up getting. It was all covered. I’m a nurse and have been working the past ten years navigating the VA, tricare, and Medicare coverage and networks for my husband, myself and other family members. Each year I read and update myself on the different coverages, don’t throw the books away. The biggest mistake people many is they don’t read and know what is covered, what doctors and facilities are in or out of network. That makes a big differences if it’s covered or you’re going to have to pay for it out of pocket. I had my husband do an appointment with his VA doctors in Wichita just before he came down so he had enough meds for 3 months. As soon as we got here, like the next day, went right over to the VA clinic got all of his new patient appointments. He has had no brake in service. Make sure you and you wife get your change of address in to express scripts as soon as you know your new address and the day you close on your home here and have your mailbox key so your meds don’t get hung up if you use home delivered for meds. That’s why I made sure we both had 90 day supply of our meds, it made the move easier.

[Lblueocala]

I understand the villages healthcare may or may not take tricare, but not regular Medicare. I didn’t want to have to change doctors and I knew up front We would NOT give up our regular Medicare and tricare for life so I never even tried to get in the villages healthcare. When I talked to them and asked the right questions about their coverage the person I talked to realized I knew about the different coverages and the limitations the villages healthcare put on you to see a specialist outside their network. My husband and I are from here and are medical and worked in central Florida.

[jjiggers]

Good morning and welcome! My husband and I have been here almost 16 years and are perm residents. We uses Tricare Prime exclusively. We're in our 70's and since we have been here he has had 2 knee's and 1 shoulder replaced, and a bout with colon cancer which we chose to have treated at Mayo Clinic in Jacksonville. I have had a pacemaker implanted and two broken wrists. We are healthy and very active. We have had no problem with our Tricare Prime/ medicare combo and have never had to pay out of pocket for medical expenses. Many Dr's are now excluding this combo for the new Advantage plans. We've chosen not to go that route as we are VERY happy with what we have. The Village Health uses the Advantage plan, we can uses their specialists and I do, but we also have the option of using any Dr. we choose, thus Mayo. All the Drs we have used (many) are here in The Villages and practice in the local hospitals when needed. Just so you know you have that choice if you want Tricare Prime!

[mainelovr]

When my wife and I moved to The Villages, we considered keeping Tricare Prime, but the availability of providers was very underwhelming. So we switched to Tricare Select (formerly standard and extra). We were able to keep our provider in Maine, who we love, and see her during the summer months when we’re up there. When we make the switch in the next couple of years, I think we’ll stay with Select unless Tricare has more Prime providers available in this area.

[vinceg35]

Tricare standard and USAA Mediplus worked great for me.

[mooned]

Greetings the Wife and I moved here last Aug, am retried Navy, under the age of 65. Prior to moving here researched the TRICARE web sites and based on our ZIP Code, was told that there was no TRICARE Prime available in the area. So we assumed that we would have to shift to TRICARE Select.
When we called TRICARE and talk to a human we were told that TRICARE Prime was available in the town of Leesburg, the same location most of the TRICARE Select providers reside. So we chose to stay with TRICARE Prime. So.. moral of story, talk to a human, don't trust the web sites alone.

[Weschupp@gmail.com]

