Retired Military moving to Villages....Healthcare info needed...Please?

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  #16  
Old 12-27-2019, 07:53 AM
Lblueocala Lblueocala is offline
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I also have my husband as a patient with the civilian doctor I see as a backup to the VA. He got a real bad cough and I sent him to a urgent care for the chest X-ray and the antibiotic prescription he ended up getting. It was all covered. I’m a nurse and have been working the past ten years navigating the VA, tricare, and Medicare coverage and networks for my husband, myself and other family members. Each year I read and update myself on the different coverages, don’t throw the books away. The biggest mistake people many is they don’t read and know what is covered, what doctors and facilities are in or out of network. That makes a big differences if it’s covered or you’re going to have to pay for it out of pocket. I had my husband do an appointment with his VA doctors in Wichita just before he came down so he had enough meds for 3 months. As soon as we got here, like the next day, went right over to the VA clinic got all of his new patient appointments. He has had no brake in service. Make sure you and you wife get your change of address in to express scripts as soon as you know your new address and the day you close on your home here and have your mailbox key so your meds don’t get hung up if you use home delivered for meds. That’s why I made sure we both had 90 day supply of our meds, it made the move easier.
  #17  
Old 12-27-2019, 08:08 AM
Lblueocala Lblueocala is offline
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I understand the villages healthcare may or may not take tricare, but not regular Medicare. I didn’t want to have to change doctors and I knew up front We would NOT give up our regular Medicare and tricare for life so I never even tried to get in the villages healthcare. When I talked to them and asked the right questions about their coverage the person I talked to realized I knew about the different coverages and the limitations the villages healthcare put on you to see a specialist outside their network. My husband and I are from here and are medical and worked in central Florida.
  #18  
Old 12-27-2019, 08:33 AM
jjiggers jjiggers is offline
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Good morning and welcome! My husband and I have been here almost 16 years and are perm residents. We uses Tricare Prime exclusively. We're in our 70's and since we have been here he has had 2 knee's and 1 shoulder replaced, and a bout with colon cancer which we chose to have treated at Mayo Clinic in Jacksonville. I have had a pacemaker implanted and two broken wrists. We are healthy and very active. We have had no problem with our Tricare Prime/ medicare combo and have never had to pay out of pocket for medical expenses. Many Dr's are now excluding this combo for the new Advantage plans. We've chosen not to go that route as we are VERY happy with what we have. The Village Health uses the Advantage plan, we can uses their specialists and I do, but we also have the option of using any Dr. we choose, thus Mayo. All the Drs we have used (many) are here in The Villages and practice in the local hospitals when needed. Just so you know you have that choice if you want Tricare Prime!
  #19  
Old 12-27-2019, 08:39 AM
mainelovr mainelovr is offline
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When my wife and I moved to The Villages, we considered keeping Tricare Prime, but the availability of providers was very underwhelming. So we switched to Tricare Select (formerly standard and extra). We were able to keep our provider in Maine, who we love, and see her during the summer months when we’re up there. When we make the switch in the next couple of years, I think we’ll stay with Select unless Tricare has more Prime providers available in this area.
  #20  
Old 12-27-2019, 09:52 AM
vinceg35 vinceg35 is offline
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Tricare standard and USAA Mediplus worked great for me.
  #21  
Old 12-27-2019, 10:58 AM
mooned mooned is offline
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Default TRICARE Prime in the Villages

Greetings the Wife and I moved here last Aug, am retried Navy, under the age of 65. Prior to moving here researched the TRICARE web sites and based on our ZIP Code, was told that there was no TRICARE Prime available in the area. So we assumed that we would have to shift to TRICARE Select.
When we called TRICARE and talk to a human we were told that TRICARE Prime was available in the town of Leesburg, the same location most of the TRICARE Select providers reside. So we chose to stay with TRICARE Prime. So.. moral of story, talk to a human, don't trust the web sites alone.

