[bwasman]

Not saying the Villages are at fault...I am stuck with Aetna and know the retirement system I come from negotiated the new contract. They did say we have identical coverage but did not say Aetna was available at the same places. Thanks for your response.

[villagetinker]

Originally Posted by BrianL99

Yes they do.

The highlighted section is correct, AT THEIR SPECIALITY CENTERS, the villages health system DOES NOT accept medicare. I use 2 or 3 village specialists with medicare, I cannot use the villages health for a PCP.

[Keninches]

So true. The regular internists are not the same as specialists. At The Villages Health.

[Karmanng]

Originally Posted by bwasman

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.

INSURANCES can change at any time from year to year ESPCIALLY if they are advantage plans.........FYI

[lulliedoll]

I have Michigan Blue which is identical to Florida Blue. All my bills are run through Florida Blue however The Villages Healthcare will not accept Michigan Blue although they do now accept Florida Blue. It makes no sense.

[Rainger99]

Originally Posted by villagetinker

The highlighted section is correct, AT THEIR SPECIALITY CENTERS, the villages health system DOES NOT accept medicare. I use 2 or 3 village specialists with medicare, I cannot use the villages health for a PCP.

Now I am confused. This is from their website.

At our Specialty Care Division, we accept most major medical insurance, including Medicare and Medicare Supplement plans.

Medical Specialty Specialist & Services | The Villages Health Florida

[rustyp]

Originally Posted by Rainger99

Now I am confused. This is from their website.

At our Specialty Care Division, we accept most major medical insurance, including Medicare and Medicare Supplement plans.

Medical Specialty Specialist & Services | The Villages Health Florida

The primary care side of the villages health has the advantage plan only rule while the specialty care has a different set of rules as you outlined.

From The Villages Health website:

"If you are Medicare Eligible, you have an important choice to make about Medicare and the primary care services you receive in this community. The Villages Health is a health care system specifically designed for your lifestyle, but when it comes to Medicare we only partner with a few Medicare Advantage plans."

[Buckeyephan]

I have had an Aetna Medicare advantage plan through Ohio teachers’ retirement for 12 years and am very pleased. When we moved here 9 years ago, I joined the Villages system. About 15 months later, I was kicked out. Technically, my plan is considered a PPO but because it is from Ohio, there aren’t any in network doctors. That is why mine has an extended service area. That means every doctor and hospital is in network for me. Perhaps the Illinois coverage will be broad like mine is. I hope so.

[JoMar]

Originally Posted by bwasman

I'm not certain which system you "stayed" in. The Villages Health or Aetna. Thank you for your input...it was very helpful!

We wanted to stay with The Villages Health so we switched to United Health. Also, they came out with a new Focus plan this year, we switched to that...co-pays came down and coverages went up.

[JoMar]

Originally Posted by loweglor

Same thing happened to me over a year ago. I liked my PCP at Villages Health but had to change. Not too happy with new PCP but will survive. Aetna has proven to be a little more complicated than UHC to work with. They don't require a PCP and the ones they do have in-network are few and far between. Also, they require prior authorization on many procedures that UHC did not. I have no choice because my husband worked at Pinellas County Government and they made the decision to change whether we liked it or not, no alternative. I would go back to UHC in a minute if they had an affordable plan.

Not sure what you mean by affordable?

[YouNeverKnow]

Originally Posted by lulliedoll

I have Michigan Blue which is identical to Florida Blue. All my bills are run through Florida Blue however The Villages Healthcare will not accept Michigan Blue although they do now accept Florida Blue. It makes no sense.

I also have Michigan Blue. (Medicare Advantage Blue Cross Blue Shield) All my billing goes through Florida Blue. The Villages Health and all the PCP providers are listed in my Providers booklet. I’ve met with several new patient representatives and they said they will not take my Insurance. I called my insurance and they said they don’t understand why they will not take the insurance since they get paid the same and it’s the same network. The Villages insisted I had to drop that insurance (from my Michigan retirement system) and switch to Florida Blue.

[Jayhawk]

Originally Posted by jarodrig

The discussion is about PRIMARY CARE doctors.

My wife and I were kicked out upon reaching 65 and going on Medicare…..

No one was "kicked out' of TV Health, but those who CHOOSE not to use the accepted insurance plans can not utilize the services. But everyone who says they were kicked out made their own decision.

Isn't that pretty much how it works for ALL MEDICAL providers, who decide which insurances to accept and which to not?

[HawkinsGuy]

Originally Posted by GaryKoca

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’ll have to look into that. Right now between my FEHB Blue Cross/Blue Shield plan and Medicare parts A and B, for my wife and I, it costs a total of about $1400 a month. Medicare is primary. We get to choose our own physicians. Our wonderful PCP is outside The Villages Health but we use Villages Specialists and I had a brief stay in The Village emergency room and hospital. Fully paid between both plans. Not even a copay. Expensive and not worth it- until it is!

[bp243]

Originally Posted by Buckeyephan

I have had an Aetna Medicare advantage plan through Ohio teachers’ retirement for 12 years and am very pleased. When we moved here 9 years ago, I joined the Villages system. About 15 months later, I was kicked out. Technically, my plan is considered a PPO but because it is from Ohio, there aren’t any in network doctors. That is why mine has an extended service area. That means every doctor and hospital is in network for me. Perhaps the Illinois coverage will be broad like mine is. I hope so.

Thanks for your post! It sounds like the Illinois plan that switched from UHC to Aetna will work the same way, at least that’s what we were told. Since the switch just occurred on January 1, 2023, is there any advice that would be helpful to know?

[retiredguy123]

Originally Posted by HawkinsGuy

. I’ll have to look into that. Right now between my FEHB Blue Cross/Blue Shield plan and Medicare parts A and B, for my wife and I, it costs a total of about $1400 a month. Medicare is primary. We get to choose our own physicians. Our wonderful PCP is outside The Villages Health but we use Villages Specialists and I had a brief stay in The Village emergency room and hospital. Fully paid between both plans. Not even a copay. Expensive and not worth it- until it is!

If you are paying $16,800 per year in insurance premiums, I would recommend that you do the math and compare what would happen if you cancel Medicare Part B. Part A is free. I have the FEHB Blue Cross standard plan as my only insurance. The annual catastrophic limit is only $6,000. So, the maximum out of pocket expense for me would be $6,000 (which I can afford if necessary) and everything after that, including drugs, is fully covered. The Medicare Part B benefits are mostly redundant with Blue Cross and almost every provider accepts the Blue Cross. For me, it is a no brainer to not carry Medicare Part B.