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Talk of The Villages Florida (https://www.talkofthevillages.com/forums/)
-   Medical and Health Discussion (https://www.talkofthevillages.com/forums/medical-health-discussion-94/)
-   -   Received my The Villages Health notice last week (https://www.talkofthevillages.com/forums/medical-health-discussion-94/received-my-villages-health-notice-last-week-179690/)

Avista 02-03-2016 10:39 AM
It is my understandng that we are NOT limited to these 12 specialists. Please check with the United Medicare Store as well as Shine. Best to do your homework.

CritterLover 02-03-2016 11:35 AM
Quote:
Originally Posted by birdawg (Post 1178989)
Was at Colony yesterday, no rumors. THIS IS HAPPENING...
Nowhere did I say that it wasn't happening..just that if you want the facts, call and get them, rather than reading/listening to all the rumors and supposition.

jfwclark 02-03-2016 05:26 PM
Quote:
Originally Posted by Vladimir (Post 1176637)
I joined The Villages Health system two years ago and when they and United Health made a decision to be the only acceptable insurance plan I was told I was grandfathered. Well, I just received my notice to either go with United Health or seek services some place else. United Health is losing too much money so their new business plan is to have The Villages Health accept only United Health, which I think will fail. My health plan is far superior to theirs so now all my medical needs will be met by doctors, specialists and hospitals outside The Villages network. I will be driving to Ocala, Leesburg and Tavares or areas on Rt 441. It's a shame since a turn key health care concept that The Villages Health was espousing sounded intriguing and was a good selling point. If you are not with United Health then expect a call in the future as they transition their patients.
My wife turned 65 yesterday and she was dropped by them as well even though she was originally told she would be grandfathered in. We are now considering leaving The Villages altogether.

RickeyD 02-04-2016 08:19 AM
Quote:
Originally Posted by jfwclark (Post 1181298)
My wife turned 65 yesterday and she was dropped by them as well even though she was originally told she would be grandfathered in. We are now considering leaving The Villages altogether.

Are you linking a false promise with leaving ? Or is it something else...

golfing eagles 02-04-2016 08:27 AM
Quote:
Originally Posted by jfwclark (Post 1181298)
My wife turned 65 yesterday and she was dropped by them as well even though she was originally told she would be grandfathered in. We are now considering leaving The Villages altogether.
Isn't that just a bit of an over reaction? There are a lot of doctors, a lot of health insurance plans, but there's only one "The Villages". If you leave, you still don't get TV Health system, but you lose everything else this place has to offer.

rjn5656 02-04-2016 08:55 AM
Villages Health Center Notice
 
SEnd them a note on email with your displeasure with this whether you got a notice or not. We did and got a phone call quickly to discuss. One call may not make a difference but if they get a lot of them, who knows.

CtButterfly 03-29-2016 03:45 PM
Quote:
Originally Posted by Vladimir (Post 1176637)
I joined The Villages Health system two years ago and when they and United Health made a decision to be the only acceptable insurance plan I was told I was grandfathered. Well, I just received my notice to either go with United Health or seek services some place else. United Health is losing too much money so their new business plan is to have The Villages Health accept only United Health, which I think will fail. My health plan is far superior to theirs so now all my medical needs will be met by doctors, specialists and hospitals outside The Villages network. I will be driving to Ocala, Leesburg and Tavares or areas on Rt 441. It's a shame since a turn key health care concept that The Villages Health was espousing sounded intriguing and was a good selling point. If you are not with United Health then expect a call in the future as they transition their patients.
Please note...the Villages Health Care System only offers you one choice - United Health Care Medicare Advantage. My mom had this insurance, it worked great until she got sick, then it was a problem with limited choices & coverage from hospital to rehab facility, back & forth three times within two months. She finally just gave up, refused to eat & passed away two days later.
The Health Care System is a wonderful concept, but I refuse to not have a choice i my healthcare coverage.

