Talk of The Villages Florida

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-   -   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/)

POCA 02-02-2016 11:32 AM

My letter from the Villages Health came yesterday informing me that I need to be on Medicare Advantage or find a new Doctor. I called the person whose name was on the letter. This policy change came about January 1, 2016.

outlaw 02-02-2016 12:38 PM

Quote:

Originally Posted by POCA (Post 1180784)
My letter from the Villages Health came yesterday informing me that I need to be on Medicare Advantage or find a new Doctor. I called the person whose name was on the letter. This policy change came about January 1, 2016.

Ditto for my wife, today. She received the dreaded letter; their way or the highway". Oh well. The search begins.

Shimpy 02-02-2016 05:39 PM

Quote:

Originally Posted by POCA (Post 1180784)
My letter from the Villages Health came yesterday informing me that I need to be on Medicare Advantage or find a new Doctor. I called the person whose name was on the letter. This policy change came about January 1, 2016.

How can you enroll if the enrollment period is over?

villagetinker 02-02-2016 07:26 PM

Here is my take on the situation;
First, if you read the recent article in the Daily Sun, it actually noted there were 12 (yes twelve) specialists in the system. Think about this, anyone who needs more care then the PC, will be referred to a specialist, if they are "limited to 1250 patients", guess what LONG wait times, etc. Unfortunately my wife sees 3 to4 specialists, what a mess.
No add it the news release a few months ago that United Health Care (sound familiar) is LOSING several hundred MILLION dollars on these SUPPLEMENT programs.

Here is my take:
1. If UHC goes out of the SUPPLEMENT programs TVHC will need to scramble to "fix" their system, my guess they will need to open it to all of the ADAVANTAGE plans.
2. TVHC sees the handwriting on the wall, and changes their stance (we can only hope.)
3. UHC, goes from a FREE (aka zero monthly cost) type of program to a monthly charge program. I actually think this is the most likely outcome. UHC and TVHC would be able to keep the original program will all of the goodies, and charge a suitable monthly charge to make up for the losses.

NOW, here are the potential CONTINUING problems:
Due to the lack of specialists, you may end up with an OUT OF NETWORK doctor, guess what, better have a really healthy checkbook.
If you go to a hospital other then TVRH, you may find additional OUT OF NETWORK charges on your bill.
Due to the lack of specialists, you may need to go outside the TVHC network to get a LOCAL specialist, guess what, they will NOT accept the United Health Care insurance card, carry a big check book....

For all of the above reason, we converted from the existing advantage plan to a supplemental plan. Yes, we have a monthly premium, but yes we are covered by ANY DOCTOR that accepts Medicare, yes we are covered at ANY HOSPITAL that accepts Medicare.

Please look over your options carefully, contact SHINE:
SHINE - Home
Florida Department of Elder Affairs' SHINE Program
1-800-963-5337
for an UNBIASED assessment of your situation.

Hope this helps, and please do not shoot the messenger.

champion6 02-03-2016 09:24 AM

Quote:

Originally Posted by villagetinker (Post 1180964)
Here is my take on the situation;
First, if you read the recent article in the Daily Sun, it actually noted there were 12 (yes twelve) specialists in the system. Think about this, anyone who needs more care then the PC, will be referred to a specialist, if they are "limited to 1250 patients", guess what LONG wait times, etc. Unfortunately my wife sees 3 to4 specialists, what a mess.
No add it the news release a few months ago that United Health Care (sound familiar) is LOSING several hundred MILLION dollars on these SUPPLEMENT programs. <snip>

I have a different take:
1. I have never read that specialists in the system are limited to 1,250 patients. I can only recall this limit pertaining to primary care physicians.
2. In November 2015 UnitedHealth announced that it is scaling back its marketing of Obamacare exchange plans and may exit the program completely. These are NOT Medicare Supplement plans.

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.


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