Last edited by mooned; 12-27-2019 at 12:31 PM.
  #22  
Old 12-27-2019, 12:02 PM
Weschupp@gmail.com Weschupp@gmail.com is offline
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Hi Troy, Smart of you to do your research. I understand exactly what you are going through. When we first started looking one of the first things we did was check the availability of Tricare Prime support. Two years ago, before Tricare switched to the current administrator, there were thousands of providers in the area you could find on the Tricare site. Which was perfect. We purchased a home and a year ago with that initial research in our background. However, after the transition, the number of providers went to zero. Since then I have spent many many hours on the phone with Humana, contacted our congressmen and filed grievances. Here is what I found, during the transition, all the doctors were supposedly sent letters advising them that they needed to reapply to be a provider. And Humana's feedback they did what they were supposed to do and would do no follow up on the anomalous situation, thousands of providers and hospitals to none in the two zip codes 32159 and 32162 which covered the Villages. I had even gone as far as calling Doctors and hospitals asking if they accepted Tricare Prime, every one I contacted replied they did and thought themselves to be network providers. All were in awe when i conveyed that according to the provider site, they were not identified as network nor non network providers. Over the last year in my plight I have gone as far as making accusations that there were area managers that needed to be fired because they did not do their job, thousands to zero was definitely someone not doing their job. I do not know if any of my efforts have done anything, but I can tell you that as of last month there are now several hundred network providers and many more non network providers that have shown up on the list of Tricare Prime providers as well as several PCM's. It is working out for us we hope, because we only moved from the other side of the state, and we still had our home in the other area, so we have continued to use our old providers, but we have now sold our home so we will have to transition to a new PCM. Like a couple of the other posts have I believe the doctors in the area will accept Tricare Prime, but would advise caution when getting a new doctor asking the important questions about acceptance of Tricare Prime. If they say they do and can file the claim, one would think they are registered and accept assignment of Tricare Allowable charges,,,but I will still be cautious. You will never have a problem should you need to go to an emergency room, but doctors and medical procedures could pose an issue. Until the new Tricare administrator finally gets their stuff together I will be cautious, but eventually I think it will be great. Also, the Tricare provider search site "s" leaves a bit to be desired, like trying to find a PCM. If just doing a search for PCM's to change you may find a few. But if you look at GP's and Family doctors you will see several more are listed as PCM's in their services. Hope this helps, I am under 65 also so Medicare and Tricare for life in a few years down the road but my research in that area is almost every doctor and hospital accepts medicare and Tricare for Life picks up the rest so we will be in good hands at that milestone.
  #23  
Old 12-27-2019, 12:05 PM
arbajeda arbajeda is offline
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I have United Health Care (UHC) zero-premium plan that bills Medicare and Tricare For Life (TFL), and I use The Villages Health facilities. Very happy.

Medicare Resources - The Villages Health
  #24  
Old 12-27-2019, 02:52 PM
Curtisbwp Curtisbwp is offline
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Sir, I am a village resident and am USN retired. Tricare prime is all but gone, there is one prime provider in leesburg but I would not recommend it. I retired at 53 and wife at 48. I also retired from postal service and had federal bc/bs. I suspended the bc/bs as the cost was up to $400.00 per month. I stayed with tri standard. The absolute most out of pocket was $3,000.00 a year vs bc/bs $4,800.00 per year in payments. No brainers. I did establish an account with $3,000.00 to cover any unexpected medical issues. The VA clinic in the villages is new and quite well equipped. The VA hospital is in Gainsville and is partnered with Shands hospital. I have had simple procedures and tests at Gainsville, all with good results. For any major surgery I go to a private doctor and to the Mayo clinic in Jacksonville (2.5 hours away but well worth it) gainsville is about 1.5 hours away. I am now on tricare for life and medicare. Tricare for life is at no cost. Between the two i NEVER have a copay or deductible. You can not get better coverage. The village hospital is a place i stay away from. There are other much better hospitals, Leesdurg, ocala, shands...
The goal is to stay healthy till you turn 65. I have lived here since 2003.
Curtisbwp@yahoo.com
  #25  
Old 12-27-2019, 07:43 PM
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Sparty6971 Sparty6971 is offline
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//////

I really need to remember to fully read ALL the previous postings before I insert my foot and bite down hard.

