AARP United Health Care Insurance

[dp000]

Just received a letter from AARP Medicare Complete by United Health Care that my primary physician will no longer be part of my plan. No reason just that I can't use my doctor as my primary physician. The they assigned me a new doctor to use. This doctor is with The Village Health Care System.
I contacted my doctor to find out what is going on with UHC. She told me that her medical group had nothing to do with this decision that United Health Care is dropping a lot of physician that are not with The Villages Health Care System. She states their is nothing they can do.
My doctor was all right all the time I had AARP Medicare Complete by UHC, but since The Villages Health Care System and UHC got into bed with each other they are dropping doctors that are not with The Villages.
My physician says that most doctors practicing in The Villages have signed a non compete clause and couldn't go with The Villages Health Care if they wanted or they would lose there patients for two years.
I don't know about the rest of you but I don't like an insurance company and The Villages telling me who my doctor is or will be.
I think The Villages Health Care System is good and should recruit new patients through good medicine not this way.

[ilovetv]

Just received a letter from AARP Medicare Complete by United Health Care that my primary physician will no longer be part of my plan. No reason just that I can't use my doctor as my primary physician. The they assigned me a new doctor to use. This doctor is with The Village Health Care System.
I contacted my doctor to find out what is going on with UHC. She told me that her medical group had nothing to do with this decision that United Health Care is dropping a lot of physician that are not with The Villages Health Care System. She states their is nothing they can do.
My doctor was all right all the time I had AARP Medicare Complete by UHC, but since The Villages Health Care System and UHC got into bed with each other they are dropping doctors that are not with The Villages.
My physician says that most doctors practicing in The Villages have signed a non compete clause and couldn't go with The Villages Health Care if they wanted or they would lose there patients for two years.
I don't know about the rest of you but I don't like an insurance company and The Villages telling me who my doctor is or will be.
I think The Villages Health Care System is good and should recruit new patients through good medicine not this way.

Why is AARP not advocating for you and other patients who pay them dues?

[dp000]

AARP monies mostly comes from insurance companies.

[ilovetv]

AARP monies mostly comes from insurance companies.

"AARP operates as a non-profit advocate for its members and as one of the most powerful lobbying groups in the United States. AARP has two affiliated organizations: AARP Services Inc. which is managed wholly for profit, and the AARP Foundation, a charity that operates on a non-profit basis.

AARP Services Inc. offers: Medicare supplemental health insurance, discounts on prescription drugs and consumer goods, entertainment and travel packages, long-term care insurance and automobile, home and life insurance. It provides quality control over the products and services made available by AARP-endorsed providers.

According to AARP's 2008 Consolidated financials, it was paid $652,000,000 in royalties from insurance companies that sold products referred by AARP. AARP also received an additional $120,000,000 for the ads placed in its publications.[3]
The AARP Foundation's website says the nonprofit "wants to win back opportunity for those now in crisis, so thousands of vulnerable low-income Americans 50+ can regain their foothold, continue to serve as anchors for their families and communities and ensure that their best life is still within reach." Key areas of focus are hunger, income, housing and isolation. The Foundation's vision is "a country that is free of poverty where no older person feels vulnerable."......

....AARP does a "thriving business" in marketing branded Medigap policies. As of October 2009, Medical care reform contained a proposal to trim an associated program Medicare Advantage, which was expected to increase demand for Medigap policies. However, as cited above, AARP also brands a Medicare Advantage plan (MedicareComplete), and would also be subject to cuts under health care reform.....

AARP - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/AARP)

[Floridagal]

Could you please give me the name of the doctor that you used. I am also on the same plan as you and so far I have not received a letter. I really do not want to change doctors, so I may have to look elsewhere.

[gerryann]

I'm also with AARP United Health preferred care. I haven't received a letter regarding my primary, but 2 weeks ago I received a letter regarding four other providers that I had used recently. Three of them are affiliated with a dermatology office and one a surgeon. All three are doctors practicing here in TV.....am wondering if my PCP is going to leave as well.....not good....

[Indydealmaker]

Just received a letter from AARP Medicare Complete by United Health Care that my primary physician will no longer be part of my plan. No reason just that I can't use my doctor as my primary physician. The they assigned me a new doctor to use. This doctor is with The Village Health Care System.
I contacted my doctor to find out what is going on with UHC. She told me that her medical group had nothing to do with this decision that United Health Care is dropping a lot of physician that are not with The Villages Health Care System. She states their is nothing they can do.
My doctor was all right all the time I had AARP Medicare Complete by UHC, but since The Villages Health Care System and UHC got into bed with each other they are dropping doctors that are not with The Villages.
My physician says that most doctors practicing in The Villages have signed a non compete clause and couldn't go with The Villages Health Care if they wanted or they would lose there patients for two years.
I don't know about the rest of you but I don't like an insurance company and The Villages telling me who my doctor is or will be.
I think The Villages Health Care System is good and should recruit new patients through good medicine not this way.

This arrogant treatment is to be expected. AARP used their considerable clout to advocate for Obamacare even though they had absolutely no idea what was contained in the legislation. And surprise, surprise, AARP as an insurance company are one of the few benefitting from this colossal redistribution of wealth.

[dp000]

The plan that is effected is AARP Medicare Complete. I just talked with my doctors office, and all their doctors in The Villages have been dropped. My doctors group is Institute of Cardiovascular Excellence and the only doctors effected are the ones that practice in The Villages.