kstew43 03-29-2016 03:52 PM
Quote:
Originally Posted by CtButterfly (Post 1205961)
Please note...the Villages Health Care System only offers you one choice - United Health Care Medicare Advantage. My mom had this insurance, it worked great until she got sick, then it was a problem with limited choices & coverage from hospital to rehab facility, back & forth three times within two months. She finally just gave up, refused to eat & passed away two days later.
The Health Care System is a wonderful concept, but I refuse to not have a choice i my healthcare coverage.
that is very sad.......that someone decided it was eaiser to end there life rather than fight due to health care issues..... sorry for your loss....
:sing:

champion6 03-29-2016 03:58 PM
Quote:
Originally Posted by CtButterfly (Post 1205961)
Please note...the Villages Health Care System only offers you one choice - United Health Care Medicare Advantage. My mom had this insurance, it worked great until she got sick, then it was a problem with limited choices & coverage from hospital to rehab facility, back & forth three times within two months. She finally just gave up, refused to eat & passed away two days later.
The Health Care System is a wonderful concept, but I refuse to not have a choice i my healthcare coverage.
I'm sorry for your loss. With all due respect and for clarity to others, The Villages Health System takes more plans than you indicated. One is a regional PPO. From their website:

If you are eligible for Medicare, we want you to know that the only Medicare Advantage plans The Villages Health participates in are those offered by UnitedHealthcare®.
  • UnitedHealthcare® The Villages® MedicareComplete® (HMO) Plan 1
  • UnitedHealthcare® The Villages® MedicareComplete® (HMO) Plan 2
  • AARP® Medicare Complete Choice® (Regional PPO)
  • AARP® Medicare Complete Choice® (HMO)
  • United Healthcare® Medicare Advantage Dual Complete

CtButterfly 03-29-2016 04:12 PM
Quote:
Originally Posted by champion6 (Post 1205968)
I'm sorry for your loss. With all due respect and for clarity to others, The Villages Health System takes more plans than you indicated. One is a regional PPO. From their website:

If you are eligible for Medicare, we want you to know that the only Medicare Advantage plans The Villages Health participates in are those offered by UnitedHealthcare®.
  • UnitedHealthcare® The Villages® MedicareComplete® (HMO) Plan 1
  • UnitedHealthcare® The Villages® MedicareComplete® (HMO) Plan 2
  • AARP® Medicare Complete Choice® (Regional PPO)
  • AARP® Medicare Complete Choice® (HMO)
  • United Healthcare® Medicare Advantage Dual Complete
Interesting...when my husband went on Medicare last year, we went to the Pinellas TVHC office to ask and we were only given that one option.

graciegirl 03-29-2016 05:46 PM
///

dbussone 03-29-2016 06:46 PM
Without having a copy of their local operations financials in front of me, I would not want to conclude that UHC is losing money here. It may be that they want to focus on the most profitable product at this time.

I'm familiar with UHC operations in other parts of the country. They will morph as necessary to achieve their goals.

lovsthosebigdogs 03-29-2016 09:01 PM
It happened to me also. I have been seeing a doctor in the Villages Health Care System with my regular insurance and all is well. Going on Medicare and not choosing the UHC so I am not going to be able to see the doctor I have been seeing previously. I won't choose this doctor because I go to out of network doctors for some things and it doesn't work for me with ALL my doctors and I travel. So I am forced to find a new doctor. Oh well...

spuds51 04-06-2016 07:19 AM
In the same boat
 
Quote:
Originally Posted by outlaw (Post 1177118)
I have suspected this was going to happen. As I posted previously, when I called to ask about this very specific scenario of being a current patient with them, but not yet 65, they told me that when I reached 65, I am still grandfathered in. I haven't received my letter yet, but I still have several months before 65. And yes, Jomar, they do owe their customers honesty.
I too am turning 65 this year. I too was told the only insurance they would accept was Medicare Advantage UHC. I was also more than a little surprised how they seemed to be pushing it. My wife's doctor even suggested she go with Advantage plan. Remember, that if you go with the Advantage Plan the health insurance makes the decisions on what treatments you receive not your doctors. I'm going to try to add a link. Not sure if it will let me. United Healthcare Oxford Medicare Advantage Denies Coverage - YouTube
You may have to copy and paste it. This was done by Good Morning America. It tells of one woman's experience with Medicare Advantage UHC.

spuds51 04-06-2016 07:27 AM
Not losing money
 
[QUOTE=dbussone;1206020]Without having a copy of their local operations financials in front of me, I would not want to conclude that UHC is losing money here. It may be that they want to focus on the most profitable product at this time.

