Advantage, right. I'm not well versed in nomenclature so I've been fusing the two. But the bottom line is they won't see us with our commercial Aetna Health plan, regardless of what they state on their site. Whether that's because it's not Advantage or because of our age (or a little of both), it's just a fact.

Their reasoning is NEITHER of what you state.

I'm not on medicare at all, AND I'm not old enough for it yet. They take my commercial Florida Blue plan just fine.

On their website under the list of insurances they accept (including Aetna) it says "Some restrictions may apply." So your plan might just not be one of the ones they accept. But they /do/ accept plans from Aetna. Just not yours. Aetna has a LOT of plans. Villages Health is probably just - not in your plan's network.

According to Aetna website, they ARE in Network. It is not my plan that is the issue.

Because I've been playing whisper down the lane trying to interpret what my wife heard in her phone call, I called them myself to get the actual story of the current status for The Villages Health. This is what I was told:

For anyone with commercial insurance, they are "at capacity" and are not taking new patients, UNLESS you work for The Villages. If you have commercial insurance and are employed by The Villages, you can get in as a new patient. If you are 65 or older (i.e., medicare [or Advantage, I dunno]) then they have spaces for you. She indicated when new capacity under construction comes online, that MAY change and that I (or anyone) should check back at that time.

Apologies for adding to confusion before. This hopefully clarifies it a bit better.

Oh well, it was only 30 posts of opinions, guesses and theories of what the real answer was…………………clarified by one phone call.🤷🏼

That's what I figured. They do accept your insurance, however - their doctors are already at their maximum patient load and have to cut back on accepting new patients. This was a problem last year as well, and I'm pretty sure it's been a problem since the COVID pandemic in 2020.

That was post #7.

Excellent summation. May I add once one turns 65 (Medicare) TV Health will no longer accept their commercial insurance. The choice will be to go on one of their Advantage plans or leave.

That's important information for any of us who are approaching the age when we have to make this decision!

I'll check with the desk at TVH next time I have an appointment to find out if "legacy" patients are grandfathered in or not. If not, then I have a couple more years to transition to a doctor's office that accepts "whatever" health insurance INCLUDING Medicare Advantage (since I don't know what my choices will look like by the time I'm 65 and would like to prepare for all possibilities).

As I understand it, the Villages Health facilities are built and owned by The Villages for the convenience of Villagers. The reason they don't accept original Medicare is because they would need to treat anyone in the area who has original Medicare, and it could be difficult for Villagers to get appointments. If you accept original Medicare, you must be accessible to everyone who wants to use the facilities. At least that is my theory.

There is no requirement to be a resident of TV to be a patient. Scroll down to the FAQ.

Creating Personalized Patient Experiences - The Villages Health

I know. They could not legally do that. But you do need to have a specific Medicare advantage plan, which limits the patient list.

Of course. Non-villagers follow the same rules as us.

I'm not sure what you mean when you say that an advantage plan is not Medicare. The Medicare.gov website refers to advantage plans as "Medicare Part C". These advantage plans are regulated and subsidized by the Federal Government Medicare program and funding. So, it seems to me that it is not accurate to say that advantage plans are not Medicare. It is true that TVH does not accept patients who have Medicare Part B.

We just signed up for The Villages UHC Advantage 3 weeks ago. We no problems finding a doctor. We had the choice of 4 at Spanish Springs and 5 at Sumpter. Brownwood location had some as well.