[gomoho]

This has nothing to do with AARP and everything to do with United Health Care and The Villages Health directing the way they want you to choose your health care.

[janmcn]

This has nothing to do with AARP and everything to do with United Health Care and The Villages Health directing the way they want you to choose your health care.


Has anyone heard an explanation from The Villages Health about why they are only accepting United Health Care? It seems like they shouldn't care who pays the bill, BC/BS or whoever, as long as the bills get paid.

[rubicon]

This arrogant treatment is to be expected. AARP used their considerable clout to advocate for Obamacare even though they had absolutely no idea what was contained in the legislation. And surprise, surprise, AARP as an insurance company are one of the few benefitting from this colossal redistribution of wealth.

Indydealmaker: You are spot on. I immediately dropped my membership when I recognized that AARP was claiming low cost insurance. Anyone who understand distribution would realize that by inserting themselves in this process all they did was add their costs to premiums. They campaigned for Affordable Care Act because they wanted to push medicare Advantage aside and insert themselves....which as you explain they did.

I am left with the impression that AARP only cares bout AARP and so they are less than honest to advertise otherwise.

I am pleased that after living here for one year I recognized the need and benefit to me to utilize the Munroe system

[Yorio]

I couldn't help answering this post also. I went to see the UnitedHealth Retail Shop and met with an adviser. There is such a thing as AARP Medicare Supplement insured by United Health. In this case, I am told United Health just bought the brand name and apparently The Villages Health System will accept if you use their primary care physicians. If you have question, am told to,check with SHINE. The situation is getting more complicated and am still learning.

[firebiker]

I just read an article about thousands of doctors in Connecticut getting termination letters from United Healthcare (both primary care and specialty doctors) due to changes in the healthcare laws. I'm only making an assumption, but I think that may be what is happening here.

WTNH - Thousands of doctors fired by United HealthCare | WTNH.com Connecticut (http://www.wtnh.com/news/health/thousands-of-doctors-fired-by-united-healthcare)

[ilovetv]

And people wonder why it's hard to find a good dr. here.

Most drs. are driven crazy (and into insolvency in private practice) by insurance companies' clerks at a computer, reading a script on screen and telling the dr. what he can and cannot do for a patient.

So now this insurance company, the largest in the USA, gets even bigger and more powerful!!

No wonder drs. around the country are deciding to not accept private insurance, Medicare nor Medicaid, and only CASH which allows them to cut their fees in half and they can actually treat the patient for less or for free with the poorest (but Medicare doesn't let them).

Read about the United Healthcare CEO's......

"...McGuire's exit compensation from UnitedHealth, expected to be around $1.1 billion, would be the largest golden parachute in the history of corporate America......"
UnitedHealth Group - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/United_healthcare)

[ilovetv]

AARP Plans Drop Cancer Center

By HEALTH NEWS FLORIDA STAFF

H. Lee Moffitt Cancer Center says that treatment there will no longer be covered as in-network care by AARP Medicare plans as of Jan. 1. After that date, members of Evercare, Secure Horizons and AARP Medicare Complete will have to pay at a higher out-of-network rate, according to a letter published in the Tampa Tribune by Dr. Alan List, Moffitt's CEO and president.

List is urging AARP customers to switch plans during open-enrollment, which begins Oct. 15. AARP's insurance partner for Medicare plans is UnitedHealthcare.

In other business news, Humana, which captured a huge market share by selling its Medicare drug plan in Walmart, now wants to try the same thing with the Affordable Care Act.......

AARP Plans Drop Cancer Center | Health News Florida (http://health.wusf.usf.edu/post/aarp-plans-drop-cancer-center)

[wendyquat]

And who was it that said the ACA would not affect people on Medicare? Balderdash!

[LndLocked]

get a grip people. just a few postings back it was all about how AARP / UHC were forcing people to use Villages Health Care .... now the ACA boogieman is to blame

insurance companies have changed who is in their provider networks ever since the advent of the system. several years ago my mothers plan F through Humana dropped both the tv & leesburg hospitals off their list. i moved her to another provider that does ... no big deal.

if your provider has dropped your dr and you want to stay with them ... ask your dr's billing dept for a list of insurance providers that accept them.

[gustavo]

get a grip people. just a few postings back it was all about how AARP / UHC were forcing people to use Villages Health Care .... now the ACA boogieman is to blame

insurance companies have changed who is in their provider networks ever since the advent of the system. several years ago my mothers plan F through Humana dropped both the tv & leesburg hospitals off their list. i moved her to another provider that does ... no big deal.

if your provider has dropped your dr and you want to stay with them ... ask your dr's billing dept for a list of insurance providers that accept them.

What he said, get a new carrier, no big deal, it's like changing cable companies for a free season of NFL ticket.

[OCsun]

get a grip people. just a few postings back it was all about how AARP / UHC were forcing people to use Villages Health Care .... now the ACA boogieman is to blame

insurance companies have changed who is in their provider networks ever since the advent of the system. several years ago my mothers plan F through Humana dropped both the tv & leesburg hospitals off their list. i moved her to another provider that does ... no big deal.

if your provider has dropped your dr and you want to stay with them ... ask your dr's billing dept for a list of insurance providers that accept them.

This statement is fact! I worked for one of the largest national health insurance carriers for 30 years. When providers did not want to accept our billing rules and fees, we dropped them. It did not mean the members could not continue receiving care by these doctors ..... It simply meant they would be considered as out of network providers and members would need to share the costs through deductibles or co-insurance. It was business that's all - nobody even heard of Obama Care back then. Cutting costs by using providers and facilities who accept our discounted rates helped keep out rates down. That's the real meaning of managed care.

