[RoseyRed]

Originally Posted by bobeaston

Wrong! It is not discrimination for / against The Villages residents. Some time ago, I learned from one of The Villages Health leaders, who was part of the original planning, that it was ALL ABOUT the cost structures of what practitioners are paid for Medicare Advantage patients. That cost structure was a key component of recruiting the professionals needed to make the business successful.

The Villages Health said they could not accept me as a new patient due to not being on Medicare. They accepted my husband who is on an Advantage plan. I am not an expert but sounds like age discrimination in reverse . I am over 55 so thought I would be accepted.

[talonip]

Originally Posted by USNA87

For the TV veterans who have Parts A and B and TriCare for Life, what are your experiences?

It works well. If I remember we were grandfathered in when the villages changed their policy. We have been treated very well.

Only issue I don’t like is that when you are selected to use the villages health you cannot select a location near where you live or doctor.

[Mluzinas]

A must read article!!! Take the time to read, excellent, accurate summary. Thanks for sharing!

[LoisR]

The Villages Med Plan doesn't have access to the Moffitt Cancer Center.

[Andyb]

Originally Posted by GreggC69

What do you think the breakdown is for The Villages on Medicare between the two options? Most I talk with are on the advantage plan; I have spoken to very few on traditional Medicare. I have been surprised by that.

Also, I was shocked that The Villages Health Centers only accept Medicare Advantage and not traditional Medicare. Is that because the reimbursement for physician services is that much different between the two options?

Ever wonder why the push and advertise the Advantage plans so much? That should set off red flags. More money for them. Advantage gives less doctor options and very limited across state lines.

[MX rider]

Originally Posted by TomPerry

People complain about The Villages Advantage Plan and Advantage Plans in general, but we have had great experiences after switching when we moved to TV! I had heartburn while on my morning walking, went to my PCP at Colony and ended up with a triple bypass. Got an EKG, stress test, heart Catherization then a triple bypass. From initial PCP visit to triple bypass, 17 days! After giving myself 15,000 - 20,000 injections over my life, now down to ONE injection per week, off insulin and A1C is 5.7 - 6.0! My wife has had severe back issues, received back surgery and has NO back issues since! We travel back to Massachusetts every summer and have no issues seeing out former doctors if and when needed. Complain all you want, but you can’t prove it by us!

Well said.
We're on UHC Advantage and are very happy with it, and The Villages Health. No waiting weeks for an appointment and we never wait more than 15 minutes for our PCP. We also use all the wellness benefits from UHC.
Our best friends are on Humana MA and like it. I hear Florida Blue is very good as well.

Contrary to what some will say, there is no real one size fits all.
Do your research and talk to SHINE. They said MA was a great option for us.

Choice is a good thing!

[Professor]

Originally Posted by retiredguy123

Personally, I think that The Villages health care facilities do not accept original Medicare because they want to make them more accessible to Villagers. If they accepted original Medicare, they would be required by law to accept all original Medicare patients from the surrounding areas, and they would soon become overcrowded with non-Villagers. These facilities were constructed within The Villages to be convenient to Villagers, not non-Villagers. Otherwise, what is the point of using Villages property to operate health care facilities within The Villages? My opinion.

Your response seems to assume that Medicare Advantage is only for Villagers. Hate to break it to you, but Medicare Advantage is all over and everyone can choose it.

[Mulliganguy]

If The Villages wanna treat only villagers then they should probably ask for their resident ID before treatment at sign in. Insurance type shouldn’t even play into it.

[Professor]

Originally Posted by GreggC69

What do you think the breakdown is for The Villages on Medicare between the two options? Most I talk with are on the advantage plan; I have spoken to very few on traditional Medicare. I have been surprised by that.

Also, I was shocked that The Villages Health Centers only accept Medicare Advantage and not traditional Medicare. Is that because the reimbursement for physician services is that much different between the two options?

I chose Original Medicare because I travel some and want to be able to choose my own specialists when needed. Have not been disappointed. I spend some time in Maryland with my kids and grandchild during the summer and have had to have some medical procedures done. As an example, Johns Hopkins does not accept Medicare advantage.

There are those who will respond to this and say they do have options for specialists, but I did check into this and the options are still limited. I want the best care I can find as quickly as I can get it with no runaround from a company telling me who I can see and when.

As a final note, I loved my Villages Health physician Kathie Greene when I was still working and had a corporate plan, which they accepted. Hated to switch but need to do what is best for me.

[retiredguy123]

Originally Posted by Andyb

Ever wonder why the push and advertise the Advantage plans so much? That should set off red flags. More money for them. Advantage gives less doctor options and very limited across state lines.

I agree that it should set off red flags. But, if you think about it, a "for profit" company can increase their profits by screening out waste and fraud. On the other hand, Traditional Medicare claims are processed by the Federal Government by people who don't need to make a profit, and who don't seem to care much about screening out waste and fraud.

[MX rider]

[QUOTE=Andyb;2418681]Ever wonder why the push and advertise the Advantage plans so much? That should set off red flags. More money for them. Advantage gives less doctor options and very limited across state lines.[/QUOT

Omg, they make a profit! You mean like all doctors and most Hospitals?

Btw, over 50% of new medicare enrollees choose Adavntage plans. Many I'm sure did their research and made an eductated decision, like us.

We are happy with our provider list with UHC. And it has a huge nationwide network. We've used it here and in Indiana with zero problems.

Painting with a broad brush is not a good idea when it comes to this. Having options is always a good thing.

[MX rider]

Originally Posted by Professor

Your response seems to assume that Medicare Advantage is only for Villagers. Hate to break it to you, but Medicare Advantage is all over and everyone can choose it.

I'm not 100% sure on this, but I think The Villages Health accepts anyone on a qualifying MA plan. Not just villagers.
And each PCP can only have a certain number of patients. So the can't overbook.

[Jensor17]

Medicare advantage plans cost more because they are generated by different entities so you have to shop around. Medicare is a federal Govt. entity, so they will receive (example) $1000 Doctor bill and tell the doctor he can only charge $600 - then Medicare will pay 80% of that $600 and you pay remainder. If you choose a supplemental plan through your employer, then Supplemental plans will pay 80% of the 20% that Medicare didn’t pay. That leaves a small balance that you owe a few $dollars.
I don’t have a Medicare advantage plan. It’s much cheaper to go Medicare, then seek a supplemental carrier…(sometimes secondary insurer premium payments may be partially covered by your employer.)

Originally Posted by GreggC69

What do you think the breakdown is for The Villages on Medicare between the two options? Most I talk with are on the advantage plan; I have spoken to very few on traditional Medicare. I have been surprised by that.

Also, I was shocked that The Villages Health Centers only accept Medicare Advantage and not traditional Medicare. Is that because the reimbursement for physician services is that much different between the two options?

[retiredguy123]

Originally Posted by MX rider

I'm not 100% sure on this, but I think The Villages Health accepts anyone on a qualifying MA plan. Not just villagers.
And each PCP can only have a certain number of patients. So the can't overbook.

You are correct, but the Villages health facilities only accept a small number of selected Advantage plans.

[retiredguy123]

Originally Posted by Mulliganguy

If The Villages wanna treat only villagers then they should probably ask for their resident ID before treatment at sign in. Insurance type shouldn’t even play into it.

This would be illegal if they accept any type of Medicare insurance.