[rustyp]

Originally Posted by rustyp

Please specify what you mean by TVHS. I am enrolled in The Villages Health System (the official system owned / operated by the developer). In my experience there is no way your scenario would happen there.

Originally Posted by dano121

You must be lucky or very healthy. Thank you for your post

I wish I was very healthy. I speak from experience with "The Villages Health" from their inception. I also have observed many newbies refer to "TVHS" as to any health facility / service within the bubble. TVH is the health network in TV owned and operated by the developer. There are hundreds of other facilities within TV that have to affiliation to the TVH system. Again my experience with TVH is no way would your doctor refuse to see you unless there is more to the story. TVH has a network available for their patients to call 24/7. They answer the phone immediately. They also have a patient portal which I usually get a response back within one hour or less.The majority of the time they ask if you can come in by the end of the day. You may have to see your primary doctor's nurse practitioner under that circumstance but that has worked well for me. I have liked every nurse practitioner my primary has had in the last 11 years.

So you did not answer my question. What do you mean by TVHS ?

[ThirdOfFive]

Does this "practical nurse" work for your doctor? If so, the nurse is SUPERVISED by your doctor and is privy to the same information that the nurse is. Seems that a lot of primary care physicians have two or more APRNs working for them who see the patients on a routine basis, with the doctor seeing patients on the first visit or on subsequent visits when something serious or outside the APRN's expertise pops up. But it is the doctor who makes that call, not the patient.

Not saying that this is the case...but many of us geezers interpret every ache, pain or twinge as "something serious".

[rustyp]

Originally Posted by Djean1981

Not all advantage plans are the same, some are PPO/open plans. But, my understanding is that TVHS' plan is not.

Not true. One of the plans TVH accepts is AARP Medicare Advantage Choice PPO. This is a very flexible plan with a huge out of state network.

[dano121]

Originally Posted by ThirdOfFive

Does this "practical nurse" work for your doctor? If so, the nurse is SUPERVISED by your doctor and is privy to the same information that the nurse is. Seems that a lot of primary care physicians have two or more APRNs working for them who see the patients on a routine basis, with the doctor seeing patients on the first visit or on subsequent visits when something serious or outside the APRN's expertise pops up. But it is the doctor who makes that call, not the patient.

Not saying that this is the case...but many of us geezers interpret every ache, pain or twinge as "something serious".

I appreciate your interest "Sage" I have been ill for 2 mos. The Doc sent me for ultra sound which showed a potential problem. She is now sending me to get a CT. This whole process is taking a month ??? I requested an appointment with my DOC to review the results. Someone returned my call and said the DOC said for me to see her nurse. Who earlier suggested that this could be serious. I just feel that I should get the diagnosis from a Doctor. I just can't believe how indifferent the doctor is. I guess that is why VHS mandated that I sign a waiver before the doctor would even see me.

I could go on and on but really just want to get a reality check on medicine here in the Villages. Can I expect better? If so, where can I find it? Your thoughts are much appreciated. If you reply please send a private message. Thanks again

[graciegirl]

Originally Posted by blueash

I have no idea what a practical nurse might be. Maybe you mean nurse practitioner certainly not an LPN. But might be serious is a long way from is likely to be serious. No doctor who likes keeping their medical license will refuse to see an established patient. That is abandonment and is taken very seriously by medical boards and trial attorneys.

If you are in the Villages Health System, they are not paid by you or per patient seen so it is not money. There are lots of places besides Lake Medical Imaging that can do Xrays and scans. They are going to get you in sooner. Lake Medical does not do stat MRIs no matter what the nurse ordered.

A headache can be just a headache or a brain tumor. See what I mean by "might be serious" A good history and good exam often guides the intensity of the evaluation. The nurse practitioners have far less training than MDs and DOs and within the Villages system they certainly discuss their cases with their supervising physicians.

If you want to communicate with your doctor, who you claim refuses to see you, send a portal message to the doctor asking what is the next step. What you might learn is that the next step is to wait until it is your turn to be imaged then to come back and be seen with that information now available.

Listen to this man. He is an excellent M.D.

[PugMom]

this has not been my experience with the villages health system. i've always had prompt replies & have not been kept waiting for an appt longer than 24hours. if they say only a nurse can see you @ the moment, do it. it's getting that 1st step completed before a dr sees you. i use Creekside & they are wonderful. if you still get no replies, drive down & speak to 1 of the reps, it will get fixed. remember to use complete communication with all staff, from the guy who takes your blood to the gal who does your bp. i hope you have better success.

[Carla B]

Originally Posted by dano121

I appreciate your interest "Sage" I have been ill for 2 mos. The Doc sent me for ultra sound which showed a potential problem. She is now sending me to get a CT. This whole process is taking a month ??? I requested an appointment with my DOC to review the results. Someone returned my call and said the DOC said for me to see her nurse. Who earlier suggested that this could be serious. I just feel that I should get the diagnosis from a Doctor. I just can't believe how indifferent the doctor is. I guess that is why VHS mandated that I sign a waiver before the doctor would even see me.

I could go on and on but really just want to get a reality check on medicine here in the Villages. Can I expect better? If so, where can I find it? Your thoughts are much appreciated. If you reply please send a private message. Thanks again

We (husband and I) were enrolled with The Villages Health System until they changed the policy regarding patients 65 and over. Being skeptical of letting an insurance company manage our health care, we kept our supplemental insurance and went with a doctor outside the system.