[Indydealmaker]

What he said, get a new carrier, no big deal, it's like changing cable companies for a free season of NFL ticket.

You could be right. It is probably not a big deal IF you can duplicate the coverage that you are forced to walk away from if you want to keep your current doctors.

[gomoho]

This statement is fact! I worked for one of the largest national health insurance carriers for 30 years. When providers did not want to accept our billing rules and fees, we dropped them. It did not mean the members could not continue receiving care by these doctors ..... It simply meant they would be considered as out of network providers and members would need to share the costs through deductibles or co-insurance. It was business that's all - nobody even heard of Obama Care back then. Cutting costs by using providers and facilities who accept our discounted rates helped keep out rates down. That's the real meaning of managed care.


Talk to some of the doctors that have been dropped. They are desperately trying to negotiate their way back into United Health Care - too much of their business is tied up with patients that have this insurance. They feel it is a push for people to go the The Villages Health Care - lot of money tied up in those centers and somebody has to pay for that.

[OCsun]

It's like any other kind of business, you get what you pay for. If the doctors you are comfortable with accept one of the Advantage Health Care Plans being offered at no additional premium to you - great! All things are good. The theory insurer's use is to guide you to capable doctors who they either hire through their health networks or who are not associated with the more expensive teaching hospitals such as Johns Hopkins or in this case it sounds like The Moffitt Cancer Center.
There are options for people who want to choose, when, where and who provides their health care, but they will cost more.
Sometimes even the most comprehensive coverages are not accepted by all doctors. Doctors are businessmen too! If they can bring in patients who are willing to pay them at the time of care , requiring their patients wait to be reimbursed at a lower rate by their health carrier, they do.
Each person must examine their own medical needs with consideration to the medical expenses they can afford to incur. If you decide to go with a plan which appears to provide the medical care you need, but provides an option to opt out to non-participating providers, do yourself a favor and put aside a monthly amount for one year to use in the case that you want to go to a dotor not associated with your plan. Only we can plan for the medical care we may need. Hope this information is helpful to some of you facing health care issues.

[eweissenbach]

Lots of misinformation about healthcare and the AHCA out there right now. If the primary source of your "news" has a right wing slant, such as Fox News or a left wing slant, such as MSNBC, you may be led down a very misleading path. There is both good and bad about the new law, and presumably the bad will be amended as the facts are known, just like any massive legislation which changes the status quo. The AARP has no control over the issue brought up by the OP, as it simply endorses and brands the product sold and administered by United Healthcare. I have had the UHC/AARP plan F for three years and found it to be stellar for my needs.

[Villages Kahuna]

...And surprise, surprise, AARP as an insurance company are one of the few benefitting from this colossal redistribution of wealth.AARP is not an insurance company. AARP health insurance is provided by United Healthcare. AARP is little more than an agent for United Healthcare. If there's a "redistribution of wealth" going on, the money is going into the coffers of companies like Unirted Healthcare.

[ilovetv]

"Little more than an agent"????????

Here is an interesting look at AARP's Non-Profit 501(c)(4) Status:

Full AARP Organizational Chart is here:

http://waysandmeans.house.gov/uploadedfiles/aarp_charts.pdf

https://www.talkofthevillages.com/forums/attachment.php?attachmentid=23062&stc=1&d=1381941127

https://www.talkofthevillages.com/forums/attachment.php?attachmentid=23063&stc=1&d=1381941365

[John95019]

This has nothing to do with AARP and everything to do with United Health Care and The Villages Health directing the way they want you to choose your health care.

Totally agree.

[jflynn1]

The plan that is effected is AARP Medicare Complete. I just talked with my doctors office, and all their doctors in The Villages have been dropped. My doctors group is Institute of Cardiovascular Excellence and the only doctors effected are the ones that practice in The Villages.
Have medicare Complete not all Drs being dropped however if what this writer states is true then this is very scary. This has nothing to do with The affordable Care Act.aka OBAMACARE

[OCsun]

AARP is a branded name of the Medicare Supplemental Plan which is part of UnitedHealthcare, which just goes to show how big UnitedHealthcare has gotten since they entered into their endorsement relationship with AARP.

UnitedHealthcare Insurance Company pays royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and it's affiliates are not insurers, nor do they employ or endorse agents or brokers to sell insurance.

This disclaimer is listed in every informational marketing pamphlet produced for the purpose of selling the AARP Medicare Supplemental Plans.

UnitedHealthcare has taken on the financial risk and will reap the profits, if any from the plans success. AARP gets a royalty fee for using their name. Plan and simple.

[jflynn1]

This arrogant treatment is to be expected. AARP used their considerable clout to advocate for Obamacare even though they had absolutely no idea what was contained in the legislation. And surprise, surprise, AARP as an insurance company are one of the few benefitting from this colossal redistribution of wealth.

This has nothing to do with The Affordable care Act (OBAMACARE) and everything to do do with who owns the Villages Health System. That being The Villages Develoment and USF.

[Indydealmaker]

This has nothing to do with The Affordable care Act (OBAMACARE) and everything to do do with who owns the Villages Health System. That being The Villages Develoment and USF.

Just be patient. Time will reveal all. This is all part of the consolidation of healthcare in the U.S. Hospital closures and/or mergers are up dramatically. Insurers all over the country are dropping doctors and hospitals. They are trying to optimize profits in the face of the ACA. I think you will find that health caregivers are being extorted as the result of their pushback against the new law. "If you are at the top of your field, you either work with us or you limit your practice to cash customers."

