TVH changes and effect on Medicare participants

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Old 07-27-2016, 08:30 AM
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Default TVH changes and effect on Medicare participants

Recently, several posts have commented that the change at TVH in not accepting traditional Medicare insurance is no big deal as doctors change insurance plans frequently. I strongly disagree in that while it is not a big deal if one doctor changes insurance plans but when a group of roughly 40 doctors simultaneously change insurance plans that affect 10,000 to 15,000 that is a huge deal!! - particularly when we were welcomed into the plan originally and were encouraged to join through various sales representations. Moveover, the fact that those 40 physicians are no longer accessible to traditional Medicare patients greatly reduces the pool of doctors who continue to accept traditional Medicare. For those not affected by this change that's great but for those of us affected I share your sense of outrage and betrayal. Ultimately for some of this will affect our decision to stay in the villages. I also hope that any future Villages sales representations are accurate in spelling out the new TVH restrictions
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Old 07-27-2016, 09:16 AM
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Recently, several posts have commented that the change at TVH in not accepting traditional Medicare insurance is no big deal as doctors change insurance plans frequently. I strongly disagree in that while it is not a big deal if one doctor changes insurance plans but when a group of roughly 40 doctors simultaneously change insurance plans that affect 10,000 to 15,000 that is a huge deal!! - particularly when we were welcomed into the plan originally and were encouraged to join through various sales representations. Moveover, the fact that those 40 physicians are no longer accessible to traditional Medicare patients greatly reduces the pool of doctors who continue to accept traditional Medicare. For those not affected by this change that's great but for those of us affected I share your sense of outrage and betrayal. Ultimately for some of this will affect our decision to stay in the villages. I also hope that any future Villages sales representations are accurate in spelling out the new TVH restrictions
Not a chance!
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Old 07-27-2016, 09:23 AM
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Originally Posted by jampbell View Post
Recently, several posts have commented that the change at TVH in not accepting traditional Medicare insurance is no big deal as doctors change insurance plans frequently. I strongly disagree in that while it is not a big deal if one doctor changes insurance plans but when a group of roughly 40 doctors simultaneously change insurance plans that affect 10,000 to 15,000 that is a huge deal!! - particularly when we were welcomed into the plan originally and were encouraged to join through various sales representations. Moveover, the fact that those 40 physicians are no longer accessible to traditional Medicare patients greatly reduces the pool of doctors who continue to accept traditional Medicare. For those not affected by this change that's great but for those of us affected I share your sense of outrage and betrayal. Ultimately for some of this will affect our decision to stay in the villages. I also hope that any future Villages sales representations are accurate in spelling out the new TVH restrictions
If, in the grand scheme of things, having to find another primary care doctor in The Villages would cause you to leave altogether, you aren't having enough fun here! TVH making this change does not "greatly" reduce the pool at all. There are hundreds of primary care doctors in and around TV. Find one and be happy!
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Old 07-27-2016, 11:16 AM
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Originally Posted by jampbell View Post
Recently, several posts have commented that the change at TVH in not accepting traditional Medicare insurance is no big deal as doctors change insurance plans frequently. I strongly disagree in that while it is not a big deal if one doctor changes insurance plans but when a group of roughly 40 doctors simultaneously change insurance plans that affect 10,000 to 15,000 that is a huge deal!! - particularly when we were welcomed into the plan originally and were encouraged to join through various sales representations. Moveover, the fact that those 40 physicians are no longer accessible to traditional Medicare patients greatly reduces the pool of doctors who continue to accept traditional Medicare. For those not affected by this change that's great but for those of us affected I share your sense of outrage and betrayal. Ultimately for some of this will affect our decision to stay in the villages. I also hope that any future Villages sales representations are accurate in spelling out the new TVH restrictions
We were of Medicare age and on Medicare together with our very good company insurance when the Health System opened here and they did not accept our insurance. Oh well.

We found other doctors but I am still jealous of anyone who can use the health system. I have only heard good things about it. All of the time I hear from folks here, No I don't go to that doctor because he doesn't accept my insurance. I keep looking for someone to blame, but it won't be the Morses.
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Old 07-27-2016, 03:26 PM
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The online news source has an interesting article on this subject. If their numbers are correct (and I suspect they are very close), there is going to be a net loss of income for the VHS. 80% of 15,000 patients leaving, the additional income of the 20% staying cannot possibly cover the lost income from those leaving. This is the opposite of their (VHS) stated goal, so IMHO, VHS may need to review their decision. Our biggest concern is that once you drop Medicare ( and your supplement plan) you may have trouble getting back in if you do not like the Advantage plan.
I would hope that TVHS reviews the developing situation and goes back to accepting supplemental insurance and Medicare, but they will need to do this VERY soon, as people are jumping ship already.
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Old 07-27-2016, 03:53 PM
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The numbers suggest about 1/3 of the current total patients would choose to leave. That seems like a big number to me and they should be concerned