The medical system here has changed over the years. Lake Imaging (which the doctors seem to use) went from readily available appointments to a 3-week delay in our case, likely caused by the population explosion in this area. When this happened (more than once) we simply called another imaging center (in Ocala) and went there the next day. Having Original Medicare allowed us to do this.

Having Original Medicare also allows for choosing one's physicians, but it can be a rocky path, too. GP's must juggle Medicare's rules, maintain a competent and polite office staff (different every time we go to our GP), and make enough income to maintain the practice, plus, hopefully, diagnose patients correctly, with prompt follow-up care. I remember way back when I use to go for a yearly physical it was a real hands-on workout. Now, under Medicare, it is a twice-a-year blood test, followed up by a quick 10 minute discussion with the doctor in person.

It sounds like your doctor is not seeing you, because your cat scan hasn't been done. Will your Advantage policy allow for using another imaging company? If that were so, then the doctor might see you sooner. It is tortuous waiting and not knowing.

TVHS was established on the premise that their doctors would not be burdened with an excessive patient roster, and that would allow sufficient time devoted to each patient. Has that changed?

[rustyp]

Originally Posted by Carla B

We (husband and I) were enrolled with The Villages Health System until they changed the policy regarding patients 65 and over. Being skeptical of having an insurance company manage our health care, we kept our supplemental insurance and went with a doctor outside the system.

The medical system has changed over the years. Lake Imaging (who the doctors like to use) went from readily available appointments to a 3-week delay in our case, probably caused by the population explosion in this area. So we simply called another imaging center (in Ocala) and went there the next day. This happened more than once. Having Original Medicare allowed us to do this.

Having Original Medicare also allows for choosing one's doctors, but it can be a rocky path, too. GP's (and specialists) must juggle Medicare's rules, maintain a competent and polite office staff (different every time we go), and make enough income to maintain the practice, plus, hopefully, diagnose patients promptly and correctly. I remember way back when I went for a yearly physical it was a real hands-on workout. Now, it is a twice-a-year blood test, followed up in person by a quick discussion with the doctor.

TVHS was established with the promise that their doctors would not be burdened with an excessive patient roster; that would allow sufficient time devoted to each patient. Has that changed? When I was a patient, my only complaint was that my doctor would never remain with TVHS very long. They were fairly young, so something about this place or method of practice must not have been to their liking. My husband's doctor was older and he remained there.

I have the TVH AARP Medicare Advantage PPO plan and like you can go to
other imaging centers. I have frequent ultrasounds and have used three different imaging centers here in TV with no problem. I also have the imaging done in New York State with no issue. Probably different than you I have a deductible up to out of pocket amount but then again I don't have a supplemental premium.Given my health I would probably financially be better off with picking Medicare and a supplemental at 65. However like you I was in TVH health and had to go on their acceptable Advantage Plans or leave the system. We liked TVH system so much we decided to stay with them. I still do not regret that decision.We also have had no problems with being on the advantage ppo plan (we are snowbirds). We have had 100's of thousands of $'s of claims with no problem in Florida and New York State.

I have been lucky with my primary doctor. I have the same primary I started with 11 years ago. My spouse has been in the same system with me but has had her primary changed 3 times.

[OrangeBlossomBaby]

Originally Posted by Topspinmo

I thought ACA was supposed to fix that? I guess they didn’t read it did they?

In states where there's medicaid expansion, it's working pretty well. Florida opted out of that though, and so Floridians have to accept the consequences.

[Marathon Man]

Originally Posted by dano121

I appreciate your interest "Sage" I have been ill for 2 mos. The Doc sent me for ultra sound which showed a potential problem. She is now sending me to get a CT. This whole process is taking a month ??? I requested an appointment with my DOC to review the results. Someone returned my call and said the DOC said for me to see her nurse. Who earlier suggested that this could be serious. I just feel that I should get the diagnosis from a Doctor. I just can't believe how indifferent the doctor is. I guess that is why VHS mandated that I sign a waiver before the doctor would even see me.

I could go on and on but really just want to get a reality check on medicine here in the Villages. Can I expect better? If so, where can I find it? Your thoughts are much appreciated. If you reply please send a private message. Thanks again

So, you could go in and get the information that you need and perhaps a plan for care. But you are choosing not to go because you insist on seeing the doctor (who no doubt has a loaded schedule) rather than a nurse. OK. Got it.

Please make an appointment and get yourself moving forward. The nurses and especially the nurse practitioners are great. They will absolutely help you. I see my doctor once a year. For all other care, I see the nurse practitioners. I actually prefer them.

[RPDaly]

///

[Topspinmo]

Originally Posted by blueash

Apparently you didn't read the ACA. It is a law to provide care and establish minimum levels of coverage for private, not governmental, health plans. You know the ones you or your employer buy. It forced insurance to cover women, ignore pre-existing conditions, cover mammograms and colonoscopies, cover your children to age 26, the list goes on.

But it did not change Medicare, or supplements. Now if you think that supplements are too expensive, guess how much the government controls that cost. Zero. They are sold by the private insurance industry and are not part of Medicare.

Now the ACA did impact Medicare Advantage plans cutting the payment to them as they were making too much of a profit and a few other tweaks including lowering the cost of the "donut hole" for seniors and some adjustments in Medicare taxes for high earners.

No I didn’t read it because people who passed didn’t either.