If you can't tell, I am against the implementation of the ACA. It is only a good thing as a concept. In its implementation stage, it is a huge minefield that is only going to result in fewer middle class families finding affordable insurance while taxes escalate to pay for insurance for non-taxpayers. Not to mention that all people will struggle to extract quality healthcare from a healthcare system mired in red tape and bureaucratic impotency.

I say all of the above in spite of the fact that I am a 63-year old person with pre-existings who had to drop my insurance when my monthly premiums topped $3000.

[Bucco]

Just be patient. Time will reveal all. This is all part of the consolidation of healthcare in the U.S. Hospital closures and/or mergers are up dramatically. Insurers all over the country are dropping doctors and hospitals. They are trying to optimize profits in the face of the ACA. I think you will find that health caregivers are being extorted as the result of their pushback against the new law. "If you are at the top of your field, you either work with us or you limit your practice to cash customers."

If you can't tell, I am against the implementation of the ACA. It is only a good thing as a concept. In its implementation stage, it is a huge minefield that is only going to result in fewer middle class families finding affordable insurance while taxes escalate to pay for insurance for non-taxpayers. Not to mention that all people will struggle to extract quality healthcare from a healthcare system mired in red tape and bureaucratic impotency.

I say all of the above in spite of the fact that I am a 63-year old person with pre-existings who had to drop my insurance when my monthly premiums topped $3000.

Knock on wood...I have no personal experience with any major healthcare at this point.

I do agree with your sentence explaining your objection to the new bill, plus the cost has already risen through the roof without the lowering of health costs, which was supposed to be the objective.

My main thing is to ask you.....since you have a tangible experience with it.....what has the new availability to insurance done for you...as that is something good about the bill, and what will it do to your insurance costs ?

Thanks for any response.

[Indydealmaker]

Knock on wood...I have no personal experience with any major healthcare at this point.

I do agree with your sentence explaining your objection to the new bill, plus the cost has already risen through the roof without the lowering of health costs, which was supposed to be the objective.

My main thing is to ask you.....since you have a tangible experience with it.....what has the new availability to insurance done for you...as that is something good about the bill, and what will it do to your insurance costs ?

Thanks for any response.

Actually, there is no current change at all, of course, because insurance companies do not have to take pre-existings until January 1, 2014. I have been offered coverage by Florida Blue for a monthly premium of around $600, and an annual deductible of over $6000 with no services (office visits, labs, etc.) provided before the deductible is satisfied. Not great but better than nothing. The sole saving grace is that I only need this coverage for a couple of years because I expect that the cost of this will be nearly $1000 per month within two years.

[Bucco]

Actually, there is no current change at all, of course, because insurance companies do not have to take pre-existings until January 1, 2014. I have been offered coverage by Florida Blue for a monthly premium of around $600, and an annual deductible of over $6000 with no services (office visits, labs, etc.) provided before the deductible is satisfied. Not great but better than nothing. The sole saving grace is that I only need this coverage for a couple of years because I expect that the cost of this will be nearly $1000 per month within two years.

Thanks for your response.

In the spirit of the boards wishes for no current affairs or politics, I will leave it at thanks for responding.

[gomoho]

I think we are very interested to see if you have priced coverage effective 1/1/14 for Obamacare and what your findings were.

[Villages Kahuna]

Several years ago the developer commissioned a thorough study of healthcare here, conducted by a nationally-recognized healthcare consulting firm. After several months of study they arrived at a number of conclusions and recommendations. Fundamental to many was the absence of an adequate number of well-trained, board certified, experienced primary care physicians. Many relocated here prior to the construction of The Villages Hospital. Many had well-documented shortcomings in either training or experience before they relocated here. Many have not improved. The results are measurables which were used to assess the quality of healthcare here.

Several years followed wherein a significant recruiting effort by TVRH, but had only minimal success. The outside consultants concluded and recommended that an essentially new model of primary healthcare be created in TV with the objective of displacing many or most of the less desirable primary care doctors. With the assistance of both the consultants and USF, the structure of Villages Health was created.

Villages Health was launched two years ago with objective of hiring 64 new primary care physicians and the necessary nursing and support staff to man eight new neighborhood doctor's offices. The Developer agreed to finance this new healthcare system.

The model for Villages Health is intended to be patient-centric, with significant measurement and monitoring of the quality of the health of resident-patients. The doctors will be salaried employees and not dependent on the significant, impersonal throughput of Medicare patients to make a living. The vast majority of the doctors employed by Villages Health will be educated in U.S. medical schools, completed their residencies in U.S. hospitals and will all be board certified. Their commitment to the concept of Villages Health will be thoroughly vetted before they are hired. Their performance will be monitored. It is expected that Villages Health be counted among the very best primary care providers, including The Mayo Clinic, The Cleveland Clinic, and others.

The program is proceeding with amazing success. By next spring, six new offices will be opened. Already 25 doctors have been hired. A few have already reached their maximum size patient panel of 1,250 patients. Villages Health appears to be a roaring success so far.

Are less competent, less committed doctors feeling the pinch of the new competition? I'm quite sure they are. But remember, that was the objective from the outset--to improve the overall quality of primary healthcare in TV.

It seems to me that the Developer and United Healthcare, partners in the program, should be roundly complimented for their commitment to improving our healthcare and our health.

