Insurance change unaccepted by The Villages Health.

Closed Thread
Thread Tools
  #1  
Old 01-11-2023, 03:57 PM
bwasman bwasman is offline
Junior Member
Join Date: May 2010
Posts: 6
Thanks: 0
Thanked 3 Times in 3 Posts
Default Insurance change unaccepted by The Villages Health.

The Teachers Retirement System in Illinois has replaced United Health Care Medicare Advantage PPO with a new policy contracted with Aetna Medicare Advantage PPO. Use of the new policy has been denied by The Villages Health System and anyone using it has to find new Dr.'s outside The Villages system resulting in delayed care and far out appointments. No reason is given by The Villages System other than a flat No to Aetna personell.
  #2  
Old 01-11-2023, 04:17 PM
Babubhat Babubhat is offline
Platinum member
Join Date: May 2021
Posts: 1,873
Thanks: 306
Thanked 1,707 Times in 761 Posts
Default

Bad luck. A victim of Teachers cost cutting likely.
  #3  
Old 01-11-2023, 04:18 PM
Davonu Davonu is offline
Senior Member
Join Date: May 2017
Posts: 467
Thanks: 52
Thanked 611 Times in 190 Posts
Default

Amazing. My employer did the same…with Aetna also. After one year, we went back to UHC on our own and are very happy. We even save money on premiums every month with very small increases in deductibles.
  #4  
Old 01-11-2023, 04:21 PM
Altavia Altavia is offline
Sage
Join Date: Jun 2019
Posts: 3,411
Thanks: 1,445
Thanked 2,786 Times in 1,248 Posts
Default

And that's why you want to stay with standard Medicare if you can afford it...
  #5  
Old 01-11-2023, 04:25 PM
JoMar JoMar is offline
Sage
Join Date: Apr 2014
Posts: 4,830
Thanks: 10
Thanked 2,317 Times in 871 Posts
Default

Quote:
Originally Posted by bwasman View Post
The Teachers Retirement System in Illinois has replaced United Health Care Medicare Advantage PPO with a new policy contracted with Aetna Medicare Advantage PPO. Use of the new policy has been denied by The Villages Health System and anyone using it has to find new Dr.'s outside The Villages system resulting in delayed care and far out appointments. No reason is given by The Villages System other than a flat No to Aetna personell.
The Villages Health dropped Aetna plans years ago.....we were one of those that was dropped. Reasons speculated on by residents is that Aetna's payments were slow and always contested, the profit margin was adversely impacted by Aetna and procedures were routinely questioned. Don't know if true or not but The Villages Health is a business so they make their decisions based on business models. We stayed in the system and haven't regretted it.
__________________
No one believes the truth when the lie is more interesting

Berks County Pennsylvania
  #6  
Old 01-11-2023, 04:55 PM
Carla B Carla B is offline
Sage
Join Date: Mar 2008
Posts: 2,777
Thanks: 52
Thanked 703 Times in 377 Posts
Default

My daughter spent five years in her job battling against Aetna and their refusual to pay claims submitted by her employer, a hospital system. She said they have doctors and lawyers lined up to pick apart contracts and find reasons not to pay claims. And now, the irony is that this year her same employer has contracted to buy health insurance from Aetna.
  #7  
Old 01-11-2023, 05:43 PM
BrianL99 BrianL99 is offline
Platinum member
Join Date: Dec 2021
Posts: 1,809
Thanks: 227
Thanked 2,047 Times in 732 Posts
Default

Quote:
Originally Posted by bwasman View Post
The Teachers Retirement System in Illinois has replaced United Health Care Medicare Advantage PPO with a new policy contracted with Aetna Medicare Advantage PPO. Use of the new policy has been denied by The Villages Health System and anyone using it has to find new Dr.'s outside The Villages system resulting in delayed care and far out appointments. No reason is given by The Villages System other than a flat No to Aetna personell.
This what they accept and they've always been clear & upfront about it.

https://thevillageshealth.com/wp-con...-Update-v4.pdf
  #8  
Old 01-12-2023, 07:09 AM
GaryKoca GaryKoca is offline
Senior Member
Join Date: Jan 2014
Location: Chicago area but spend a month every year in The Villages
Posts: 177
Thanks: 0
Thanked 155 Times in 81 Posts
Default

