I spoke with SHINE a week ago or so, and there has been some discussion about possible changes to the VHS health care. There was supposed to be an announcement a few weeks ago, as this affects some 15,000 current patients of VHS. There is supposed to be an informational article in either the POA or VOA newsletter (sorry I forget which was mentioned). Hopefully this article will have additional real information. Also, each patient should be getting a letter about any changes to the system.

What was the reason you were kicked out? I am not on Medicare and I haven't received any letter telling me that I need to go elsewhere.

By reading past threads on TV Health clinics opening, people wondered how they would be able to hire excellent primary care doctors and pay them the comfortable salaries, while still being able to have a smaller number of patients for each dr. to have needed time with each patient. Looking at the quality built into the TV Health system and clinicians, it should be evident that somebody has to pay the bills to keep it running pristinely as it is.

The more time spent with each patient, the fewer the patients seen in a day, and then the less revenue coming in to pay the bills and salaries.

AARP has its brand name on the Medicare Advantage plans and rakes in a fortune into its "non-profit" conglomerate. It seems to me that The Villages is lending its trade name to such plans, to make such royalties too, but TV is spending the royalties money on the TV Health system to keep it solvent and running as intended.

From experience here, I'd trust TV reinvesting those royalties back into the TV Health system far more than I'd trust AARP.

"An AARP spokesman declined to say how much the organization receives in royalties from UnitedHealthcare, but the most recent IRS Form 990 records available show non-profit AARP reported royalties of $762.6 million in 2013, more than half its revenue of $1.3 billion. That’s up from $723. 3 million in royalties the previous year.

The money includes a portion of the premiums collected by AARP-endorsed insurers in fields including health and auto, along with royalties from other ventures such as credit cards..."

AARP gets $762M from royalties. Do seniors get best insurance deal? | Protecting Your Pocket

Well that is just plain wrong. I'm sorry they did that to you, and others.


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I called Mulberry Medical and was told that by the end of the year unless I have advantage plan I would need to find Dr. outside. I asked about the grandfathering and was told no way. Got it direct from Villages Health

I went to the Medicare store in SS and the rep told me starting in 2017, one has to sign up for UHC Medical Advantage Plan as they will not take any other insurance.

If one signs up for original Medicare plus a supplement, they will have to go outside of TV Health system.

I may be wrong and frequently, I am...........

Who will they take in the future when the UHC plan as have the previous plans no longer serves their needs. This is why privatizing Medicare & SS is not such a good idea.

Just got the letter. It says "...we have decided to no longer accept Original Medicare with a traditional Medicare Supplemental policy for all new and existing patients starting January 1, 2017. This means that as of next year, you will need to be enrolled in a United Healthcare Medicare Advantage plan to remain a patient with The Villages Health."

In other words...We have decided to F you and we don't care if you walk or not.

My wife just received her letter stating "Our records indicate you have a commercial insurance plan that we accept. As long as you continue with the same plan, you can remain a patient with TVH. ... When you become Medicare eligible, you will need to choose a UnitedHealthcare Medicare Advantage plan to remain a patient with TVH."

The letter takes a "pea on their back and tell them it's raining" approach to the TVH decision.

This is correct, I checked yesterday. IF you are 65 or over, the only medicare they will take as of 1/1/17 is UHC advantage. IF you are under 65 this does not affect you, you can continue with your current insurance (until you hit 65)

The only caveat seems to be if you are under 65 with a commercial insurance plan you need to stay with your "current plan" according to the TVH letter.

The SS rep went on to say that he didn't agree with their decision not to accept original Medicare plus a supplement starting Jan 1, 2017 but thought the decision was made purely from economics. He felt they were throwing away money from all customers.

He seem to imply they get more money from UHC Advantage plans and that might be driving their decision.

It is purely an economic decision. Current management is unable to generate a positive bottom line.

The letter also says...."Because our superior care best aligns with Medicare Advantage". Translation: Because we make more money off Medicare Advantage.:a20:

Spouse on Tri Care for Life. She receives letter that she is fine. I will be on Tri Care for Life in January, receive letter that I won't be a patient. How does that make sense??

If your ages differ, it might be a factor.