Is Villages Health a not-for-profit? No. But it is a well-designed model embracing significant changes for the delivery of primary care here. If the owners of Villages Health can profit from their investment, I say good for them. If our healthcare and health is improved as the result of their investments and commitment, they have every right to enjoy a profit. And if some less qualified, less committed physicians are driven out of business as the result, I guess I struggle seeing how that is bad for The Villages. And I certainly don't understand why those trying to improve healthcare for our benefit should be criticized.

And by the way, the financial incentives available to providers such as Villages Health who are successful in improving a series of metrics measuring both the cost of healthcare and the health if the patients was created as part of The Affordable Care Act (ObamaCare).

[ilovetv]

Referring to VK's post title, "You may be criticizing Villages Health inappropriately"......

I don't think many people on here are criticizing TV Health system, but rather the promise "you'll be able to keep your doctor and insurance if you like them"; the obvious promise that the Affordable Healthcare Act will be "affordable"; and the biggest criticism is about the power and the increased market share United Healthcare has been allowed to take by way of the new law.

[Bucco]

Referring to VK's post title, "You may be criticizing Villages Health inappropriately"......

I don't think many people on here are criticizing TV Health system, but rather the promise "you'll be able to keep your doctor and insurance if you like them"; the obvious promise that the Affordable Healthcare Act will be "affordable"; and the biggest criticism is about the power and the increased market share United Healthcare has been allowed to take by way of the new law.

It has only just begun

[Bucco]

Several years ago the developer commissioned a thorough study of healthcare here, conducted by a nationally-recognized healthcare consulting firm. After several months of study they arrived at a number of conclusions and recommendations. Fundamental to many was the absence of an adequate number of well-trained, board certified, experienced primary care physicians. Many relocated here prior to the construction of The Villages Hospital. Many had well-documented shortcomings in either training or experience before they relocated here. Many have not improved. The results are measurables which were used to assess the quality of healthcare here.

Several years followed wherein a significant recruiting effort by TVRH, but had only minimal success. The outside consultants concluded and recommended that an essentially new model of primary healthcare be created in TV with the objective of displacing many or most of the less desirable primary care doctors. With the assistance of both the consultants and USF, the structure of Villages Health was created.

Villages Health was launched two years ago with objective of hiring 64 new primary care physicians and the necessary nursing and support staff to man eight new neighborhood doctor's offices. The Developer agreed to finance this new healthcare system.

The model for Villages Health is intended to be patient-centric, with significant measurement and monitoring of the quality of the health of resident-patients. The doctors will be salaried employees and not dependent on the significant, impersonal throughput of Medicare patients to make a living. The vast majority of the doctors employed by Villages Health will be educated in U.S. medical schools, completed their residencies in U.S. hospitals and will all be board certified. Their commitment to the concept of Villages Health will be thoroughly vetted before they are hired. Their performance will be monitored. It is expected that Villages Health be counted among the very best primary care providers, including The Mayo Clinic, The Cleveland Clinic, and others.

The program is proceeding with amazing success. By next spring, six new offices will be opened. Already 25 doctors have been hired. A few have already reached their maximum size patient panel of 1,250 patients. Villages Health appears to be a roaring success so far.

Are less competent, less committed doctors feeling the pinch of the new competition? I'm quite sure they are. But remember, that was the objective from the outset--to improve the overall quality of primary healthcare in TV.

It seems to me that the Developer and United Healthcare, partners in the program, should be roundly complimented for their commitment to improving our healthcare and our health.

Is Villages Health a not-for-profit? No. But it is a well-designed model embracing significant changes for the delivery of primary care here. If the owners of Villages Health can profit from their investment, I say good for them. If our healthcare and health is improved as the result of their investments and commitment, they have every right to enjoy a profit. And if some less qualified, less committed physicians are driven out of business as the result, I guess I struggle seeing how that is bad for The Villages. And I certainly don't understand why those trying to improve healthcare for our benefit should be criticized.

And by the way, the financial incentives available to providers such as Villages Health who are successful in improving a series of metrics measuring both the cost of healthcare and the health if the patients was created as part of The Affordable Care Act (ObamaCare).

If I were allowed VK, I would say I would buy one of those bumper stickers, but since I cannot make that comment, I won't

[Hancle704]

Reading VK's post I was reminded of an earlier post about total number of patients that could ultimately be served by TV Healthcare. 64 PCP X 1250 patients each=80,000. If you exclude seasonal residents that may have physicians back home, that does not leave many patients for the doctors that have been here practicing in some case for over 10 years. Many of them are still paying rent to the developer or mortgages to the banks for the buildings/offices they occupy. I think we may see some leaving the area or retiring earlier than planned. This reminds me of the statement, "if you like the doctors you have, you will be able to keep them". Maybe not.

[jamarcus]

First, I received the booklet from AARP United with the changes in benefits for 2014. I was not happy to see that the copay for the specialists had increased, the silver sneakers program had been discontinued and, perhaps more importantly, the copay for out patient surgery goes from $250 to 20% of the costs; this one could be expensive. A day or so later I receive a letter stating that a specialist that I use had been removed from the provider list and I need to find a replacement. This is, in my opinion, a brazen attempt by United to force its members to utilize The Villages Health Care System. In fact, I do currently use the system and I am happy with my primary care physician. However, my specialist is far more important to the quality of my health than the primary physician I am using. To that end, I investigated Humana PPO and found that it is far superior to United Heath. The only disadvantage they have is that they have a $10 copay for the primary physician. However, they have a lower specialist copay, they have silver sneakers, a dental benefit, a vision benefit and a $250 flat copay for outpatient surgery. To me the decision was easy...I switched today to Humana and will find a new primary. This is my only form of protest and I took it.

