[starflyte1]

Who pays for ambulance? Does advantage?

[LuvtheVillages]

Originally Posted by Marine1974

I recently went to the ER in January in the villages .
I am a veteran. I gave the registration person my VA healthcare card , but the insisted I provide my regular Medicare card and my AARp supplemental insurance card . I was surprised to find out the hospital billed all three and was paid by all three .
When I reported this to the VA , they told me not to worry , the hospital will be audited and have to pay back regular Medicare and my supplemental. So I’m not sure about the villages hospitals not accepting regular Medicare.

The hospitals DO accept regular Medicare. All hospitals do. Some do not accept Advantage plans.

But this discussion is about clinics and doctors, not hospitals.

The Village hospital, now renamed Spanish Plaines hospital, is not part of the Village Healthcare system and clinics.

[Taltarzac725]

Originally Posted by LuvtheVillages

There are LOTS of physicians here who are not connected to Villages health. And all of them take basic Medicare and many of the Advantage plans. Most of them are good. Some of them are great. Many are within golf cart access. The only trick is finding one who is accepting new patients.

Villages Health is not the only option. Different people have different needs. Go talk to SHINE, a free healthcare advisory service. (Not located inside the Villages Health clinics.)

Be aware that once you are with an Advantage plan, it may not be possible to switch back to basic Medicare, especially if your health changes.

I am aware of the problem of finding a doctor here in the Villages. Have not needed one other than Urgent Care so far. Knock on wood.

[biker1]

For Plan F, you need to have turned 65 before Jan 1, 2020. However, if you have Plan F, you may be better off switching to Plan G (assuming you can) because the difference between the Plan F and Plan G premiums might be greater than the Part B deductible, which Plan F includes but Plan G doesn't.

Originally Posted by coleprice

If it is within your budget, sign up for Medicare Plan G or Plan F, which are Medicare "Supplement" plans. Although the monthly cost is higher than a Medicare Advantage Plan, they cover many more services, and besides a small annual deductible, there are no co-pays. Also, you don't need a Primary Care Physician to recommend a procedure. Many more doctors take the Supplement plans because these plans pay them better. Check out the following website to watch videos that will educate you on the alternatives: medicare school.com

[ridge]

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?

Yes in speak with a Medicare specialist Advantage plans reimbursement is better for annual checkup but for specialist the reimbursement is better. Thus why specialist even in The Villages accept regular Medicare. I think more people here in The Villages have Advantage plans dye to budget. Nationwide it's roughly 50/50.

[westernrider75]

Originally Posted by Kliegls5@gmail.com

Why does everyone say they can go anywhere with a traditional medicare plan when in reality they can only go to doctors who accepts their plan. You can't go to any of the Villages Healthcare doctors, correct?

I might just be lucky but I have yet to find a doctor that DID NOT accept my original Medicare with supplement.

[BlueStarAirlines]

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.

Villages Health decision on only having the advantage plan is being really shortsighted. We moved here at age 55 and couldn't get ANY doctors or services from Villages Health (VH) because we did not have the Medicare advantage plan and were 10 years too young to qualify. All our doctors are outside VH and we will probably never leave those doctors. I see this same situation all over (especially in the southern villages) and as Middleton builds out.

If Orlando Health or Advent Health built a primary care location in the southern area and used that as a feeder into their overall system the future demand for VH services might not be there. I know I'm not changing doctors and going on a Medicare advantage plan in the future just because of Villages Health restrictions.

[Nana2Teddy]

Originally Posted by RUCdaze

I can tell you from personal experience, I looked into Advantage and rejected it. I have Medicare parts A, B, and D., plus I have Blue Cross/Blue Shield. I have never had a problem; I go to whatever doctor I want without a referral, and I've never had a problem with anything. Advantage doesn't come without restrictions, obligations, and limitations,

This is what we have, and it works great for us.

[MX rider]

Originally Posted by BlueStarAirlines

Villages Health decision on only having the advantage plan is being really shortsighted. We moved here at age 55 and couldn't get ANY doctors or services from Villages Health (VH) because we did not have the Medicare advantage plan and were 10 years too young to qualify. All our doctors are outside VH and we will probably never leave those doctors. I see this same situation all over (especially in the southern villages) and as Middleton builds out.