Even with standard Medicare, you probably still need some type of supplemental insurance. We have basic Federal Employees Health Benefits, with pretty much covers everything Medicare does not. But you have to be a retired Federal employee to get that insurance.
  #9  
Old 01-12-2023, 07:37 AM
Ritagoyer Ritagoyer is offline
Member
Join Date: Feb 2021
Location: ST. Catherine's
Posts: 74
Thanks: 153
Thanked 55 Times in 25 Posts
Default

Quote:
Originally Posted by Altavia View Post
And that's why you want to stay with standard Medicare if you can afford it...
But they will run into the same problem they do not except Medicare
  #10  
Old 01-12-2023, 07:47 AM
nob77@comcast.net's Avatar
nob77@comcast.net nob77@comcast.net is offline
Member
Join Date: Jun 2020
Location: Valle verde
Posts: 42
Thanks: 159
Thanked 22 Times in 14 Posts
Default

Quote:
Originally Posted by bwasman View Post
The Teachers Retirement System in Illinois has replaced United Health Care Medicare Advantage PPO with a new policy contracted with Aetna Medicare Advantage PPO. Use of the new policy has been denied by The Villages Health System and anyone using it has to find new Dr.'s outside The Villages system resulting in delayed care and far out appointments. No reason is given by The Villages System other than a flat No to Aetna personell.
Simple. Aetna doesn’t pay(enough)
  #11  
Old 01-12-2023, 07:54 AM
BrianL99 BrianL99 is offline
Platinum member
Join Date: Dec 2021
Posts: 1,809
Thanks: 227
Thanked 2,047 Times in 732 Posts
Default

Quote:
Originally Posted by Ritagoyer View Post
But they will run into the same problem they do not except Medicare

Yes they do.
Attached Thumbnails
The Villages Florida: Click image for larger version

Name:	Medicare.jpg
Views:	2432
Size:	38.0 KB
ID:	96458  
  #12  
Old 01-12-2023, 08:02 AM
jarodrig jarodrig is offline
Veteran member
Join Date: Jan 2011
Posts: 606
Thanks: 24
Thanked 329 Times in 195 Posts
Default

Quote:
Originally Posted by BrianL99 View Post
Yes they do.
The discussion is about PRIMARY CARE doctors.

Specialty Care doctors are not primary care doctors.

Once again , The Villages Health DOES NOT accept standard Medicare ……

My wife and I were kicked out upon reaching 65 and going on Medicare…..
  #13  
Old 01-12-2023, 08:11 AM
retiredguy123 retiredguy123 is online now
Sage
Join Date: Feb 2016
Posts: 14,263
Thanks: 2,349
Thanked 13,740 Times in 5,254 Posts
Default

Quote:
Originally Posted by GaryKoca View Post
Even with standard Medicare, you probably still need some type of supplemental insurance. We have basic Federal Employees Health Benefits, with pretty much covers everything Medicare does not. But you have to be a retired Federal employee to get that insurance.
I am a retired Federal employee and I save thousands of dollars by having the standard Blue Cross plan, but do not have Medicare Part B. The Blue Cross plan covers almost everything I need, and it has a low catastrophic limit of $6,000 per year. The Medicare premiums are too high, especially if you are subject to IRMAA.
  #14  
Old 01-12-2023, 08:17 AM
Babubhat Babubhat is offline
Platinum member
Join Date: May 2021
Posts: 1,873
Thanks: 306
Thanked 1,707 Times in 761 Posts
Default

Bottom line is employers get an incentive from the new insurance provider. When the contract is up they bid out the business to get another incentive. They have no interest in whether you like it or not.
  #15  
Old 01-12-2023, 08:20 AM
asiebel asiebel is offline
Senior Member
Join Date: Jun 2012
Posts: 104
Thanks: 24
Thanked 28 Times in 20 Posts
Default

We have had to change not only primary care but eye Dr, pain management, and where we purchase medications. Hope it is a good company!
Closed Thread

Tags
villages, system, health, care, policy


You are viewing a new design of the TOTV site. Click here to revert to the old version.

All times are GMT -5. The time now is 12:22 PM.