[memason]

Originally Posted by outlaw

Same here....but, when you reach 65 and are eligible for medicare, they may tell you that you have to go on UHC medicare advantage versus medicare. Pluses and minuses for both types. I have already received an email that tells me to get with them to "discuss" insurance options when I reach medicare eligibility.

ok....this makes sense to me now. We already have UHC for our insurance, from my employer. Once we hit 65, we'll have to make some decisions on supplemental carriers.

[scrapple]

Originally Posted by dotti105

I put much of the blame for our current confusion and chaos in healthcare squarely on the back of the Insurance Industry.

I am a RN and have watched, like many others out there, as Insurance companies made the decisions regarding which provider a patient could see, and making frequent changes in the list of allowable providers. ( As well as restricting medications and increasing co pays out of sight for non formulary drugs for example)

We were very concerned about the standard of health care we would receive once on Medicare. Fortunately we have been very impressed and pleased with the standard of care we receive at TV on UHC Villages Advantage plan.

We have also been able to see the specialists we have selected thus far as they have all accepted our Medicare Advantage Plan.

My father was a MD and I remember the day he walked in after work and said that the Insurance Companies had a choke hold on Doctors, Hospitals and patients. He passed away before it got really ugly.

I personally am still praying for a single payer system for all, a Medicare for all. If all the young healthy people in our country were put into the same system the cost for all would go down. WE are the ones who create the highest costs in the healthcare system. But as long as the Insurance Companies can control our health care it will be a series of changes, cuts, buyouts and profits are the name of the game.

The fact that a few Insurance companies can band together, through buy outs and mergers, and excluding other companies patients, will make having predictable convenient and dependable healthcare very difficult. It hurts us all, the providers and the patients.

I wish there was a "like" button!

[golfing eagles]

Originally Posted by outlaw

Look for the infamous email. You will get it.

If this is their intention, they better send it before Dec 7

[NYGUY]

Originally Posted by golfing eagles

And from their update web page:

If you are eligible for Medicare, we want you to know that the only Medicare Advantage plans The Villages Health participates in are those offered by UnitedHealthcare®.
•UnitedHealthcare® The Villages® MedicareComplete® (HMO)
•AARP® MedicareComplete Choice® (Regional PPO)

Please note the first word---IF. So I still think it's unclear, I'm sure it will be made more clear in the coming days

Yah, I agree GE, the IF makes you wonder. My reading says it's just clever wording (and if that is it, trust takes a hit), but, we shall see.

[outlaw]

Originally Posted by golfing eagles

If this is their intention, they better send it before Dec 7

Why dec 7?

[golfing eagles]

Originally Posted by outlaw

Why dec 7?

Medicare open enrollment deadline for 2016

[FromDC]

READ the following article. It is dated September 2014, but it is oh so relevant for today. The article talks about the Villages Advantage Plan as being a revenue generator:

**University of South Florida backed out from running the specialty care clinic due to lower than expected sales of the Plan.

**The business model relied on getting enough patients enrolled in the Plan. Only 6,000 enrolled, but they needed 20,000 enrolled the first year.

USF pulls out of its $4 million specialty care clinic at the Villages | Tampa Bay Times

If you want to enroll in this Advantage Plan because of Villages Health, go ahead. You will be helping their income stream. You will only read accolades in the local paper and hear accolades from sales people. Consider visiting a SHINE representative and have nonbiased dialog to find out what insurance is best for your situation.

I would not consider selecting a plan that restricts me and limits me to such a narrow range of doctors and services while boosting revenue.

[Garden guru]

Originally Posted by FromDC

READ the following article. It is dated September 2014, but it is oh so relevant for today. The article talks about the Villages Advantage Plan as being a revenue generator:

**University of South Florida backed out from running the specialty care clinic due to lower than expected sales of the Plan.

**The business model relied on getting enough patients enrolled in the Plan. Only 6,000 enrolled, but they needed 20,000 enrolled the first year.

USF pulls out of its $4 million specialty care clinic at the Villages | Tampa Bay Times

If you want to enroll in this Advantage Plan because of Villages Health, go ahead. You will be helping their income stream. You will only read accolades in the local paper and hear accolades from sales people. Consider visiting a SHINE representative and have nonbiased dialog to find out what insurance is best for your situation.

I would not consider selecting a plan that restricts me and limits me to such a narrow range of doctors and services while boosting revenue.

The statistics in the article really speak for themselves. If they need 20,000 people to enroll in the plan to make the finances work out, they're fighting an uphill battle. First of all, no snowbirds are going to join; they want a health care plan that will allow them to get medical care wherever they happen to be all year long, not just when they're here in TV. That right there eliminates half of TV population. Secondly, many residents in the northern sections of TV have lived there for years, and in some cases decades, and are already well established with other medical groups and other doctors around the area. Unless they're unhappy with those doctors, they're not going to have any interest in breaking all of those ties and starting over again with new Villages doctors. That means that TV Health is forced to try to get 20,000 permanent residents who have only recently arrived to fill their 20,000 person quota. However, most of those newbies are Baby Boomers who have only recently retired and have been in the trenches fighting managed care battles with their private insurance companies for several decades now. They’re not gullible, inexperienced folks who are going to be easily fooled into choosing a Medicare plan that's clearly not in their best interests.

How all of this is tied up in the financial bottom line of the whole Villages "Marcus Welby Neighborhood Clinics", I have no idea, but considering how coercive TV has decided to become about the matter, I can’t help but wonder if their whole health care system house of cards is in serious danger of collapsing.

[Mikeod]

Originally Posted by Garden guru

Th First of all, no snowbirds are going to join; they want a health care plan that will allow them to get medical care wherever they happen to be all year long, not just when they're here in TV. That right there eliminates half of TV population.

I think that enrollment in the UHC Advantage plan does not restrict a person to services only with the Villages Health Plan and can be used with network providers in their summer/home area as well. The Villages Health Plan is saying the UHC plans are the only ones they will accept. You are not contracting directly with them, only with UHC.

[outlaw]

Originally Posted by FromDC

READ the following article. It is dated September 2014, but it is oh so relevant for today. The article talks about the Villages Advantage Plan as being a revenue generator:

**University of South Florida backed out from running the specialty care clinic due to lower than expected sales of the Plan.

**The business model relied on getting enough patients enrolled in the Plan. Only 6,000 enrolled, but they needed 20,000 enrolled the first year.

USF pulls out of its $4 million specialty care clinic at the Villages | Tampa Bay Times

If you want to enroll in this Advantage Plan because of Villages Health, go ahead. You will be helping their income stream. You will only read accolades in the local paper and hear accolades from sales people. Consider visiting a SHINE representative and have nonbiased dialog to find out what insurance is best for your situation.

I would not consider selecting a plan that restricts me and limits me to such a narrow range of doctors and services while boosting revenue.

I think that is the issue. I look at Medicare Advantage as an HMO construct versus Medicare plus supplement as non-HMO, opening up the number of specialists to virtually the whole medical field.

[LynnWM158]

Originally Posted by nkrifats

I would assume that those of us already in the system are grandfathered in. At least I do hope so.

Those of us already in the system are grandfathered in with whatever insurance we currently have
. Medicare Advantage pays the provider a higher percentage that regular Medicare, and supposedly costs the insurer less in premiums. Hope this helps.

[graciegirl]

Originally Posted by golfing eagles

Way too early for me to get it

Primum non nocere

I didn't get it either. Je ne compris pas.

[golfing eagles]

Originally Posted by graciegirl

I didn't get it either. Je ne compris pas.

Latin in Hippocratic oath---"First do no harm"

[outlaw]

Originally Posted by memason

ok....this makes sense to me now. We already have UHC for our insurance, from my employer. Once we hit 65, we'll have to make some decisions on supplemental carriers.

The point is you may not have a choice. If you stay with TVH, you may be required to go with medicare advantage, which is not medicare plus supplemental.

[gomoho]

Originally Posted by Mikeod

I think that enrollment in the UHC Advantage plan does not restrict a person to services only with the Villages Health Plan and can be used with network providers in their summer/home area as well. The Villages Health Plan is saying the UHC plans are the only ones they will accept. You are not contracting directly with them, only with UHC.

You need to speak with someone at one of the United Health Care offices as you have an incorrect idea of how an Advantage plan works. You can only see the doctors in your network for that plan (limited geographically) unless you are on vacation and have an emergency. A Medicare supplement allows you to see any doctor, anywhere that accepts medicare.