If Orlando Health or Advent Health built a primary care location in the southern area and used that as a feeder into their overall system the future demand for VH services might not be there. I know I'm not changing doctors and going on a Medicare advantage plan in the future just because of Villages Health restrictions.

Over 50% of new medicare enrollees choose Advantage plans. I think The VIllages Health business plan is working very well.

[kendi]

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?

There is a lot of advertising for advantage plans. Rarely if ever for traditional plans. I read an article that this is a big influencer on the large number of people choosing the advantage plans.

I know too many people who have not been able to get the care they need approved by their advantage plan. One I know even died because of this.

It surprises me that so many are okay with leaving their health in the hands of the insurance companies. Not me! Freedom to choose who and where I want to go is priceless imho.

[Michael 61]

So much has been said already on this thread - my primary doctor is through Villages Health, but I am still under Medicare age, and they accept my Obamacare plan. Once I turn 65, I plan to go with traditional Medicare + supplement. I will have to leave Villages Health at that time, and I’m OK with that. I’ve done so much research on my own, as well have talked with SHINE (great resource I encourage everyone under 65 to engage with before making this important decision of which route to go). I think the error that many make, is they let cost alone guide their decision, and also are short-sighted, looking only at their current health situation, rather than anticipating what that could look like 20 years from now.

[biker1]

Hmmm, I'm not sure I understand that. I used the Villages Health Care (Primary Care Physician) until I reached age 65, at which time was I no longer eligible because I chose traditional Medicare and a Supplemental Plan. Before I reached age 65, I had health insurance through my employer and The Villages Health Care was more than happy to accommodate me with private insurance, which actually included an obamacare plan for about 24 months.

Originally Posted by BlueStarAirlines

Villages Health decision on only having the advantage plan is being really shortsighted. We moved here at age 55 and couldn't get ANY doctors or services from Villages Health (VH) because we did not have the Medicare advantage plan and were 10 years too young to qualify. All our doctors are outside VH and we will probably never leave those doctors. I see this same situation all over (especially in the southern villages) and as Middleton builds out.

If Orlando Health or Advent Health built a primary care location in the southern area and used that as a feeder into their overall system the future demand for VH services might not be there. I know I'm not changing doctors and going on a Medicare advantage plan in the future just because of Villages Health restrictions.

[Michael 61]

Originally Posted by biker1

Hmmm, I'm not sure I understand that. I used the Villages Health Care (Primary Care Physician) until I reached age 65, at which time was I no longer eligible because I chose traditional Medicare and a Supplemental Plan. Before I reached age 65, I had health insurance through my employer and The Villages Health Care was more than happy to accommodate me with private insurance, which actually included an obamacare plan for about 24 months.

Although things keep changing, when I moved here is 2023, I attempted to get into Villages Health with my Obamacare. I was told then, that they will not accept any new patients under the age of 60, and if between 60-65 they would put me on a waiting list. It took one year for me to clear that waiting list (I was with Orlando Health during that first year, and drove to the facility off the Turnpike and the intersection with Hwy 27). I’m still a few years away from 65, but will need to leave Villages Health at 65, since I won’t be going the Medicare Advantage route.

[tophcfa]

Originally Posted by Aces4

People can't see the forest for the trees. Once enough seniors have been, IMHO, suckered into the Medicare Advantage plans, the party will be over. Every senior will be pushed into private insurance for their healthcare and the cutting of coverages begin. Insurance companies are in business for profit, not for anything else. I foresee coverages and care squeezed as insurance companies fatten up.

Again, I encourage everyone to read this report in it's entirety.

Just a moment...

Bingo, that’s my fear. Hopefully, in that scenario, those up us already in a Medigap plan will be grandfathered in for life?

[biker1]

I suspect the issue is not enough PCPs. When we moved to The Villages in 2014, they had just opened up the facility at Pinellas and there was no issue with getting a PCP.

Originally Posted by Michael 61

Although things keep changing, when I moved here is 2023, I attempted to get into Villages Health with my Obamacare. I was told then, that they will not accept any new patients under the age of 60, and if between 60-65 they would put me on a waiting list. It took one year for me to clear that waiting list (I was with Orlando Health during that first year, and drove to the facility off the Turnpike and the intersection with Hwy 27). I’m still a few years away from 65, but will need to leave Villages Health at 65, since I won’t be going the Medicare Advantage route.