[NYBob]

We need recommendations for PCPs who accept Original Medicare in or close to The Villages and are accepting new patients. Also if there are multi-specialty groups that would be a plus. Back in NY we had Crystal Run Healthcare which had a full complement of specialties from Primary to Surgery. Thank you...

[GreggC69]

Do The Villages Health clinics not accept original Medicare?

[retiredguy123]

Originally Posted by GreggC69

Do The Villages Health clinics not accept original Medicare?

No. They only accept certain Medicare Advantage plans for their primary care doctors. They may accept original Medicare for some specialists.

[GreggC69]

Wow! I am very surprised by that. I would think there are A LOT of Villagers with original Medicare. I am curious why they don’t accept.

[retiredguy123]

Originally Posted by GreggC69

Wow! I am very surprised by that. I would think there are A LOT of Villagers with original Medicare. I am curious why they don’t accept.

My theory is that The Villages wants to make the PCP facilities that they own to be accessible to Villagers. If they accepted original Medicare, they would need to provide service to everyone who has original Medicare, including many people outside of The Villages. This could cause the Villages owned facilties to become overcrowded, and defeat the purpose of building healthcare facilities inside The Villages. This is just my opinion.

[Marathon Man]

Originally Posted by retiredguy123

My theory is that The Villages wants to make the PCP facilities that they own to be accessible to Villagers. If they accepted original Medicare, they would need to provide service to everyone who has original Medicare, including many people outside of The Villages. This could cause the Villages owned facilties to become overcrowded, and defeat the purpose of building healthcare facilities inside The Villages. This is just my opinion.

That is a good theory. One that I have heard before.

[Risuli]

I have medicare along with Blue Cross/Blue Shield through the federal government health plan and The Villages health would NOT accept it.

[retiredguy123]

Originally Posted by Risuli

I have medicare along with Blue Cross/Blue Shield through the federal government health plan and The Villages health would NOT accept it.

I also have the BC/BS Standard Federal plan, but, when I did the math, the Medicare Part B premium was a waste of money. You may want to do the math to see if you really need Medicare Part B, which is mostly redundant with BC/BS. The Medicare premium is optional.

[villagetinker]

Originally Posted by retiredguy123

My theory is that The Villages wants to make the PCP facilities that they own to be accessible to Villagers. If they accepted original Medicare, they would need to provide service to everyone who has original Medicare, including many people outside of The Villages. This could cause the Villages owned facilties to become overcrowded, and defeat the purpose of building healthcare facilities inside The Villages. This is just my opinion.

I do not think this holds water as the VHS could just require to see the villagers ID card. We were able to use this service in 2013 to 2014 with original Medicare and then the VHS said no sorry, Medicare Advantage only. At the time I left, my wife went on a Medicare Advantage plan, BIG MISTAKE, she lost access to all of her specialists and had long wait times for the new specialists, we got lucky and in discussions with SHINE found out she could get back to original Medicare and we made it just under the deadline. We miss the local PCP doctors, I could walk to the office, but we do not regret the decision to go back to Medicare.

[retiredguy123]

Originally Posted by villagetinker

I do not think this holds water as the VHS could just require to see the villagers ID card. We were able to use this service in 2013 to 2014 with original Medicare and then the VHS said no sorry, Medicare Advantage only. At the time I left, my wife went on a Medicare Advantage plan, BIG MISTAKE, she lost access to all of her specialists and had long wait times for the new specialists, we got lucky and in discussions with SHINE found out she could get back to original Medicare and we made it just under the deadline. We miss the local PCP doctors, I could walk to the office, but we do not regret the decision to go back to Medicare.

From the website, Medicare.gov:

If you have original Medicare:

"You can:
See any doctor or specialist (including women's health specialists), or go to any Medicare-certified hospital, that participates in Medicare."

I think it would be illegal to require a patient to live in The Villages to use a provider who accepts original Medicare. If a provider accepts original Medicare, they must accept any patient who has original Medicare. They cannot discriminate based on where they live.

[barbara828]

they want to manage your care for the insurer

[riley2011]

Originally Posted by GreggC69

Wow! I am very surprised by that. I would think there are A LOT of Villagers with original Medicare. I am curious why they don’t accept.

They don’t accept it because with regular Medicare the doctor only gets paid when he sees the patient. With an advantage plan the doctor gets paid a certain amount every year for every patient he has whether he sees you or not.

[bowlingal]

Greg....the used to accept original Medicare, but the villages put a squash on that about 8 years ago. This is for primary care only. The villages health SPECIALISTS DO accept regular Medicare. Sinai Internal Medicine in Lake Sumter is a primary care office that does accept traditional Medicare.

[RoboVil]

Originally Posted by GreggC69

Do The Villages Health clinics not accept original Medicare?

I called some which listed only Medicare Advantage plans they accepted, including the hospital, and all said they took original Medicare as well. I don't know why they list on their website they take Medicare Advantage but omit they take original Medicare. So, call to be certain, I think almost all will take original Medicare though not listed on their website. UF-affiliated physician offices would have to accept original Medicare if UF Health is accepting original Medicare in Gainsville.

[retiredguy123]

Originally Posted by RoboVil

I called some which listed only Medicare Advantage plans they accepted, including the hospital, and all said they took original Medicare as well. I don't know why they list on their website they take Medicare Advantage but omit they take original Medicare. So, call to be certain, I think almost all will take original Medicare though not listed on their website. UF-affiliated physician offices would have to accept original Medicare if UF Health is accepting original Medicare in Gainsville.

The Villages Health clinics do not accept original Medicare for their primary care doctor visits. You must have one of their specified Medicare Advantage plans.

This is from their 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.

We only accept Medicare Advantage because we care about the physical, emotional and financial needs of our patients. With Medicare Advantage, our patients stay healthier, experience less stress and save money on health care."