Preferred Care Partners

[JenAjd]

I signed up for PCP for the coming new year. Today I learned something I didn't know before. Went out to Mid-Florida Eye as I wanted to make a future app't. Was asked if I live in Lake County (I don't) so then was told that they ONLY take patients from Lake County....and I believe they're located in Marion Cnty. Isn't this strange?? I thought that as long as the practices were "in network" one could choose from anyone within it! I should calle the PCP 800# and ask what gives. Has anyone else run into this issue??

[JenAjd]

Bump!

[dstege]

I am an independent agent and am authorized to offer several companies, including Preferred Care Partners. This situation at Mid-Florida Eye didn't sound right, so I double checked with PCP, and here is their response "Our clients can see any provider in the network regardless of county." Obviously whoever you talked to at Mid-Florida were not informed on their PCP contract details. I've never heard any medical office here offer that response! You should call Mid-Florida main office and try again.

[JenAjd]

I am an independent agent and am authorized to offer several companies, including Preferred Care Partners. This situation at Mid-Florida Eye didn't sound right, so I double checked with PCP, and here is their response "Our clients can see any provider in the network regardless of county." Obviously whoever you talked to at Mid-Florida were not informed on their PCP contract details. I've never heard any medical office here offer that response! You should call Mid-Florida main office and try again.

THANK YOU!!! (not shouting just emphasizing!!!) I was puzzled with that one too! They asked what county I lived in...Sumter...and then proceded to tell me I'd need to go to a clinic called Omni Eye in Ocala!!! Mid-Florida in T.V. is in Marion! I will call so want to thank you for this information!!!!

I just called Mid-Florida Eye's main office and spoke to someone there. I was told I need to see an "in-network" optometrist and have HIM refer me to Mid-Florida Eye, THEN I can be seen by one of the specialists (that is, if I have an issue that he'd need to address). Their optometrists aren't covered by PCP!!! This seems really goofy! Lange Eye is the PCP preferance for optometrists. I should just go there then it would seem. I'd heard some good, some not so good about Lange. I'd heard Excellant things about MFE!!! This was ALL confirmed by PCP whom I called as well after speaking to the woman with Mid-Florida Eye. Now I'm wondering if PCP really is the way I want to go. Anyone else have thoughts on this??????

[JenAjd]

bump

[wendyquat]

THANK YOU!!! (not shouting just emphasizing!!!) I was puzzled with that one too! They asked what county I lived in...Sumter...and then proceded to tell me I'd need to go to a clinic called Omni Eye in Ocala!!! Mid-Florida in T.V. is in Marion! I will call so want to thank you for this information!!!!

I just called Mid-Florida Eye's main office and spoke to someone there. I was told I need to see an "in-network" optometrist and have HIM refer me to Mid-Florida Eye, THEN I can be seen by one of the specialists (that is, if I have an issue that he'd need to address). Their optometrists aren't covered by PCP!!! This seems really goofy! Lange Eye is the PCP preferance for optometrists. I should just go there then it would seem. I'd heard some good, some not so good about Lange. I'd heard Excellant things about MFE!!! This was ALL confirmed by PCP whom I called as well after speaking to the woman with Mid-Florida Eye. Now I'm wondering if PCP really is the way I want to go. Anyone else have thoughts on this??????

We were considering a medicare advantage plan also. Too much information to digest so I just asked my primary care physician about it and was told that I should not change from my medicare with supplement. I do have Type II Diabetes and atrial fibrillation and it seems I may NEED a referral to a doctor that is "out of network" and it would cost quite a bit to do that.
I just decided to "shelve it" for this coming year and see how it is working for those who did switch. It seems to me it would be fine for someone with little or no health issues. I would love to save these premiums I'm paying to Medicare and AARP but I'm so afraid of losing it and not being able to "get it back" without a big premium increase due to pre-existing conditions.
Good luck with your choice. I hope it works real well for you.
BTW, I also have glaucoma and went to a dr at Lange when we first moved here. He did a lot of tests and gave me a new, generic eyedrop and wanted me to come back in a month to see if it was working. About 3 weeks later, his office called and said he was not going to be coming to TV any more and I'd have to go to Ocala to see him. I tried to make an appointment with another Lange dr in TV and was told it would be several weeks before I could be seen. I then made an appointment with Dr. Elmallah at Ocala Eye but my new drops had run out and I had reverted back to my old, tier 3 drops before my appointment so we have no idea if the generic worked. Dr. Elmallah did not want to put me on a generic drop. Getting doctors lined up has been the biggest challenge of our move to TV!