[gomoho]

Kahuna - I embraced and was excited about Villages Health Care from the beginning; however, am bothered by reports that after your initial visit you are seen by a PA rather than your primary - how does this establish the rapport they were talking about?

[doran]

Just received a letter from AARP Medicare Complete by United Health Care that my primary physician will no longer be part of my plan. No reason just that I can't use my doctor as my primary physician. The they assigned me a new doctor to use. This doctor is with The Village Health Care System.
I contacted my doctor to find out what is going on with UHC. She told me that her medical group had nothing to do with this decision that United Health Care is dropping a lot of physician that are not with The Villages Health Care System. She states their is nothing they can do.
My doctor was all right all the time I had AARP Medicare Complete by UHC, but since The Villages Health Care System and UHC got into bed with each other they are dropping doctors that are not with The Villages.
My physician says that most doctors practicing in The Villages have signed a non compete clause and couldn't go with The Villages Health Care if they wanted or they would lose there patients for two years.
I don't know about the rest of you but I don't like an insurance company and The Villages telling me who my doctor is or will be.
I think The Villages Health Care System is good and should recruit new patients through good medicine not this way.

My Suggestion--get a new health care plan!!!!!!!!!

[gerryann]

First, I received the booklet from AARP United with the changes in benefits for 2014. I was not happy to see that the copay for the specialists had increased, the silver sneakers program had been discontinued and, perhaps more importantly, the copay for out patient surgery goes from $250 to 20% of the costs; this one could be expensive. A day or so later I receive a letter stating that a specialist that I use had been removed from the provider list and I need to find a replacement. This is, in my opinion, a brazen attempt by United to force its members to utilize The Villages Health Care System. In fact, I do currently use the system and I am happy with my primary care physician. However, my specialist is far more important to the quality of my health than the primary physician I am using. To that end, I investigated Humana PPO and found that it is far superior to United Heath. The only disadvantage they have is that they have a $10 copay for the primary physician. However, they have a lower specialist copay, they have silver sneakers, a dental benefit, a vision benefit and a $250 flat copay for outpatient surgery. To me the decision was easy...I switched today to Humana and will find a new primary. This is my only form of protest and I took it.

Re check the new rates for 2014. UHC will also be charging $10 for your PCP.

[trichard]

One of the biggest complaint of villagers over the past few years was about the quality of health care in the community. The Villages heard your concerns and has taken steps to address the matter. Like it or not, The Villages Health in an alliance with USF is the most effective and expediant way to do something about the quality of care. If you like your physician who is not part of United Healthcare you have the right to change Medicare Advantage plans during the annual election period which is underway right not. However, many physicians do not accept any Medicare Advantage plans or not candidates for participating in a plan for quality or business reasons.

[mixsonci]

This may sound like a strange question, but what exactly is AARP? I will be 65 in a year's time and will retire. I work for the US Government and will keep their health insurance plus possibly I will also get Medicare, do I still need/want AARP? Do you use them for anything else? How much do they cost? Thank you.

[OCsun]

This may sound like a strange question, but what exactly is AARP? I will be 65 in a year's time and will retire. I work for the US Government and will keep their health insurance plus possibly I will also get Medicare, do I still need/want AARP? Do you use them for anything else? How much do they cost? Thank you.

AARP is a nonprofit, nonpartisan organization that helps people 50 and older improve the quality of their lives. They have allowed UnitedHealthcare to attach their name to one of their health care plans, in exchange for a royalty fee.

The plan referred to within this thread, is a Medicare Supplemental Plan, insured through UnitedHealthcare. No, you do not need this plan if you are currently covered by a Federal Employee Health Care Plan (FEHP). The same holds true for many people who have health care benefits through a large employer plan.

Some of the plans offered as part of the FEHP, do not require you to enroll in Medicare Part B. The advantage to applying for Medicare in addition to paying the premium for your current FEHP, is the combination of both plans will cover most if not all of your medical care bills.

It is very important to review how your current health care benefits work with and without Medicare, once you become eligible for Medicare. I hope this helps to answer your question.

[jebartle]

Villages Kahuna you have a way of clearing the "muddy water"....Thank you

[mulligan]

AARP may be non profit, but if you dig deeply, you will find that they are owned by Hartford Insurance Group.

[Parker]

I happen to have just called The Villages Health clinic today. The told me they take all major insurance companies except Aetna, and they take many smaller ones. Got it from the horse's mouth.

[2BNTV]

AARP is American Association for Retired People.

[NotGolfer]

In chatting with folks here and there, I've heard that other physicians are dropping certain insurances---so it's not just insurance companies dropping physicians. So folks still have to scramble to find the package that will work for them. I think that advantage plans such as we experienced with Preferred Care Partners are now a thing of the past. Yes, there is Freedom...but they have a limited list of doctors in their network. Healthcare in this country is changing, in case you're reading or listening to the news these days. Wait until 2014, I think we all will be shaking our heads and wishing for the "good old days:!!

[blueash]

Medicare managed care programs are paid a fixed amount by the Federal Government per month per enrollee and the insurance company then assumes the risk that the enrollee cost them more than their reimbursement. Obviously if you are an insurance company you would love to get the payment from the government based on the usual cost of a Medicare enrollee and figure out a way to only enroll healthy seniors. The 2012 rate was about $825 per month per enrollee. Thus if you cost the insurance company less than $825/mo they make money. Now your cost is not just the amount they pay the doctors and others but also their overhead and of course their profit.