I'm familiar with UHC operations in other parts of the country. They will morph as necessary to achieve their goals.[/QUOT








You may have copy and paste this. It won't let me add a link

spuds51 04-06-2016 08:05 AM
answer
 
Quote:
Originally Posted by rexxfan (Post 1177258)
I am in a similar situation. What is it exactly about the UHC Medicare Advantage plan that is so unattractive to so many? I've read the plan description and it seems reasonable to me, but I admit to having limited experience in this area as I am fortunate to be in excellent health and rarely need to see a doctor (so far, anyway).
--
Bob C
The single biggest difference between Original Medicare and Medicare Advantage is with the Advantage plan your doctor does not decide what care you receive, the insurance company does. I have myself seen the words not medically necessary. My doctor prescribed a treatment and the insurance company denied it. I can tell you that there is no more helpless feeling.
With Original Medicare your doctor and YOU decide what care you need, not someone setting miles away that has never seen you.
If you decide to go with the Advantage plan I hope your health remains excellent.

spuds51 04-06-2016 08:18 AM
I'm from Ohio
 
Quote:
Originally Posted by TidalWalkers (Post 1177690)
I am in the process of exploring my Medicare options for turning 65 in May. I am a retired Ohio teacher and have received the STRS information and visited the Medicare store RE: United Health Care. Any Ohio retirees have pros or cons on the two options? I have struggled to find a DR I liked with my Ohio medical mutual and would like to return to The Villages health system. I found out today that would have to be part of United Health Care. Any comments from Ohio retirees?
I'm going to give you a number of a Independent agent who deals in Medicare. He will explain the difference between the two plans.

Matthew Clasasen
800-847-9680

Talk to this guy, he is the most knowledgeable person I have talked to on the subject. He has been at it since 1984 and his wife works in Medicare billing.

champion6 04-06-2016 08:20 AM
Quote:
Originally Posted by spuds51 (Post 1209214)
According to the piece done by Good Morning America they are far from losing money. Try 4.1 billion in profits last year.

https://www.youtube.com/watch?v=H8erunWFyT4

You may have copy and paste this. It won't let me add a link
Based on your comment, I'm not sure the link is the one you intended to post.

But "4.1 billion in profits last year"??? The video was uploaded on Dec 27, 2007. They may still be making money, but this source is outdated.

spuds51 04-06-2016 08:56 AM
You're right
 
Quote:
Originally Posted by champion6 (Post 1209245)
Based on your comment, I'm not sure the link is the one you intended to post.

But "4.1 billion in profits last year"??? The video was uploaded on Dec 27, 2007. They may still be making money, but this source is outdated.
You're right. I did not notice the date. I'm guessing they are doing alright tho. The biggest point I wanted to make was the difference between the Medicare programs. People that are considering Medicare Advantage should know that it won't be the doctors and you that decide what health procedures you need, the insurance company will.

spuds51 04-06-2016 09:30 AM
I removed the link. You're right the info was outdated.

SookeyJo 04-07-2016 09:54 PM
I have Florida Blue right now but will turn 65 later this year. I SUPPOSE this will screw everything up for me.
I have a terminal illness and can't afford to keep changing doctors all the time. But then I guess they just don't give a toot's hoot.

dbussone 04-07-2016 10:10 PM
Quote:
Originally Posted by SookeyJo (Post 1210030)
I have Florida Blue right now but will turn 65 later this year. I SUPPOSE this will screw everything up for me.
I have a terminal illness and can't afford to keep changing doctors all the time. But then I guess they just don't give a toot's hoot.
If you go with traditional Medicare, and have FL Blue as a supplement, consider Angel Tafur, MD as your primary doc. I would discourage you from converting to a Medicare Advantage policy with a "terminal illness.". Your out of pocket costs will be quite expensive.

My wife has MS, and uses traditional Medicare, with a FLBLUE supplement and FLBLUE drug plan. She hits the ceiling every year, but our out of pocket costs would be much greater if she had an Advantage Plan.

And don't take what I say as gospel - talk to an insurance consultant. Call AARP, United Healthcare, and FLBLUE at a minimum. Please!