[JenAjd]

Thank you Wendyquat.....Your comments are appreciated. We all have to be our own advocates with the medical profession. This was the case before moving here (at least for me) so I haven't minded it, really! Though I already had established myself with providers and now have to change over to new ones again. The savings will be worth it probably! IF for some reason I don't like it I'll change to something different for 2013. With your heart issues I can see why you wanted to stay with your present situation. Dr. Elmalleh has been my eye doctor as well and I think he's very good!! Unfortunately Ocala Eye isn't a part of PCP and won't be....I checked!!! I'd have preferred to remain there, truth be told.

[NotGolfer]

Was going to make an appointment over at the WalMart on 441 a week or so ago. In the conversation found out that PCP no longer is carried at Mid-Florida Eye. In conversing with an agent at the PCP office found out that this is true. Patients are now to go to The Villages Eye Institute over on 441. Does anyone know anything about this practice and it's doctors? Would be curious to find out. I've been happy so far with PCP but feel they really need to recruit doctors for their dental and eye care! It's slim pickins!!!

[rhood]

I am in Sumter Co and a few months ago I had an exam and saw the retina specialist at MFE and it just cost me a $10 copay.

[NotGolfer]

I am in Sumter Co and a few months ago I had an exam and saw the retina specialist at MFE and it just cost me a $10 copay.

Yes...but MFE is NO longer a part of Preferred Care Partners AS OF MARCH sometime! I'm not shouting just using this for emphasis! So the new question is....has anyone had experience with "The Villages Eye Institute". It's located across 441 from the WalMart...take a left turn I think, at the light past Billy's.

[VillagesFlorida]

Was going to make an appointment over at the WalMart on 441 a week or so ago. In the conversation found out that PCP no longer is carried at Mid-Florida Eye. In conversing with an agent at the PCP office found out that this is true. Patients are now to go to The Villages Eye Institute over on 441. Does anyone know anything about this practice and it's doctors? Would be curious to find out. I've been happy so far with PCP but feel they really need to recruit doctors for their dental and eye care! It's slim pickins!!!

Hubby and I saw Dr. Heidi Gonzales at The Villages Eye Institute. We were happy with the exam and the staff. She is on the staff of the Perich Eye Center and they have several other offices, all south of The Villages. I didn't know that Mid-Florida Eye had pulled out of PCP. My husband used to see Dr. Panzo there. I heard a while ago that Lange Eye also pulled out due to not being paid for services by PCP. (This is not the first complaint I have heard about them not paying) The latest news is that PCP was bought out by United Healthcare. Can anyone confirm this? I have no idea what this means for those of us on this insurance. All in all, I'm not sure I like what I am hearing about this company and I am a little worried about the future if we stay with them. I think we will be looking at other options later this year.

[NotGolfer]

Hubby and I saw Dr. Heidi Gonzales at The Villages Eye Institute. We were happy with the exam and the staff. She is on the staff of the Perich Eye Center and they have several other offices, all south of The Villages. I didn't know that Mid-Florida Eye had pulled out of PCP. My husband used to see Dr. Panzo there. I heard a while ago that Lange Eye also pulled out due to not being paid for services by PCP. (This is not the first complaint I have heard about them not paying) The latest news is that PCP was bought out by United Healthcare. Can anyone confirm this? I have no idea what this means for those of us on this insurance. All in all, I'm not sure I like what I am hearing about this company and I am a little worried about the future if we stay with them. I think we will be looking at other options later this year.

Thanks for your response! We can always pull at next year "IF" things go 'south' with them. I went with them due to everyone I'd talked with, who had them, liked being with them. I said I'd try it for a year then re-evaluate! I would wonder who said this about UHC buying them out. Rumors again!! I'm just going on my personal experiences with them and other than the dental and eye not having enough choices---I'm happy!

[VillagesFlorida]

Thanks for your response! We can always pull at next year "IF" things go 'south' with them. I went with them due to everyone I'd talked with, who had them, liked being with them. I said I'd try it for a year then re-evaluate! I would wonder who said this about UHC buying them out. Rumors again!! I'm just going on my personal experiences with them and other than the dental and eye not having enough choices---I'm happy!

Not a rumor that United Healthcare is buying Preferred Care Partners......apparently, the deal has not yet gone through.

UnitedHealthcare buys Preferred Care, Medica HMOs - Florida - MiamiHerald.com (http://www.miamiherald.com/2012/02/28/2665453/unitedhealthcare-buys-preferred.html)

http://www.bizjournals.com/southflorida/news/2012/02/28/unitedhealthcare-buying-preferred.html

We also have been happy with PCP, even though it has sometimes been difficult to find good doctors and dentists. I was hoping that more and more professionals would sign on with this insurance company, instead of some of the good ones pulling out as we are now seeing. Perhaps we will have the same provider choices that the folks on United Healthcare plans have, and we can only hope there are more than we have now with PCP.

[NotGolfer]

Not a rumor that United Healthcare is buying Preferred Care Partners......apparently, the deal has not yet gone through.

UnitedHealthcare buys Preferred Care, Medica HMOs - Florida - MiamiHerald.com (http://www.miamiherald.com/2012/02/28/2665453/unitedhealthcare-buys-preferred.html)

UnitedHealthcare buying Preferred Care Partners, Medica - South Florida Business Journal (http://www.bizjournals.com/southflorida/news/2012/02/28/unitedhealthcare-buying-preferred.html)

We also have been happy with PCP, even though it has sometimes been difficult to find good doctors and dentists. I was hoping that more and more professionals would sign on with this insurance company, instead of some of the good ones pulling out as we are now seeing. Perhaps we will have the same provider choices that the folks on United Healthcare plans have, and we can only hope there are more than we have now with PCP.

Amen to that...for sure!!! I mean hoping to get more doctors AND that we'd have more choices as well. Feel in some ways we're limited!

[Mimivillager]

Went to Mid Fla Eye today for a retina checkup(a followup patient from cataract surgery). Was told that PCP cancelled the office(not the other way around). Was also told that I could not be treated because I could not have followup. Was told that I must find a new eye dr who takes the ins to have the procedure which need on my retina.

[VillagesFlorida]

Went to Mid Fla Eye today for a retina checkup(a followup patient from cataract surgery). Was told that PCP cancelled the office(not the other way around). Was also told that I could not be treated because I could not have followup. Was told that I must find a new eye dr who takes the ins to have the procedure which need on my retina.

Don't hesitate to call PCP regarding a good specialist. I believe that Perich Eye, which is technically The Villages Eye Institute, has some very good ophthalmologists on staff. MY doctor is referring me to one there (I have diabetes (well-controlled) but she feels that the optometrist there did not give me a comprehensive enough exam. I DO believe that on PCP we must see an optometrist before we can go to a specialist.

[NotGolfer]

Don't hesitate to call PCP regarding a good specialist. I believe that Perich Eye, which is technically The Villages Eye Institute, has some very good ophthalmologists on staff. MY doctor is referring me to one there (I have diabetes (well-controlled) but she feels that the optometrist there did not give me a comprehensive enough exam. I DO believe that on PCP we must see an optometrist before we can go to a specialist.

You are correct re: needing a referral! I too have diabetes (type 2 and well-controlled) and have had to be monitored in the past for high pressure which is now in the "normal" range. Also have cataracts so we'll see when my appointment takes place what happens. I've never been to an optometrist, only opthamologists, so this should prove "interesting".

[VillagesFlorida]

You are correct re: needing a referral! I too have diabetes (type 2 and well-controlled) and have had to be monitored in the past for high pressure which is now in the "normal" range. Also have cataracts so we'll see when my appointment takes place what happens. I've never been to an optometrist, only opthamologists, so this should prove "interesting".

If the optometrist doesn't refer you on to the specialist you should ask your primary care doctor to do it. In fact, I am not sure if it is the optometrist who refers or if it HAS to be our primary care doc.?? MY doctor was calling The Villages Eye Institute to get the appointment in the works.

[NotGolfer]

If the optometrist doesn't refer you on to the specialist you should ask your primary care doctor to do it. In fact, I am not sure if it is the optometrist who refers or if it HAS to be our primary care doc.?? MY doctor was calling The Villages Eye Institute to get the appointment in the works.

I think it could be either! Maybe the primary would have a bit more clout!

[wendyquat]

I'm sorry but I'm a firm believer in " you get what you pay for". Medical care is a REAL challenge here in TV and I need to be armed with the best insurance I can afford!

[Mimivillager]

This should be interesting.He was already seeing the specialist and they stopped the ins to that office. I hope he does not have to start over with Primary care-then Optomotrist-then Ophthomologist! Oh dear!

[dog friendly]

anyone with PCP ever go to Walmart in summerfield? I understand they are in net
work

[VillagesFlorida]

anyone with PCP ever go to Walmart in summerfield? I understand they are in net
work

Yes, husband is picking up new lenses today.....will post as to how they work out.......PCP only covered about $55 of his progressive, polarized lenses.....no new frame since he loves his current sunglass frame.

[Mimivillager]

Yes, We were treated wonderfully there. Very happy with the service and the price.

[VillagesFlorida]

Husband's new lenses didn't work out today at Wal-mart.....something is wrong with the Rx.......they are going to remake them using his old prescription, which is just fine......I think I am going to call the optometrist's office to see if he can be examined again........I will say that doing new lenses was not a problem for Wal-mart, even though this most likely was not their fault.

[Mimivillager]

Walmart has a good optomotrist as well.

[gomoho]

Husband turning 65 in the next few months and is seriously considering PCP. He is in good health with no special needs at this point. How difficult is it to a)find a competent doctor and b)get an appointment. Will you stay with PCP when enrollment time comes?

[NotGolfer]

I came on to PCP at the 1st of this year....just a bit skeptical as I'd been happy with my former supplemental. I will attest that so far I'm very happy with PCP. My former primary is in network which makes me very happy. I've now been out to the eye clinic twice since my former posts. I was very happy with my care there. I have eye issues but nothing that needs to be addressed immediately. I was worked in for an emergancy issue that had developed and was warned I'd have to wait---so I brought my own reading material. Read but also had some good conversations with others in the waiting room. I think I will "re-up" when the new enrollment begins!!

[Avista]

I came on to PCP at the 1st of this year....just a bit skeptical as I'd been happy with my former supplemental. I will attest that so far I'm very happy with PCP. My former primary is in network which makes me very happy. I've now been out to the eye clinic twice since my former posts. I was very happy with my care there. I have eye issues but nothing that needs to be addressed immediately. I was worked in for an emergancy issue that had developed and was warned I'd have to wait---so I brought my own reading material. Read but also had some good conversations with others in the waiting room. I think I will "re-up" when the new enrollment begins!!

I had a similar experience. We are very pleased with our primary doctor. My husband just had surgery, and he was pleased with his surgeon. We also went to the Eye institute and felt we had good checkups. If everything continues to go well, we will sign up again next year.

[Mimivillager]

Husband turning 65 in the next few months and is seriously considering PCP. He is in good health with no special needs at this point. How difficult is it to a)find a competent doctor and b)get an appointment. Will you stay with PCP when enrollment time comes?

We will not stay with PCP in Jan. They keep dropping drs that we use,but we cannot drop them in the middle of the year. unfair. :mad:They dropped our wonderful eye dr and our great dentist. Had to go home to Pa to get a second opinion and get the necessary work done ($600 instead of $4,000.)Dr Fisher said 5 crowns were needed and Our Pa dentist said none were needed(only a few fillings).
We have been ok with medical dr though. Prescriptions are OK.
You could try them for 6 months if you want to and change if necessary in Jan if you don't care about dentist or eye dr.

[Avista]

We will not stay with PCP in Jan. They keep dropping drs that we use,but we cannot drop them in the middle of the year. unfair. :mad:They dropped our wonderful eye dr and our great dentist. Had to go home to Pa to get a second opinion and get the necessary work done ($600 instead of $4,000.)Dr Fisher said 5 crowns were needed and Our Pa dentist said none were needed(only a few fillings).
We have been ok with medical dr though. Prescriptions are OK.
You could try them for 6 months if you want to and change if necessary in Jan if you don't care about dentist or eye dr.

We don,t use PCP dentists as we have Delta Dental. Other docs,have worked out for us.

[franco]

Yes...but MFE is NO longer a part of Preferred Care Partners AS OF MARCH sometime! I'm not shouting just using this for emphasis! So the new question is....has anyone had experience with "The Villages Eye Institute". It's located across 441 from the WalMart...take a left turn I think, at the light past Billy's.

I made an appointment for the first visit and arrived 20 min. early. After waiting for well over and hour I questioned the long wait. "Well, we have elderly patients who may not know they have problems and that takes extra time" - That's YOUR problem - don't make it mine! Why not call me and tell me to arrive an hour and half later? No appology - nothing. Waited another 15 min and the patients before me still weren't called (same doctor) - I canceled my appt. and will NEVER go there again!! Plus, the bathroom was filthy - overfilled wastebasket with papers strewn all over the floor, empty toilet paper rolls under the holder. Tells you the quality of the place - stay away!!!!!

[Avista]

I am with Preferred Care Partners and have long standing Glaucoma. I called Mid Florida Eye to see how to get a referral. They said since I already had my diagnosis, I did. not need a referral. So, I made an appointment with Dr Panzo. I then called Preferred Care Partners at Sumter Landing. They said that was correct. No need for referral if you have an established diagnosis.

