[jeriteri]

Anyone else hear about this? I wonder how it will affect our coverage, premiums and out of pocket costs?

[champion6]

Originally Posted by jeriteri

Anyone else hear about this? I wonder how it will affect our coverage, premiums and out of pocket costs?

Not changing, but ADDING a Florida Blue Medicare Advantage plan.

It was in the Daily Sun on July 26, 2019 and is already being discussed here: The Villages Health offering second insurer

[trichard]

They have changed management. Understand they will be selling to Optum effective 1/1/20. Hearing they will begin accepting original Medicare at that time. I won’t go back after being “grandfathered in”. And they told “things change”. What has changed is that they had been running negative cash and losing money since kicking us out.

[graciegirl]

Originally Posted by trichard

They have changed management. Understand they will be selling to Optum effective 1/1/20. Hearing they will begin accepting original Medicare at that time. I won’t go back after being “grandfathered in”. And they told “things change”. What has changed is that they had been running negative cash and losing money since kicking us out.

What makes you say that they are "running negative cash"? What does that mean? They can't pay their bills? They are underfunded?

I think those who had to leave were those who didn't have the insurance company they used.

[NotGolfer]

Originally Posted by graciegirl

What makes you say that they are "running negative cash"? What does that mean? They can't pay their bills? They are underfunded?

I think those who had to leave were those who didn't have the insurance company they used.

Exactly Graciegirl! Also to be clear...it was UnitedHealth who dictated the changes back in the day, NOT TVHC.

[lake5798]

Are you naive enough to believe that the TVHC and UHC did not work in consortium to limit the patients to ONLY UHC?? This is a case of one hand washing the other in pursuit of maximum profitability!! I am not saying this is wrong, just putting the cards in place.

[graciegirl]

Originally Posted by lake5798

Are you naive enough to believe that the TVHC and UHC did not work in consortium to limit the patients to ONLY UHC?? This is a case of one hand washing the other in pursuit of maximum profitability!! I am not saying this is wrong, just putting the cards in place.

Can you explain how that works??? The Villages Health care (TVHC) is the local group of medical centers owned by The Villages and only in The Villages and United Health Care( UHC) is a very large National Insurance company.


Plus being in pursuit of maximum profitability is not necessarily a bad thing in and of itself.

United Healthcare Health Insurance Company Review

Healthcare Providers - The Villages Health


Insurance Plans for Primary Care The Villages Health

[rustyp]

Originally Posted by graciegirl

Can you explain how that works??? The Villages Health care (TVHC) is the local group of medical centers owned by The Villages and only in The Villages and United Health Care( UHC) is a very large National Insurance company.


Plus being in pursuit of maximum profitability is not necessarily a bad thing in and of itself.

United Healthcare Health Insurance Company Review

Healthcare Providers - The Villages Health


Insurance Plans for Primary Care The Villages Health

There is a thing called reinsurance where an insurance company assumes part of the risk and the employer (this case TVHC) assumes another part. These are custom built policies built between the two parties. I vaguely remember that TVHC was using this model with United thus one reason why only one provider allowed. Anyone else know better ?

[justjim]

Perhaps this is a Trend for Village Health. It would be nice if they accepted more companies IMHO.

[graciegirl]

I think it isn't that the Villages aren't accepting new insurance companies, but that new insurance companies may not want to be part of this system.

[skyking]

The Villages Healthcare signed a capitated agreement with UHC in which they would be the exclusive providers for the Medicare Advantage plan in our area and Villages Health would not accept other carriers.

It's apparent that the arrangement has not worked well (probably for both parties) thus it is being changed. Agreements such as these have been around since the 70s.

[Polar Bear]

Originally Posted by skyking

...It's apparent that the arrangement has not worked well (probably for both parties)...

Just wondering...how is it so apparent?

[skyking]

Originally Posted by Polar Bear

Just wondering...how is it so apparent?

They are desperately advertising for patients. The switch from exclusivity is a sign of a troubled marriage.

[NotGolfer]

Originally Posted by skyking

They are desperately advertising for patients. The switch from exclusivity is a sign of a troubled marriage.

Desperately?? I go to the Santa Barbara Clinic and the parking lot was full, as was much of the waiting room yesterday. People standing waiting to check in. This time of year, I think it's common that health-care advertises....OR....in thinking of the ads on t.v. The entities in Orlando are always advertising. I don't think they're desperate there neither. I don't understand why people think there's a vast conspiracy going on here.

[skyking]

Vast conspiracy? This is a normal occurrence in healthcare.