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Originally Posted by villagetinker View Post
The online news source has an interesting article on this subject. If their numbers are correct (and I suspect they are very close), there is going to be a net loss of income for the VHS. 80% of 15,000 patients leaving, the additional income of the 20% staying cannot possibly cover the lost income from those leaving. This is the opposite of their (VHS) stated goal, so IMHO, VHS may need to review their decision. Our biggest concern is that once you drop Medicare ( and your supplement plan) you may have trouble getting back in if you do not like the Advantage plan.
I would hope that TVHS reviews the developing situation and goes back to accepting supplemental insurance and Medicare, but they will need to do this VERY soon, as people are jumping ship already.
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Old 07-27-2016, 04:11 PM
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Originally Posted by CritterLover View Post
If, in the grand scheme of things, having to find another primary care doctor in The Villages would cause you to leave altogether, you aren't having enough fun here! TVH making this change does not "greatly" reduce the pool at all. There are hundreds of primary care doctors in and around TV. Find one and be happy!
CritterLover: You may be correct but may I offer another possibility. Perhaps this OP or others have medical conditions, etc that require continual care and an interruption such as this that would have to cause them to start all over again in finding primary care and specialist etc is very discouraging. so perhaps for them the priority is not having fun but staying alive so that they may, perhaps have fun in the future

I speculate like others as to why TVHCS made such a choice but irrespective as to why it has place quite a burden on those who now need to find another doctor, etc.

Corporation have 5 year plans when and how TVHCS came to this change is anyone's guess... but on such matters I default to my neighbors side because they are my neighbors and friends

Personal Best Regards:
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Old 07-28-2016, 06:17 AM
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Originally Posted by rubicon View Post
CritterLover: You may be correct but may I offer another possibility. Perhaps this OP or others have medical conditions, etc that require continual care and an interruption such as this that would have to cause them to start all over again in finding primary care and specialist etc is very discouraging. so perhaps for them the priority is not having fun but staying alive so that they may, perhaps have fun in the future

I speculate like others as to why TVHCS made such a choice but irrespective as to why it has place quite a burden on those who now need to find another doctor, etc.

Corporation have 5 year plans when and how TVHCS came to this change is anyone's guess... but on such matters I default to my neighbors side because they are my neighbors and friends

Personal Best Regards:
Hence, in such cases, leaving altogether would certainly pose even greater stress, no? The point was, to go to such extremes as to leave TV altogether is rather irrational.
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Old 07-28-2016, 06:24 AM
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irrational? I suggest we don't know unless we have walked in their shoes.
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Old 07-28-2016, 01:43 PM
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Whether to be on Medicare with a supplement plan or to go to an MA plan, that is a decision everyone has to decide for themselves.

MA plans are geared toward healthy people and practices preventive measures, to ward off illnesses.

TVH practices this type of medicine.

Medicare plus a supplement plan is geared for those who have a known recurring condition and think they may need to be hospitalized in the near future. It also gives some people peace of mind as they probably won't see a bill for services rendered.

As of 2017, Medicare people will need to find a doctor outside of TVH.

Do it cause anxiety for people? Probably YES!

Is deciding something like this easy? Probably, NO!

Everyone has to look at their present medical needs and future needs, and make a decision that best suits them.

All this medical info is confusing to most and they need to enlist the aid of the SHINE organization, if they are confused or need help.

Be your own health advocate and check what you need to do to get the best possible care.
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Old 07-28-2016, 01:57 PM
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Quote:
Originally Posted by jampbell View Post
Recently, several posts have commented that the change at TVH in not accepting traditional Medicare insurance is no big deal as doctors change insurance plans frequently. I strongly disagree in that while it is not a big deal if one doctor changes insurance plans but when a group of roughly 40 doctors simultaneously change insurance plans that affect 10,000 to 15,000 that is a huge deal!! - particularly when we were welcomed into the plan originally and were encouraged to join through various sales representations. Moveover, the fact that those 40 physicians are no longer accessible to traditional Medicare patients greatly reduces the pool of doctors who continue to accept traditional Medicare. For those not affected by this change that's great but for those of us affected I share your sense of outrage and betrayal. Ultimately for some of this will affect our decision to stay in the villages. I also hope that any future Villages sales representations are accurate in spelling out the new TVH restrictions
I know what you are saying .... So many people were put out and healthcare is a MAJOR concern at our age. We got settled, most liked their doctors, were told they were "included" and lucky to be accepted, some told they were not to be let go....and THEN the fallout. No matter what posters say many are going through a roller coaster of emotions and angry. This should be acknowledged. Yet, in spite of this huge upset, I doubt people will leave or newcomers will be put off. Where else offers so much as The Villages? The dust will settle but things like this and the selling of the water are not totally forgotten. Things build on each other and the wise understand this. In the meanwhile, this is truly a unique place to live and we plan to enjoy it but not with hooded eyes. We love it here.
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Old 07-28-2016, 10:34 PM
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Just a word of caution, please read the small print of the MA plans and make sure it is something you can live with. If THe Villages Health does not get the expected income they are anticipating from MA plans they may very well have to close their doors and there may be consequences if you want your Medicare plus supplement back! Also, there appears to be many primary care doctors in the area but if you check vitals.com or healthgrades.com you may not find many that meet your requirements!
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