[NotGolfer]

This is good to know! It's refreshing to get a positive response re: a post on here.

We've been VERY happy with PCP so far.

[Avista]

This is good to know! It's refreshing to get a positive response re: a post on here.

We've been VERY happy with PCP so far.
Thanks. We also are very pleased with PCP. Husband had hernia surgery last year. Wonderful surgeon and wonderful recovery.

[franco]

Yes...but MFE is NO longer a part of Preferred Care Partners AS OF MARCH sometime! I'm not shouting just using this for emphasis! So the new question is....has anyone had experience with "The Villages Eye Institute". It's located across 441 from the WalMart...take a left turn I think, at the light past Billy's.

Don't go there unless you don't mind waiting for hours and don't mind using filthy bathrooms!!!

[jimmy D]

bump

Lets talk a minute, Mid-Florida eye has opthalmologist and you need a referral from an Optomtrist. This is in your Book of Benefits. PCP is a good choice, but it is a HMO and will have some rules. If you signed up on the phone, they are your agent. If you signed up thru an Agent they should help you. You will not be able to change on a whim, it may take awhile. good luck and read the book

[Avista]

Lets talk a minute, Mid-Florida eye has opthalmologist and you need a referral from an Optomtrist. This is in your Book of Benefits. I am an Agent and PCP is a good choice, but it is a HMO and will have some rules. If you signed up on the phone, they are your agent. If you signed up thru an Agent they should help you. You will not be able to change on a whim, it may take awhile. good luck and read the book

If you are on PCP and have an eye diagnosis as glaucoma, you do not need a referral at Mid Florida eye opthomologists.. Check with folks at Śumter landing

[franco]

Yes...but MFE is NO longer a part of Preferred Care Partners AS OF MARCH sometime! I'm not shouting just using this for emphasis! So the new question is....has anyone had experience with "The Villages Eye Institute". It's located across 441 from the WalMart...take a left turn I think, at the light past Billy's.

If you don't mind waiting hours to get called (no apology) and filthy bathrooms, this is the place for you!

[NotGolfer]

If you don't mind waiting hours to get called (no apology) and filthy bathrooms, this is the place for you!

I used Ocala Eye before we signed with PCP...there too you will wait and wait and wait...long hours. The PCP optometrist also makes you wait. It's just the way things work I guess. Take a book and relax!! We're retired!! :smiley:

[jimmy D]

I. too am an Independant Agent since 1981 and most everyone on this post is wrong, or is not telling the full story. You can go back to Med Supp etc, etc, etc. Drs get paid quicker with med sup and it is the cadillace at the moment. You should talk to someone who knows and who does not guess. Find an agent who in business year around and not just 3 months in the fall

[Barbara Meissner]

Yes, I am having the same problem, and preferred care is telling me "try to take care of the problem yourself". I have visited Mid Florida eye, and The Eye Institute, and I am getting more confused by the day.

[jimmy D]

Thank you Wendyquat.....Your comments are appreciated. We all have to be our own advocates with the medical profession. This was the case before moving here (at least for me) so I haven't minded it, really! Though I already had established myself with providers and now have to change over to new ones again. The savings will be worth it probably! IF for some reason I don't like it I'll change to something different for 2013. With your heart issues I can see why you wanted to stay with your present situation. Dr. Elmalleh has been my eye doctor as well and I think he's very good!! Unfortunately Ocala Eye isn't a part of PCP and won't be....I checked!!! I'd have preferred to remain there, truth be told.

Just a short note. I did not here you say you talked to your agent or did you sign up on the internet., Some of this confusion is not reading the info correctly a HMO is not for everyone. Most doctors do not like them because they can not just bill bill bill but must be a Primary Physician. Sooooo here goes Call your agent and I am sure they will and can help you.

[happy1]

I signed up for PCP for the coming new year. Today I learned something I didn't know before. Went out to Mid-Florida Eye as I wanted to make a future app't. Was asked if I live in Lake County (I don't) so then was told that they ONLY take patients from Lake County....and I believe they're located in Marion Cnty. Isn't this strange?? I thought that as long as the practices were "in network" one could choose from anyone within it! I should calle the PCP 800# and ask what gives. Has anyone else run into this issue??

Call Advantica 1-877-488-5131 and asked to be assigned there. It is something new...being assigned to eye provider based on zip codes

[NotGolfer]

This thread is about a year and a half old. I'd say "some" of the information is no longer true so why keep it going?? I know for a fact JenAjd did not sign up over the phone, but with the Preferred Partners folks at their office, as did we---just to clarify.