So find your company a bunch of healthy seniors and put them into a network that is an HMO so they have little or no out of network benefits. Try to keep them healthy as it lowers your overall cost. Bingo big profits. Well, here in America's healthiest hometown we have a self selected population of seniors who are active. If you are chronically ill at retirement age you didn't likely move here. If you live here and develop a severe expensive illness it is even likely you may move away, back home to be nearer family and perhaps where you have a higher intensity hospital and specialty services available and you will change to a different Medicare plan as this one won't cover you there.

Thus you also have removed those expensive sick people from your enrollee panel as they leave the area. Wow, even more profits. Brilliant. Get the payment for a usual panel of Medicare patients and only have to provide services to a panel that is much healthier than average. I applaud UHC and whomever their partners in this venture might be for a clever plan. Then of course don't forget to advertise it like crazy to the potential enrollee. In no way do I want anyone to take from this any opinion of the quality of care that may be provided. They are still hiring doctors, and NP's, and PA's. I would encourage looking for the most highly trained providers all other factors being equal. Someone with a geriatrics fellowship would be great for a senior patient. An internist has much more residency training in adult medicine than a family physician. Look for board certification and while I suggest looking at online reviews, take those with a ton of salt.

[ilovetv]

Medicare managed care programs are paid a fixed amount by the Federal Government per month per enrollee and the insurance company then assumes the risk that the enrollee cost them more than their reimbursement. Obviously if you are an insurance company you would love to get the payment from the government based on the usual cost of a Medicare enrollee and figure out a way to only enroll healthy seniors. The 2012 rate was about $825 per month per enrollee. Thus if you cost the insurance company less than $825/mo they make money. Now your cost is not just the amount they pay the doctors and others but also their overhead and of course their profit.

So find your company a bunch of healthy seniors and put them into a network that is an HMO so they have little or no out of network benefits. Try to keep them healthy as it lowers your overall cost. Bingo big profits. Well, here in America's healthiest hometown we have a self selected population of seniors who are active. If you are chronically ill at retirement age you didn't likely move here. If you live here and develop a severe expensive illness it is even likely you may move away, back home to be nearer family and perhaps where you have a higher intensity hospital and specialty services available and you will change to a different Medicare plan as this one won't cover you there.

Thus you also have removed those expensive sick people from your enrollee panel as they leave the area. Wow, even more profits. Brilliant. Get the payment for a usual panel of Medicare patients and only have to provide services to a panel that is much healthier than average. I applaud UHC and whomever their partners in this venture might be for a clever plan. Then of course don't forget to advertise it like crazy to the potential enrollee. In no way do I want anyone to take from this any opinion of the quality of care that may be provided. They are still hiring doctors, and NP's, and PA's. I would encourage looking for the most highly trained providers all other factors being equal. Someone with a geriatrics fellowship would be great for a senior patient. An internist has much more residency training in adult medicine than a family physician. Look for board certification and while I suggest looking at online reviews, take those with a ton of salt.

Thank you for these helpful insights.

Regarding this, "So find your company a bunch of healthy seniors and put them into a network that is an HMO so they have little or no out of network benefits. Try to keep them healthy as it lowers your overall cost...Thus you also have removed those expensive sick people from your enrollee panel as they leave the area. Wow, even more profits. Brilliant......"

Why are so many people here content with the government giving so much more business like this to the giant insurers that nobody likes (both patients and doctors are sick of them)? The insurers' control over patient care, and shrinking treatment, is increasing instead of decreasing, and it seems like many seniors are looking only at the low premiums they pay (for now).

I don't think people buy a new car based on low price only, so why do that in buying health coverage? Is it really worth it to save $100-$200 per month in premiums, only to find out when you get a dire illness or disease that the above listed limitations are in play?

[blueash]

Thank you for these helpful insights.

Regarding this, "So find your company a bunch of healthy seniors and put them into a network that is an HMO so they have little or no out of network benefits. Try to keep them healthy as it lowers your overall cost...Thus you also have removed those expensive sick people from your enrollee panel as they leave the area. Wow, even more profits. Brilliant......"

Why are so many people here content with the government giving so much more business like this to the giant insurers that nobody likes (both patients and doctors are sick of them)? The insurers' control over patient care, and shrinking treatment, is increasing instead of decreasing, and it seems like many seniors are looking only at the low premiums they pay (for now).

I don't think people buy a new car based on low price only, so why do that in buying health coverage? Is it really worth it to save $100-$200 per month in premiums, only to find out when you get a dire illness or disease that the above listed limitations are in play?


Opinion, not facts but here goes. I think a large segment of Americans believe that the free enterprise system, businesses, can do a better job with whatever task is required than can the government. Certainly those businesses have been quite generous with their campaign donations to candidates who hold that belief. So when health care legislation was being written, the authors determined that private insurance companies would be the only player in the market. Recall that during the discussion of the outline of the ACA there were proposals for the additional option of Medicare for all or what was called the Public option. However this was not included in the law. The two largest factors, again my opinion, were that the Medicare for all option had no lobbyists, and the real risk of a repeat of the Harry and Louise commercials that killed the Clinton proposal in the 1990's.

So this is where we are. Private insurers are poised to profit from the implementation of the ACA. And seniors who obviously have government provided insurance (Medicare) are being offered alternative coverage from private carriers with promises of a better product. Time will tell. It may be a better product for you the patient, or a better product for the stockholders of UHC (and their business partners in this venture) or for both or neither.