Chi-Town 04-07-2016 10:13 PM
Quote:
Originally Posted by SookeyJo (Post 1210030)
I have Florida Blue right now but will turn 65 later this year. I SUPPOSE this will screw everything up for me.
I have a terminal illness and can't afford to keep changing doctors all the time. But then I guess they just don't give a toot's hoot.

Get Medicare A and B along with Florida Blue Cross Blue Shield supplemenr F. Also sign up for Medicare prescription drug plan D. You should be fine.

dbussone 04-07-2016 10:17 PM
Received my The Villages Health notice last week
 
Quote:
Originally Posted by Chi-Town (Post 1210036)
Get Medicare A and B along with Florida Blue Cross Blue Shield supplemenr F. Also sign up for Medicare prescription drug plan D. You should be fine.
Good advice. A concise summary of my suggestion.

rubicon 04-08-2016 05:38 AM
Quote:
Originally Posted by Chi-Town (Post 1210036)
Get Medicare A and B along with Florida Blue Cross Blue Shield supplemenr F. Also sign up for Medicare prescription drug plan D. You should be fine.
That's my plan too

Jimmydoodlebug 04-08-2016 05:57 AM
Who Needs Them
 
I ran into this the other day. I have Medicare and United Health Care for a supplemental, but when I went to join the Villages Health system they said they don't accept Medicare. I would need to give up Medicare and my United plan and join their HMO instead. That puts restrictions on who you can see and when you can see him, so it would be a big step down. If you need to see a doctor while away from the Villages, good luck.

I've never had my current Medicare/United plans refused until now, so why give up the freedom to go anywhere I want!

I would join the Villages system for a matter of convenience, but I'm not trading steak for hamburger.

virgind 04-08-2016 06:06 AM
I have a Humana Medicare PPO Advantage plan and it is accepted every where. I pay only the Medicare cost and thats it. Every thing is covered. It sounds like United health owns The Village health.

Doro22 04-08-2016 07:29 AM
Quote:
Originally Posted by gomoho (Post 1176764)
Of course they are dictating who you must choose for your insurance. Paint it any rosy color you want, but if you like your doctor at TV health you won't be keeping him unless you do what they want. Doesn't affect me, but things like this just make my blood boil.

When this health system was proposed it was in an effort to make The Villages the healthiest hometown not fill the pockets of United Health Care. This isn't a case of "if you don't like it move or go to another doctor", but a change of the rules mid-game.
Their policies made my blood boil also several years ago when they first started opening clinics. I had been to their P.R. seminar @ Savannah & was fully prepared to join. So I called up to join & was told that I didn't live in the "right" village to belong to one of their clinics. It was only open to the new areas. I said "What is this...Communist Russia?" I had all the right insurance....and sure enough, about 9 months later I began to receive their phone calls & letters practically begging me to become a member. I said no way would I join now.

spuds51 04-08-2016 09:19 AM
Quote:
Originally Posted by Jimmydoodlebug (Post 1210072)
I ran into this the other day. I have Medicare and United Health Care for a supplemental, but when I went to join the Villages Health system they said they don't accept Medicare. I would need to give up Medicare and my United plan and join their HMO instead. That puts restrictions on who you can see and when you can see him, so it would be a big step down. If you need to see a doctor while away from the Villages, good luck.

I've never had my current Medicare/United plans refused until now, so why give up the freedom to go anywhere I want!

I would join the Villages system for a matter of convenience, but I'm not trading steak for hamburger.
Smart man. Here is a chart comparing Medicare and Medicare Advantage.



https://medigapseminars.org/wp-conte...vs-medigap.png

spuds51 04-09-2016 07:42 AM
Another link I found very interesting plan F



https://medigapseminars.org/2015/03/...orida-seniors/

avillager 04-29-2016 05:53 PM
I heard yesterday that if you don't have the United health advantage plan the villages HMO- PPO then you would no longer be able to go to one of the 5 (I believe) health centers they have built but as far as I know it doesn't apply to the Docs who practice within the villages but not in their centers.

graciegirl 04-29-2016 06:50 PM
Quote:
Originally Posted by avillager (Post 1219430)
I heard yesterday that if you don't have the United health advantage plan the villages HMO- PPO then you would no longer be able to go to one of the 5 (I believe) health centers they have built but as far as I know it doesn't apply to the Docs who practice within the villages but not in their centers.
You are correct and there are many. Our insurance is not a match for the very nice Villages Health Care but we have found several doctors that we are comfortable with. In fact we see THEM now more than we see our children, lol.

