[Larchap49]

Originally Posted by krick093

While seeking to establish myself as a patient with a general practitioner or internal medicine doctor I have found that most of those in TV do not accept Medicare (including Medicare supplement plans), only Medicare Advantage Plans. Why is that when all of the hospitals and specialists take Medicare readily?

I had the same problem. I found Dr. Joseph Carrasco on That St. In Leesburg. Internal Medicine. Like him just fine so far. Seems very through compared to last GP I had

[Larchap49]

Originally Posted by retiredguy123

If The Villages health system accepted original Medicare for their primary care doctors, they would be inundated with patients from the surrounding areas, and the health centers would no longer be convenient for Villages residents to use. If you accept original Medicare, you must accommodate all patients who have it.

It's simple if you want to see any Dr. In the USA or go to any hospital in the USA get original Medicare, if you want to be restricted to a short list of Doctors with high deductibles in a network get an advantage plan. If you are very healthy an advantage plan would work out financially If not the money you save on premiums will be eaten up and then some by deductibles and copays. Remember once you opt for an advantage plan there is no going back to traditional Medicare

[Marathon Man]

Originally Posted by BrianL99

That's ridiculous.

It's a strictly financial decision. Medicare Advantage Plans are more profitable for providers, under most circumstances. The Provider gets to determine what is necessary & not necessary for a given patient. Advantage Plans promote shoddy medical care, for the sake of profits. Why do you think they all advertise financial incentives to sign onto their plans?

Advantage plans are for folks who can't afford real insurance and are willing to sacrifice their health to save a few bucks.

I sense bitterness.

I am perfectly happy with my advantage plan and The Villages Healthcare System thank you very much.

[NoMo50]

Originally Posted by retiredguy123

I am a retired Federal employee with the Federal BC/BS standard plan. My employer doesn't require me to have Medicare Part B, so I don't have it. I have saved thousands of dollars by not paying the Medicare premiums. I have no problem finding providers to accept my insurance. So, if you are not required to buy Medicare, you may want to do the math and see if it is worth buying.

We are in the same boat with the federal BCBS (FEP Blue). But, I opted to take Medicare Part B in addition to BCBS. If you don't sign up for Part B when first eligible, there are penalties imposed if you sign up later. Those penalties are severe, and you would pay them for life. Plus, BCBS reimburses each member who has Part B $800 each year to help offset the cost.

For us, this approach has worked well. I have yet to pay a dime out of pocket for medical expenses, including a major surgery last year. We can go to any doctor or specialist we want. And, with the FEP Blue we have worldwide coverage, which can be important when you travel. Everyone's situation is unique, but for us, this works.

[tuccillo]

No, that is incorrect. You can go back to Medicare from a Medicare Advantage Plan during the open season.

Originally Posted by Larchap49

It's simple if you want to see any Dr. In the USA or go to any hospital in the USA get original Medicare, if you want to be restricted to a short list of Doctors with high deductibles in a network get an advantage plan. If you are very healthy an advantage plan would work out financially If not the money you save on premiums will be eaten up and then some by deductibles and copays. Remember once you opt for an advantage plan there is no going back to traditional Medicare

[Sunflower33]

Originally Posted by krick093

While seeking to establish myself as a patient with a general practitioner or internal medicine doctor I have found that most of those in TV do not accept Medicare (including Medicare supplement plans), only Medicare Advantage Plans. Why is that when all of the hospitals and specialists take Medicare readily?

About 6 years ago those of us that had Medicare and part D not advantage the villages made a decision to not accept anything but advantage so we had to find a new doctor. To be honest they did us a favor We found great doctors who are not a part of the health care system in my opinion I’m glad we kept our insurance the way it was and moved on. Best decision we made

[Kittycat2]

Yes you will have a Medicare supplement to back up original Medicare. It depends on your retirement plan as to whether you or your former employer pays the bill, or a portion of it.

[VApeople]

Originally Posted by bsloan1960

My employer allows me to take my group BC/BS into retirement so I'll have private insurance as well as Medicare. Will I face the same issues outlined in OP's post?

Yes you will.

I am a federal retiree with BC/BS and also have Medicare. When I got here in 2016, I was surprised that my insurance was not accepted by The Villages medical system.

I checked with the Villages Hospital and the Hospital in Leesburg and they said our insurance would be accepted there. There are also many other local doctors that accept our insurance.

We have had lots of treatments for skin cancer at Villages Dermatology and one treatment at the Moffitt Cancer Center in Tampa, and all of them have been fully covered by our insurance.

[retiredguy123]

Originally Posted by VApeople

Yes you will.