[ilovetv]

Opinion, not facts but here goes. I think a large segment of Americans believe that the free enterprise system, businesses, can do a better job with whatever task is required than can the government. Certainly those businesses have been quite generous with their campaign donations to candidates who hold that belief. So when health care legislation was being written, the authors determined that private insurance companies would be the only player in the market. Recall that during the discussion of the outline of the ACA there were proposals for the additional option of Medicare for all or what was called the Public option. However this was not included in the law. The two largest factors, again my opinion, were that the Medicare for all option had no lobbyists, and the real risk of a repeat of the Harry and Louise commercials that killed the Clinton proposal in the 1990's.

So this is where we are. Private insurers are poised to profit from the implementation of the ACA. And seniors who obviously have government provided insurance (Medicare) are being offered alternative coverage from private carriers with promises of a better product. Time will tell. It may be a better product for you the patient, or a better product for the stockholders of UHC (and their business partners in this venture) or for both or neither.

I think you're right. Even more onerous is that in reading United Healthcare's report to stockholders linked here, they report on having and growing a huge portion of military TRICARE business, too!

Here's just one portion of this huge report:

UnitedHealthcare's momentum continues as the fastest growing health benefits company in the market. It increased the number of people served by 24%, nearly 9 million individuals over the past year. This includes more than 2.9 million people in TRICARE and another 4.8 million people in Brazil, both new markets for us......

UnitedHealthcare Military & Veterans membership in TRICARE was well-served, with its transitional issues now well in hand. UnitedHealthcare International has added almost 400,000 people so far this year, with particular strength in the large group market.

Our UnitedHealthcare International medical assistance and clinics business continues to grow and advance, recently receiving new contracts to serve the global oil and gas industry in the Middle East, Africa and now in the North Atlantic.

Optum's technology-enabled services again grew strongly, in a market sized at over $500 billion. Our growth potential is particularly compelling as we continue to develop broader, more integrated, long-term relationships with larger clients who are pursuing new approaches to the market.

Earlier this week we announced the formation of the Optum360 business with our partner, Dignity Health. Working collaboratively and applying advanced Optum technologies, we expect to improve revenue cycle performance end-to-end, from the perspectives of both patients and care providers, across Dignity's 39 hospitals and 300 care centers in 21 states....."

UnitedHealth Group Inc UNH Q3 2013 Earnings Call Transcript (http://www.morningstar.com/earnings/57949482-unitedhealth-group-inc-q3-2013.aspx?pindex=3)

[rpensabene]

Why is AARP not advocating for you and other patients who pay them dues?
The doctors have a right to appeal that decision.

[shcisamax]

I wonder if we eventually will be a one provider healthcare nation.

[dotti105]

Looking at the other 1st world (industrialized) nations, there are several single payer systems that work VERY well and the residents of those nations LOVE their healthcare. Also their morbidity and mortality rates rank far better than ours.

Our health care system has been broken for years. Health care available only to the highest and lowest income groups, with middle income families squeezed out.

I am a RN and had hoped our country would have agreed to go to a single payer system. In my humble opinion, we have screwed up royally by letting the insurance companies have control. They are greedy and corrupt and will do anything to deny a claim.

But our political system works in the pockets of those elected. Lobbyists, pay our elected representatives to have THEIR own interests at the core of the party platforms.

I am appalled that Rick Scott, the HCA Officer legally responsible for the largest Medicare fraud in history (over 8 Billion; With a "B") was elected governor.

Yes Obama Care is flawed. But that is because the people who represent us were paid to accept universal coverage only if the insurance companies get the largest portion of the pie.

I expect we have a rough road ahead in Health care, as we did not follow the templates of the successful nation's healthcare plans and chose instead to allow the insurance companies to line their pockets at our expense.

In our political world, that has become the American way. Very sad indeed.

[Polar Bear]

Looking at the other 1st world (industrialized) nations, there are several single payer systems that work VERY well and the residents of those nations LOVE their healthcare. Also their morbidity and mortality rates rank far better than ours...

With all due respect, I have serious doubts about this claim.

[Biker Dog]

Looking at the other 1st world (industrialized) nations, there are several single payer systems that work VERY well and the residents of those nations LOVE their healthcare. Also their morbidity and mortality rates rank far better than ours.

Our health care system has been broken for years. Health care available only to the highest and lowest income groups, with middle income families squeezed out.

I am a RN and had hoped our country would have agreed to go to a single payer system. In my humble opinion, we have screwed up royally by letting the insurance companies have control. They are greedy and corrupt and will do anything to deny a claim.

But our political system works in the pockets of those elected. Lobbyists, pay our elected representatives to have THEIR own interests at the core of the party platforms.

I am appalled that Rick Scott, the HCA Officer legally responsible for the largest Medicare fraud in history (over 8 Billion; With a "B") was elected governor.

Yes Obama Care is flawed. But that is because the people who represent us were paid to accept universal coverage only if the insurance companies get the largest portion of the pie.

I expect we have a rough road ahead in Health care, as we did not follow the templates of the successful nation's healthcare plans and chose instead to allow the insurance companies to line their pockets at our expense.

In our political world, that has become the American way. Very sad indeed.

Single payer system will help to lower our population due to early deaths from lack of doctors. What person would take the time and expense to become a doctor when the government would control their income and dictate their work schedule.:bowdown: