[spiritels]

Originally Posted by wendyquat

You obviously have Medicare Advantage and the disappointment in the system does not affect you personally so I doubt you'd be the one to comment and gloat to those of us who were sold property and promised this EXCELLENT healthcare in Americas FRIENDLIEST hometown. It is understandable that one might not have been happy with our choice of physicians. After two years with the same Doctor I determined he was not the one for me so I asked for and got a new doctor that I liked very much! We understand that the bottom line is what it's all about but that does little to excuse their promises and method of notification. It is a great inconvenience for most of us and it would have made it a bit easier to stomach if only they had made a little effort to tack one little paragraph in their letter saying they were sorry!

Because of my background in health insurance it is my opinion that the Advantage plan is great for the healthy but not so good if you have health problems and your trusted doctors do not participate. Although I have reason to believe that not everyone is getting top care at TVs health centers, there are those of us who value good health care and don't want to settle for second best!

I replied to your post and had a lot of negative things to say about this change plus more details since we just spoke today to a Santa Barbara rep. My reply will need to be approved by a moderator, hope they allow it thru.

[spiritels]

Originally Posted by cableb08

I am new to TV, 2015, and joined the VHS because I talked to a rep from United and he told me I should keep what I had because it was better than what they would offer.
PLUS, I could keep my heath plan, retiree Medicare and supplemental, BC/BS of MD.
I have never had any problem w/ my current health plan coverage. As a matter of fact, I just had a knee replacement by the top Ortho in the area, and my out-of-pocket expense was <$200 vs. original cost of $ 85K.
Now I am being told change to VHS plans or go find another PCP- damned this is not easy to do, where do you find who is good or not so good???

We also have secondary BCBS from MD. If we change to what the Villages Health wants we were told that they would NOT accept secondary ins like BCBS specifically! I can't believe that they would prey on the elderly in this way! We need to get advocates! I hope Villages Health lose a ton of patients

[spiritels]

Originally Posted by blicata

I moved to tv in 2013. The villages accepted original medicare & my nys insurance. Now they are telling me that to stay with tv health i have to join
medicare advantange. My nys insurance says they they will drop me if i do this. This will result in loss of benefits & a $2,500 reimbursement from my former employer. The villages runs ads saying "new" villagers can join tv health & pick a medicare advantage plan. This ad also states royalties will be paid to the villages. Best of all you don't have to reside in the villages to use tv health as long as you have medicare advantage.
The phone number for info rang 30 times with no answer or recording to leave a message. Call administrative ofc. 352-674-1700. They are taking names & have a team looking at the responses to this decision. Please call & voice your opinion. I spoke to barbara oliver she did not want to give me her name but i insisted. Fight for your rights.

We have to make this a HUGE issue!!! We, who feel that we are getting forced to accept what we believe is more out of pocket expenses and lower quality health care(and if you think that not being able to find good doctors/specialists or other locations to choose from isn't lower quality health care, then you're absolutely wrong) we need to stand up and fight this! Don't be silent, people!!! Let others with more power and authority know what's going on here! Because if you don't think the Villages isn't somehow involved you're also wrong. This is after all a real estate company owned city. Including the hospital! And a specialist of mine told me this

[spiritels]

Originally Posted by bachfan

Many people here have also worked their whole life and have been able to retire with benifits for life. They will all have to leave TVH if they want to keep the insurance they worked for. The entire thing seems shady to force ins down your throat if you wish to remain in TVH . I am not of Medicare age so my letter stated that I'm still allowed to remain but I will be looking for a new dr also .

I also am not of Medicare age but my husband is and we have BCBS secondary. They will no longer even be accepting the secondary insurance! This is legal, doctors can choose what insurance they will accept but I also think there is something shady going on behind the scenes. There is definitely money, and more money involved. Would like to see this blow up in their faces. And what about the ethics of the doctors who know what's happening to their patients? SAD

[Lauramore]

I wish to alert Villagers of a recent problem I faced with a new physician. I was told I must have tests not covered by any insurance or Medicare. These tests were to be paid by me and would total thousands of dollars. Since I am in excellent health, I refused these tests saying I could not afford them and only wanted those covered by Medicare. I continued to be pressured and politely left the office. Medicare ,my insurance, and I received bills. Prior to their arrival, I received a call from the doctor's office telling me to either come back for ALL the tests or find another doctor. I had already chosen the later. The secretary warned me my insurance would not pay for another visit for one year. I knew this was incorrect.

My message is to watch for unscrupulous activities everywhere. They"re also present in the professional group too.

[Lauramore]

I wish to alert Villagers of a recent problem I faced with a new physician. I was told I must have tests not covered by any insurance or Medicare. These tests were to be paid by me and would total thousands of dollars. Since I am in excellent health, I refused these tests saying I could not afford them and only wanted those covered by Medicare. I continued to be pressured and politely left the office. Medicare ,my insurance, and I received bills. Prior to their arrival, I received a call from the doctor's office telling me to either come back for ALL the tests or find another doctor. I had already chosen the later. The secretary warned me my insurance would not pay for another visit for one year. I knew this was incorrect.

My message is to watch for unscrupulous activities everywhere. They"re also present in the professional group too.

[spiritels]

Originally Posted by ColdNoMore2

OK, that was funny.

No, that was minimalizing the serious issues and worries that some of our families and neighbors have.

[Villageswimmer]

Originally Posted by Lauramore

I wish to alert Villagers of a recent problem I faced with a new physician. I was told I must have tests not covered by any insurance or Medicare. These tests were to be paid by me and would total thousands of dollars. Since I am in excellent health, I refused these tests saying I could not afford them and only wanted those covered by Medicare. I continued to be pressured and politely left the office. Medicare ,my insurance, and I received bills. Prior to their arrival, I received a call from the doctor's office telling me to either come back for ALL the tests or find another doctor. I had already chosen the later. The secretary warned me my insurance would not pay for another visit for one year. I knew this was incorrect.

My message is to watch for unscrupulous activities everywhere. They"re also present in the professional group too.

Could you please tell us the name of the Doctor/group? Many among us are looking for a new dr. Thanks,

[spiritels]

We were told today they would also not be accepting secondary insurances like BCBS. The rep at Santa Barbara only found one positive thing to changing to Med Advantage w/TVHC no longer accepting secondary insurance: get rid of BCBS and save the extra couple hundred dollars a month to cover all the extra copays and out of pocket expences. Some Advantage, huh???

[spiritels]

Originally Posted by Villageswimmer

Could you please tell us the name of the Doctor/group? Many among us are looking for a new dr. Thanks,

We're thinking of definitely looking OUTSIDE the Villages for a new primary care phys. You don't know if ultimately every group in the Villages will follow the lead of VHC. And changing to Med Advan is going to be bad for the long term. You will not be able to change back!

[spiritels]

Contacted Marco Rubio's ofc about VHC. Cannot count on anything but we have alot of voters here. Maybe they could just help w/advocacy for folks having to leave VHC.

[Wandatime]

Originally Posted by spuds51

Medicare Advantage video




No Premium "FREE" Medicare Plans | You Get What You Pay For - YouTube

EXCELLENT VIDEO! Thanks so much for posting. Great explanation of the differences between a Medicare supplement plan and a Medicare advantage plan. Education is vital, folks!

[John_W]

Originally Posted by spiritels

We're thinking of definitely looking OUTSIDE the Villages for a new primary care phys. You don't know if ultimately every group in the Villages will follow the lead of VHC. And changing to Med Advan is going to be bad for the long term. You will not be able to change back!

After moving to TV from Baltimore in 2011, my wife signed up for a United Health medigap plan. It started out at $185 a month and was over $200 when she changed last open season. She used Premier Medical at Lake Sumter for her doctor. She was never happy with the service, or really lack of service. In her final year her doctor left the firm and she only found out from reading this website, they never told her. In addition she had a drug plan with Humana for $22 a month that required getting all her drugs from Walmart. They didn't have 2 or 3 of her drugs in stock whenever we ordered, and that would delay a day or two and they always were saying we ordered too soon, we would have to wait because of the insurance.

Last January she signed up for The Villages Medicare Advantage Plan at the Pinellas office. Immediately we saved over $220 a month in premiums, and the drug plan was included free. She's had no out pocket expenses this year and gets her drugs at Walgreens and they're always in stock and are cheaper than Walmart. One time VHS did want to send her for a bone density test at Lake Imaginng. She turned it down because if she was found in need of a drug, the drug that is most commonly used is Bisphosphonates, which has very serious side effects and rather not take it. She had no problem with her doctor.

Myself, I had been with the VA Medical system but turned 65 a year ago July, so I also signed up with VHS and I've had great care. I had to pay a co-pay twice to specialist of $30 each. One was a pain management doctor and the other was a pulmonary doctor. I had pneumonia in the spring and had a chest x-ray, a CT scan and a MRI all at Lake Imaginng, my total out of pocket was less than $100. So far, I'm very pleased with the care and it's much more hands on and attentive than that I was receiving from the VA.

[Wandatime]

All I can tell you people is to read the schedule of benefits for both plans! If we had a Medicare Advantage plan when Sheldon was going through his cancer treatments we would be living under a bridge about now. Medicare Advantage may be great when you are relatively healthy but I guarantee it is not so great if you have get seriously or chronically ill.

[golfing eagles]

Originally Posted by Wandatime

All I can tell you people is to read the schedule of benefits for both plans! If we had a Medicare Advantage plan when Sheldon was going through his cancer treatments we would be living under a bridge about now. Medicare Advantage may be great when you are relatively healthy but I guarantee it is not so great if you have get seriously or chronically ill.

I'm not an insurance expert. My understanding is that the only way you end up responsible for more than the $4400 out of pocket max under their MA plan is if you go out of network. Even then, if someone needs a service that is not available at all in network, they will approve out of network coverage. I'm sure you are happy with the cancer specialist/hospital Sheldon chose, but would your choice be to go out of network if you had an MA plan?
The reason I ask, is that the biggest criticism of the decision by TVH to take only TV UHC MA plan is the restriction to in-network specialists