:welcome:Hi Troy, Smart of you to do your research. I understand exactly what you are going through. When we first started looking one of the first things we did was check the availability of Tricare Prime support. Two years ago, before Tricare switched to the current administrator, there were thousands of providers in the area you could find on the Tricare site. Which was perfect. We purchased a home and a year ago with that initial research in our background. However, after the transition, the number of providers went to zero. Since then I have spent many many hours on the phone with Humana, contacted our congressmen and filed grievances. Here is what I found, during the transition, all the doctors were supposedly sent letters advising them that they needed to reapply to be a provider. And Humana's feedback they did what they were supposed to do and would do no follow up on the anomalous situation, thousands of providers and hospitals to none in the two zip codes 32159 and 32162 which covered the Villages. I had even gone as far as calling Doctors and hospitals asking if they accepted Tricare Prime, every one I contacted replied they did and thought themselves to be network providers. All were in awe when i conveyed that according to the provider site, they were not identified as network nor non network providers. Over the last year in my plight I have gone as far as making accusations that there were area managers that needed to be fired because they did not do their job, thousands to zero was definitely someone not doing their job. I do not know if any of my efforts have done anything, but I can tell you that as of last month there are now several hundred network providers and many more non network providers that have shown up on the list of Tricare Prime providers as well as several PCM's. It is working out for us we hope, because we only moved from the other side of the state, and we still had our home in the other area, so we have continued to use our old providers, but we have now sold our home so we will have to transition to a new PCM. Like a couple of the other posts have I believe the doctors in the area will accept Tricare Prime, but would advise caution when getting a new doctor asking the important questions about acceptance of Tricare Prime. If they say they do and can file the claim, one would think they are registered and accept assignment of Tricare Allowable charges,,,but I will still be cautious. You will never have a problem should you need to go to an emergency room, but doctors and medical procedures could pose an issue. Until the new Tricare administrator finally gets their stuff together I will be cautious, but eventually I think it will be great. Also, the Tricare provider search site "s" leaves a bit to be desired, like trying to find a PCM. If just doing a search for PCM's to change you may find a few. But if you look at GP's and Family doctors you will see several more are listed as PCM's in their services. Hope this helps, I am under 65 also so Medicare and Tricare for life in a few years down the road but my research in that area is almost every doctor and hospital accepts medicare and Tricare for Life picks up the rest so we will be in good hands at that milestone.

[arbajeda]

I have United Health Care (UHC) zero-premium plan that bills Medicare and Tricare For Life (TFL), and I use The Villages Health facilities. Very happy.

Medicare Resources - The Villages Health (https://thevillageshealth.com/medicare-resources/)

[Curtisbwp]

Sir, I am a village resident and am USN retired. Tricare prime is all but gone, there is one prime provider in leesburg but I would not recommend it. I retired at 53 and wife at 48. I also retired from postal service and had federal bc/bs. I suspended the bc/bs as the cost was up to $400.00 per month. I stayed with tri standard. The absolute most out of pocket was $3,000.00 a year vs bc/bs $4,800.00 per year in payments. No brainers. I did establish an account with $3,000.00 to cover any unexpected medical issues. The VA clinic in the villages is new and quite well equipped. The VA hospital is in Gainsville and is partnered with Shands hospital. I have had simple procedures and tests at Gainsville, all with good results. For any major surgery I go to a private doctor and to the Mayo clinic in Jacksonville (2.5 hours away but well worth it) gainsville is about 1.5 hours away. I am now on tricare for life and medicare. Tricare for life is at no cost. Between the two i NEVER have a copay or deductible. You can not get better coverage. The village hospital is a place i stay away from. There are other much better hospitals, Leesdurg, ocala, shands...
The goal is to stay healthy till you turn 65. I have lived here since 2003.
Curtisbwp@yahoo.com

[Sparty6971]

//////

I really need to remember to fully read ALL the previous postings before I insert my foot and bite down hard. :)

[carolfry44]

You will be just fine here in The Villages with your Tri-Care Prime. Not to worry at all.

[NavyVet]

I'm no expert, but here are my experiences.
DH is retired military (1992). I am 100% disabled Veteran since 2001. We always stuck with Tricare Standard (has a cost-share, not a co-pay so no payment out of pocket up front.) When I got SS disability, Medicare became my primary with Tricare For Life as secondary. Every provider I went to said I had the 'holy grail' of insurance coverage. Always ask up front to be sure provider accepts. The only place that was a problem is the Villages Health system. When DH turned 65, his Tricare Standard became Medicare with Tricare for Life and Villages Health kicked him out because he didn't switch to a Medicare Advantage Plan. Who on Earth would give up Tricare benefits? We earned them! Do NOT switch from Tricare; those Advantage plans are HMOs and only to THEIR advantage, not YOURS. They are fine if you are healthy, but if you start having expensive issues ... not so much. There are plenty of providers outside The Villages system. We have no problems finding them and don't need preauthorization for specialists.
Also, the VA Outpatient Clinic is a large facility on the Northern end of TV. It is very good. Yes, they are busy. Get enrolled there as soon as you move here.
We have PCPs with both the VA and on the 'outside' so between them we are fully covered for any health need. If you have an acute problem and can't get a same day appointment with your doctor, there are numerous Urgent Care centers. We have had very good experiences with Paramount on 466.
I have no experience with the details of Tricare Prime, so can't help you there. Hope this has helped a little. As with many things, insurance can be complicated. Clear as mud as they say! Best of luck.