My wife and I both received a letter today from TVH dated July 12,2016 signed by Tom Menichino, CEO and Jeffrey Lowenkron,MD, Chief Medical Officer which states,"Because our superior care best aligns with Medicare Advantage,we have decided to no longer accept Original Medicare with a traditional Medicare Supplemental policy for all new and existing patients starting January 1, 2017.
Therefore,for many of us, we will have to change to UHC Medicare Advantage which is an HMO and will decide the rationed type of treatment you will receive or find providers outside The Villages. The TVH powers to be have decided that money is more important the health and welfare of its residents.
This is really an outrage and a slap in the face to all of us who trusted them to insure our healthcare

You may want to check with Shine. It is my understanding that once you switch to a Medicare advantage product you can only get back to original Medicare during an initial 6-month period. Otherwise you will never be able to have original Medicare again.

The Villages Health - Grandfathered?!
 

At least In my case that was not accurate. I had a Medicare Advantage plan for 2 years through FL Blue (FL BcBs). Then switched to Medicare + supplement in 2015.


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Thanks. I will re-check this.

My letter says that since I have Tricare For Life, I will be "fine." They did encourage me to pick up their supplement to Tricare. OK, Medicare now pays part of my bill. Then they bill Tricare for the balance. Tricare For Life, which costs me nothing, gives them some chump change, and since there is no balance billing with Tricare for network care, I pay nothing. So, now, let me get this straight...they want me to pay a premium to gain nothing at all?

When we wanted to apply for a Medicare supplement and we were past age 65 + six months, we had to be able to answer several "health" questions satisfactorily, otherwise no go. So, yes, it is something you should check out.

It is my understanding you can only switch back under certain circumstances, i.e. your plan stopped offering your plan or you moved to an area where they do not offer your plan, but, yes, by all means you should check it out....good luck.

UHC also offers a Medicare Advantage Plan that is a PPO, not an HMO, and a better product in my opinion.

When I looked into an Advantage plan no one could assure me that I could switch back to my regular UHC supplement if I wanted to do so. I even talked with two UHC agents and told them my health needs and both advised me to stay with the traditional supplement. It's a shame as we liked our doctors at TV and enjoyed the beautiful offices. I hope they will be able to get enough patients to switch to allow them to remain open! I can't help but doubt it!

Are you referring to AARP Medicare Complete Choice (Regional PPO)?

If you recall, last year TVH had a big push to get patients to sign up for UHC MA. Did not seem that they had many takers. Will be interesting to see how many patients they can "force" to this plan this year or if the patients will move on to other providers.

We also have Tricare and told we were good.

Yep! Got the letter! I'm not Medicare eligible so I can stay until I am!

Reminds me what my first wife wanted from me while she planned the divorce with a me first exit strategy. I did extend her medical only because she needed a procedure, other then that she got nothing.

What they are doing is what we in healthcare used to call "Patient Dumping". A despicable practice of dumping the costliest and/or lowest revenue producting patients into a community with no regard as to where/how these patients will get their care in the future. To do this is extremely unprofessional. Really shows you how "caring" our developer and these so called "caring professionals" really are.

What I call it is a lack of business ethics.

You both nailed it! :thumbup:

What a scam!
 

Just got a cancellation letter today from Villages Health. What a scam! I have the best Medicare secondary coverage plan F, and now they only take United Healthcare Advantage Plan? Read your policies folks. That plan has serious deductables and if you are outside of "The Villages" and require a doctor or surgery you WILL HAVE AN EMPTY WALLET when they finish will you. They will try to get you to "convert" to this lower quality plan or quit taking you as a patient effective 12/31/2016. I've been with them since day one. Is this a prelude to our way of living in "America's Favorite Town?

Just got a cancellation letter today from Villages Health. What a scam! I have the best Medicare secondary coverage plan F, and now they only take United Healthcare Advantage Plan? Read your policies folks. That plan has serious deductables and if you are outside of "The Villages" and require a doctor or surgery you WILL HAVE AN EMPTY WALLET when they finish will you. They will try to get you to "convert" to this lower quality plan or quit taking you as a patient effective 12/31/2016. I've been with them since day one. Is this a prelude to our way of living in "America's Favorite Town?

We have been extremely happy with the Villages Health and our physicians. I have Cloukey and my husband has Kelly. We received our letters and will be fine until we are eligible for Medicare. This will occur in 2017 and 2018. As of this moment we do want their advantage plan and realize in the not so distance future we will need to look for new doctors. We find this disconcerting and are hoping something changes before we need to leave the practice. Hate looking for new doctors.

Grandfathered?
 

Whether it is good business or greed is open to debate. What is not open for debate is that we were lied to when TVH said we were grandfathered. We have been with the VHS since the beginning. We were told current patients could stay. Lying is never right...even if it is to make more $$ money!