Last edited by Sparty6971; 12-27-2019 at 07:54 PM.
  #26  
Old 12-27-2019, 08:57 PM
carolfry44 carolfry44 is offline
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You will be just fine here in The Villages with your Tri-Care Prime. Not to worry at all.
  #27  
Old 12-27-2019, 09:11 PM
NavyVet NavyVet is offline
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I'm no expert, but here are my experiences.
DH is retired military (1992). I am 100% disabled Veteran since 2001. We always stuck with Tricare Standard (has a cost-share, not a co-pay so no payment out of pocket up front.) When I got SS disability, Medicare became my primary with Tricare For Life as secondary. Every provider I went to said I had the 'holy grail' of insurance coverage. Always ask up front to be sure provider accepts. The only place that was a problem is the Villages Health system. When DH turned 65, his Tricare Standard became Medicare with Tricare for Life and Villages Health kicked him out because he didn't switch to a Medicare Advantage Plan. Who on Earth would give up Tricare benefits? We earned them! Do NOT switch from Tricare; those Advantage plans are HMOs and only to THEIR advantage, not YOURS. They are fine if you are healthy, but if you start having expensive issues ... not so much. There are plenty of providers outside The Villages system. We have no problems finding them and don't need preauthorization for specialists.
Also, the VA Outpatient Clinic is a large facility on the Northern end of TV. It is very good. Yes, they are busy. Get enrolled there as soon as you move here.
We have PCPs with both the VA and on the 'outside' so between them we are fully covered for any health need. If you have an acute problem and can't get a same day appointment with your doctor, there are numerous Urgent Care centers. We have had very good experiences with Paramount on 466.
I have no experience with the details of Tricare Prime, so can't help you there. Hope this has helped a little. As with many things, insurance can be complicated. Clear as mud as they say! Best of luck.
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  #28  
Old 12-28-2019, 03:44 PM
mooned mooned is offline
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Quote:
Originally Posted by NavyVet View Post
I'm no expert, but here are my experiences.
DH is retired military (1992). I am 100% disabled Veteran since 2001. We always stuck with Tricare Standard (has a cost-share, not a co-pay so no payment out of pocket up front.) When I got SS disability, Medicare became my primary with Tricare For Life as secondary. Every provider I went to said I had the 'holy grail' of insurance coverage. Always ask up front to be sure provider accepts. The only place that was a problem is the Villages Health system. When DH turned 65, his Tricare Standard became Medicare with Tricare for Life and Villages Health kicked him out because he didn't switch to a Medicare Advantage Plan. Who on Earth would give up Tricare benefits? We earned them! Do NOT switch from Tricare; those Advantage plans are HMOs and only to THEIR advantage, not YOURS. They are fine if you are healthy, but if you start having expensive issues ... not so much. There are plenty of providers outside The Villages system. We have no problems finding them and don't need preauthorization for specialists.
Also, the VA Outpatient Clinic is a large facility on the Northern end of TV. It is very good. Yes, they are busy. Get enrolled there as soon as you move here.
We have PCPs with both the VA and on the 'outside' so between them we are fully covered for any health need. If you have an acute problem and can't get a same day appointment with your doctor, there are numerous Urgent Care centers. We have had very good experiences with Paramount on 466.
I have no experience with the details of Tricare Prime, so can't help you there. Hope this has helped a little. As with many things, insurance can be complicated. Clear as mud as they say! Best of luck.
Hi I am sorry but am a bit confused. As I am approaching 65 as a retired Navy I get the fun of shifting from Tricare Prime to Tricare for Life and Medicare. I had heard several comments that "to use the Villages Health Care" clinic chain I would have to shift my TRICARE for Life to a MEDICARE Advantage i.e. Medicare part C plan, but Medicare Advantage is a Medicare change, not a TRICARE change. When I called TRICARE I was told that it made no difference to TRICARE For Life if I used Medicare A and B (i.e.traditional Medicare) or if I used Medicare C i.e. Advantage. TRICARE for Life will remain my secondary insurance.. With one condition that I should not chose a Medicare Advantage plan the included Drug coverage because that would impact my TRICARE for Life drug coverage. So was I miss informed by TRICARE ? I tried to get it in writing but TRICARE has yet to respond to my e-mail question.
  #29  
Old 12-28-2019, 06:44 PM
Troy8432 Troy8432 is offline
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Thanks to everyone for their replies. The information provided has been quite informative. I think I read somewhere that TRICARE Prime is only available if your willing to sign a waiver that basically states you are willing to travel to a Military Treatment Facility over 50 miles away on occasion. Probably Macdill Afb. It appears that TRICARE Standard and TRICARE Select are synonymous. E.g. No premium, 80% covered if doctor accepts TRICARE with a $3000 cap per year. I will continue to work following the move to Florida, so my employer may offer a good TRICARE supplement. I figure that I will use VA as much as possible and the missus will use TRICARE until Medicare/TRICARE-for-life begins. Good plan?
  #30  
Old 12-28-2019, 06:52 PM
Raymond Carter Raymond Carter is offline
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I was in very similar position two years ago. Moved here from Fairfax as retired Air Force. What I have learned and experienced since arriving is Tricare Prime is available but very limited in providers. I and a colleague in similar situation have done Tricare Prime and made it work. Not crazy about our doctor or practice but have had worse sadly. I have also recently registered with VA and have been blown away with services I have received there. So you can make it all work. Just not greatest docs and offices.
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