Talk of The Villages Florida

Talk of The Villages Florida (https://www.talkofthevillages.com/forums/)
-   Medical and Health Discussion (https://www.talkofthevillages.com/forums/medical-health-discussion-94/)
-   -   The Villages Health - Grandfathered?! (https://www.talkofthevillages.com/forums/medical-health-discussion-94/villages-health-grandfathered-199615/)

trichard 07-15-2016 07:10 PM

Quote:

Originally Posted by vinnyc (Post 1254650)
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.

dbussone 07-15-2016 07:26 PM

The Villages Health - Grandfathered?!
 
Quote:

Originally Posted by trichard (Post 1254651)
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.



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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trichard 07-15-2016 07:40 PM

Quote:

Originally Posted by dbussone (Post 1254655)
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.


Sent from my iPad using Tapatalk

Thanks. I will re-check this.

Rapscallion St Croix 07-15-2016 07:41 PM

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?

Carla B 07-15-2016 08:00 PM

Quote:

Originally Posted by trichard (Post 1254661)
Thanks. I will re-check this.

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.

NYGUY 07-15-2016 10:11 PM

Quote:

Originally Posted by trichard (Post 1254661)
Thanks. I will re-check this.

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.

NYGUY 07-15-2016 10:18 PM

Quote:

Originally Posted by vinnyc (Post 1254650)
....Therefore,for many of us, we will have to change to UHC Medicare Advantage which is an HMO....

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

wendyquat 07-15-2016 11:22 PM

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!

champion6 07-16-2016 08:58 AM

Quote:

Originally Posted by NYGUY (Post 1254689)
UHC also offers a Medicare Advantage Plan that is a PPO, not an HMO, and a better product in my opinion.

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

trichard 07-16-2016 10:01 AM

Quote:

Originally Posted by wendyquat (Post 1254695)
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!

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.

Bonny 07-16-2016 10:17 AM

Quote:

Originally Posted by Rapscallion St Croix (Post 1254662)
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?

We also have Tricare and told we were good.

MSGirl 07-16-2016 10:31 AM

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

RickeyD 07-16-2016 10:52 AM

Quote:

Originally Posted by MSGirl (Post 1254808)
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.

LvmyPug2 07-16-2016 11:23 AM

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.

trichard 07-16-2016 11:24 AM

Quote:

Originally Posted by LvmyPug2 (Post 1254839)
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.


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