Bonnevie 04-30-2016 08:23 AM
I, too, am being kicked out of Villages Health. I asked about this last month before a scheduled appt and was told they will keep me due to having Fed. BC/BS. Then just last week someone called to ask if I'm taking the advantage plan and professed no knowledge of previous call. Had I known I was out, I would have scheduled my March appt. with someone else. It's a pain because I got my hearing aids thur Villages Health. I talked to the doctor in charge and he spent considerable time trying to convince me the advantage plan was better than Medicare A&B and my BC/BS. I figure if it was that good, he wouldn't have to try so hard to convince me. I've been told to never give up my federal health insurance, so now I'll have to find another doctor.

dbussone 04-30-2016 08:34 AM
I find this discussion very interesting. Here we have The Villages Health essentially limiting its patient base to a particular Advantage plan. And the Feds have been talking about eliminating Advantage plans over the next several years. Obama Proposes Eliminating Medicare Advantage, Ousting 9 Million Seniors from Their Health Plans | Cato @ Liberty

gerryh1943 04-30-2016 09:26 AM
I have been going to the Village Health since it started with Blue Cross. I am over seventy they also told me that I was grandfather in. I am wondering because I was grandfather in when I was 69 or 70 does that mean I also will be getting the LETTERRRRRR

Bonnevie 04-30-2016 12:25 PM
you might be ok because you were already 65 when you joined. I turn 65 next month and they told me they weren't keeping anymore people like me.

goodtimesintv 04-30-2016 03:05 PM
Like AARP receiving royalities from United Healthcare for use of the AARP name, The Villages, Inc. is receiving royalties for intellectual property (brand name recognition) from United Healthcare.

Here is the page to access the four Advantage plans accepted at TV Health (I put in Sumer County and Zip 32162). And the fine print says it.

https://ma.uhcmedicaresolutions.com/...T.mc_id=881806

"Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare. UnitedHealthcare pays royalty fees to Holding Company of The Villages, Inc. (The Villages) for the use of its intellectual property. The Villages and its affiliates are not insurers."


https://www.uhcmedicaresolutions.com...ent-plans.html

"The AARP Medicare Supplement Insurance Plans carry the AARP name and UnitedHealthcare pays a royalty fee to AARP for use of the AARP intellectual property. Amounts paid are used for the general purpose of AARP and its members. Neither AARP nor its affiliate is the insurer."

It seems to me that "the playing field is being leveled" by giving AARP some competition. In terms of these two entities reinvesting in our community here in TV, I would much rather have such revenues go to The Villages, Inc., than AARP.

champion6 04-30-2016 06:33 PM
Quote:
Originally Posted by dbussone (Post 1219624)
I find this discussion very interesting. Here we have The Villages Health essentially limiting its patient base to a particular Advantage plan. And the Feds have been talking about eliminating Advantage plans over the next several years. Obama Proposes Eliminating Medicare Advantage, Ousting 9 Million Seniors from Their Health Plans | Cato @ Liberty
All I can say is the article you link to is over seven years old. A LOT has changed with healthcare in that time.

dbussone 04-30-2016 07:24 PM
Received my The Villages Health notice last week
 
Quote:
Originally Posted by champion6 (Post 1219946)
All I can say is the article you link to is over seven years old. A LOT has changed with healthcare in that time.
I can find a similar link for every year since the current admin came into office. Just contributing to the body of knowledge - Forbes Welcome

Eliminating Advantage plans has been a stated goal of CMS for a number of years now. I think I have a good handle on what's going on in healthcare, thank you.

trichard 05-09-2016 12:05 PM
Can anyone confirm that The Villages Health will no longer accept patients who were so called "grandfathered" with their original Medicare Insurance? Starting next year you either change to Medicare Advantage or seek care elsewhere.


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