I am a federal retiree with BC/BS and also have Medicare. When I got here in 2016, I was surprised that my insurance was not accepted by The Villages medical system.

I checked with the Villages Hospital and the Hospital in Leesburg and they said our insurance would be accepted there. There are also many other local doctors that accept our insurance.

We have had lots of treatments for skin cancer at Villages Dermatology and one treatment at the Moffitt Cancer Center in Tampa, and all of them have been fully covered by our insurance.

I am also a Federal retiree with the standard Blue Cross plan. I have opted to not purchase Medicare Part B. So, the only health insurance I have is the Federal Blue Cross and Medicare Part A, which has no premium. Since the Blue Cross plan has an annual out-of-pocket catastrophic limit of $5,000, it makes no sense for me to pay Medicare premiums, which would cost me thousands of dollars per year, and almost as much as my BC catastrophic limit. I will note that I am subject to IRMAA, which would make my Medicare premium higher than the minimum premium. I have had no problem finding providers who accept my Federal health insurance. It has never been rejected by any provider who also accepts original Medicare.

[Rsenholzi]

Stop talking about those outside the villages ! There is an extremely large percentage ( 70%) of people on regular Medicare that are barred from getting a primary in the villages. When I came here , I could get a primary . I was suddenly kicked out when I turned old enough to get Medicare because I stuck with my employers Medicare and did not switch to the villages advantage plan which I would have had to pay for. There is the key . I would have had to pay for the advantage plan where my employer pays for the regular plan. This was a decision made by the developers. You figure out why

[asianthree]

Anyone have ChampVA and regular Medicare? Did you see a necessity to change to an advantage plan along with your champ VA?

Champ VA is a no cost benefit for me, but so far have not had to use Medicare or ChampVA to figure out if I should switch to an Advantage Plan. Thoughts, advice from those who have experience with both

[Lillyangel]

Originally Posted by BrianL99

That's ridiculous.

It's a strictly financial decision. Medicare Advantage Plans are more profitable for providers, under most circumstances. The Provider gets to determine what is necessary & not necessary for a given patient. Advantage Plans promote shoddy medical care, for the sake of profits. Why do you think they all advertise financial incentives to sign onto their plans?

Advantage plans are for folks who can't afford real insurance and are willing to sacrifice their health to save a few bucks.

Some Advantage plans are perks for government employees. I have an Advantage PPO because I worked for the County for many years. I see who I want, where I want.

[Beta Blocker]

I find it rediculous that The Villages allows health care entities to enter TV and not take straight Medicare patients. That should be one of the requirements to be able to offer health care in a retirement community. Yes, I understand that the advantage plans offer higher reimbursements and the health care practitioners make more money but that should not be allowed here in TV. If money is your only goal in practicing medicine, go elsewhere.

[retiredguy123]

Originally Posted by NoMo50

We are in the same boat with the federal BCBS (FEP Blue). But, I opted to take Medicare Part B in addition to BCBS. If you don't sign up for Part B when first eligible, there are penalties imposed if you sign up later. Those penalties are severe, and you would pay them for life. Plus, BCBS reimburses each member who has Part B $800 each year to help offset the cost.

For us, this approach has worked well. I have yet to pay a dime out of pocket for medical expenses, including a major surgery last year. We can go to any doctor or specialist we want. And, with the FEP Blue we have worldwide coverage, which can be important when you travel. Everyone's situation is unique, but for us, this works.

I could be wrong, but as I understand it, the 10 percent per year penalty for delaying Medicare Part B only applies to the basic minimum Medicare premium, not to the much higher IRMAA premium. Because of IRMAA, my Medicare premium would be almost as much as the $5,000 Blue Cross catastrophic annual limit. So, it makes no sense for me to pay Medicare premiums that are as much as the maximum out-of-pocket cost that I could incur with the Blue Cross plan. I would be basically paying money for no additional coverage. That is why I don't have Medicare Part B.

[BrianL99]

Originally Posted by Beta Blocker

I find it rediculous that The Villages allows health care entities to enter TV and not take straight Medicare patients. That should be one of the requirements to be able to offer health care in a retirement community. Yes, I understand that the advantage plans offer higher reimbursements and the health care practitioners make more money but that should not be allowed here in TV. If money is your only goal in practicing medicine, go elsewhere.

Hopefully someone knows way more about this, than I.

Per the Medicare Database, UF Health The Villages Hospital (NPI #1275902124, NPI #1912317538, NPI #1275902124) has NOT opted out of accepting Medicare.

Which leads me to believe the exclusion of non-Advantage plan patients, isn't really an exclusion of Medicare patients, but a refusal to accept their supplemental insurance.

I'm curious if anyone can enlighten me.