[mooned]

I'm no expert, but here are my experiences.
DH is retired military (1992). I am 100% disabled Veteran since 2001. We always stuck with Tricare Standard (has a cost-share, not a co-pay so no payment out of pocket up front.) When I got SS disability, Medicare became my primary with Tricare For Life as secondary. Every provider I went to said I had the 'holy grail' of insurance coverage. Always ask up front to be sure provider accepts. The only place that was a problem is the Villages Health system. When DH turned 65, his Tricare Standard became Medicare with Tricare for Life and Villages Health kicked him out because he didn't switch to a Medicare Advantage Plan. Who on Earth would give up Tricare benefits? We earned them! Do NOT switch from Tricare; those Advantage plans are HMOs and only to THEIR advantage, not YOURS. They are fine if you are healthy, but if you start having expensive issues ... not so much. There are plenty of providers outside The Villages system. We have no problems finding them and don't need preauthorization for specialists.
Also, the VA Outpatient Clinic is a large facility on the Northern end of TV. It is very good. Yes, they are busy. Get enrolled there as soon as you move here.
We have PCPs with both the VA and on the 'outside' so between them we are fully covered for any health need. If you have an acute problem and can't get a same day appointment with your doctor, there are numerous Urgent Care centers. We have had very good experiences with Paramount on 466.
I have no experience with the details of Tricare Prime, so can't help you there. Hope this has helped a little. As with many things, insurance can be complicated. Clear as mud as they say! Best of luck.

Hi I am sorry but am a bit confused. As I am approaching 65 as a retired Navy I get the fun of shifting from Tricare Prime to Tricare for Life and Medicare. I had heard several comments that "to use the Villages Health Care" clinic chain I would have to shift my TRICARE for Life to a MEDICARE Advantage i.e. Medicare part C plan, but Medicare Advantage is a Medicare change, not a TRICARE change. When I called TRICARE I was told that it made no difference to TRICARE For Life if I used Medicare A and B (i.e.traditional Medicare) or if I used Medicare C i.e. Advantage. TRICARE for Life will remain my secondary insurance.. With one condition that I should not chose a Medicare Advantage plan the included Drug coverage because that would impact my TRICARE for Life drug coverage. So was I miss informed by TRICARE ? I tried to get it in writing but TRICARE has yet to respond to my e-mail question.

[Troy8432]

Thanks to everyone for their replies. The information provided has been quite informative. I think I read somewhere that TRICARE Prime is only available if your willing to sign a waiver that basically states you are willing to travel to a Military Treatment Facility over 50 miles away on occasion. Probably Macdill Afb. It appears that TRICARE Standard and TRICARE Select are synonymous. E.g. No premium, 80% covered if doctor accepts TRICARE with a $3000 cap per year. I will continue to work following the move to Florida, so my employer may offer a good TRICARE supplement. I figure that I will use VA as much as possible and the missus will use TRICARE until Medicare/TRICARE-for-life begins. Good plan?

[Raymond Carter]

I was in very similar position two years ago. Moved here from Fairfax as retired Air Force. What I have learned and experienced since arriving is Tricare Prime is available but very limited in providers. I and a colleague in similar situation have done Tricare Prime and made it work. Not crazy about our doctor or practice but have had worse sadly. I have also recently registered with VA and have been blown away with services I have received there. So you can make it all work. Just not greatest docs and offices.