[nyclicker]

Originally Posted by trichard

Grandfathered? Think again. If you have Medicare Original get ready to be "porked". Beginning January 1, 2017 you either switch to United Healthcare Medicare Advantage Plan or seek care elsewhere. They will tell you that it is to improve the quality of care, but it has only to do with increasing the quantity of money! They are sucking a lot of red ink due to the quality of their top management staff.

I'll ask this question again. Can anyone confirm this rumor?

[skieczius]

I have already been kicked out of the Villages Health,because I'm not on Medicare yet.I have insurance through my former Employer.I will not give that up for Medicare United Health Advantage.It's all about money!!!!!!

[dbussone]

Originally Posted by nyclicker

I'll ask this question again. Can anyone confirm this rumor?

If I were you, I would call and ask. Then it's no longer a mystery.


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[Mikeod]

Originally Posted by dbussone

If I were you, I would call and ask. Then it's no longer a mystery.


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I asked a couple of weeks ago at the Colony facility. They would not confirm or deny that there would be a change coming up in the next enrollment period. Then they invited me to speak to the UHC rep, who did the same while trying to sell me on the plan. I requested and got a call from the manager of the Colony facility who also would/could not provide a definite answer to my question.

IMO, the VHS system was and is unsustainable if they have to rely on reimbursement rates for specific procedures and keep panel sizes down. That is why they are pushing patients to the advantage plan where they have a known sum of money to manage their patients and keep each physician's patient volume optimal.

My wife and I have been tossing the question around whether to stay with VHS using the UHC plan or continue with straight Medicare and TFL. I spoke to a rep from Tricare and was assured switching to the UHC plan had no effect on my TFL except that I lose the pharmacy coverage. And was assured that in the event I dropped the UHC plan at the next enrollment period and reverted to Medicare, all I had to do was contact TFL and let them know so my pharmacy coverage would resume.

We really enjoy the access to care at VHS. If I call, I get in soon. When I have an appointment, I am called in on time or shortly thereafter. Very different from my experience taking my mom to her appointments. It's not unusual to wait 40, 50 minutes or more past the appointment time to be seen. That's because provider reimbursement has been the main area hacked in efforts to slow the growth of health care spending. As a result, overbooking is the norm. Thus the long waits.

[spk7951]

The info below is from The Villages Health web site:

Accepted Insurance
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) Plan 1
UnitedHealthcare® The Villages® MedicareComplete® (HMO) Plan 2
AARP® Medicare Complete Choice® (Regional PPO)
AARP® Medicare Complete Choice® (HMO)
United Healthcare® Medicare Advantage Dual Complete


We continue to Participate with the following Commercial Insurances:

Avmed
Blue Cross & Blue Shield
Cigna
Multiplan
Private Healthcare System/PHCS
Tricare Standard
United Healthcare

[dbussone]

A significant issue with the VHS, IMO, is their failure to provide a full panel of specialists, and especially sub-specialists from places like Gainesville, Tampa and Orlando. When USF backed out of the arrangement, it really changed the capabilities of VHS, and altered the promise of VHS to meet the needs of TV residents.

Recall that Moffitt did the same thing, and Moffitt is just another arm of USF after all.


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[trichard]

Originally Posted by dbussone

A significant issue with the VHS, IMO, is their failure to provide a full panel of specialists, and especially sub-specialists from places like Gainesville, Tampa and Orlando. When USF backed out of the arrangement, it really changed the capabilities of VHS, and altered the promise of VHS to meet the needs of TV residents.

Recall that Moffitt did the same thing, and Moffitt is just another arm of USF after all.


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Totally agree! This is the primary issue for us.

[trichard]

It looks like the marketing push for MA has started. Today's article talks about how great the quality of care is at The Villages Health because they have teamed up with UHC Medicare Advantage. Did I miss the part about how it is big money-maker for TVH? I am waiting for the other shoe to drop for Medicare Original patients. Get ready to be "porked"!

[outlaw]

Originally Posted by dbussone

If I were you, I would call and ask. Then it's no longer a mystery.


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They lied to me three times. I had to wait for the letter.

[Bonnevie]

I also was told once I would be kept and later that I would not. was told by a provider there that decisions change all the time, so I doubt there is a conclusive answer.

[villagetinker]

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.

[biker1]

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.

Originally Posted by skieczius

I have already been kicked out of the Villages Health,because I'm not on Medicare yet.I have insurance through my former Employer.I will not give that up for Medicare United Health Advantage.It's all about money!!!!!!

[goodtimesintv]

Originally Posted by trichard

It looks like the marketing push for MA has started. Today's article talks about how great the quality of care is at The Villages Health because they have teamed up with UHC Medicare Advantage. Did I miss the part about how it is big money-maker for TVH? I am waiting for the other shoe to drop for Medicare Original patients. Get ready to be "porked"!

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

[dbussone]

Originally Posted by outlaw

They lied to me three times. I had to wait for the letter.

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


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[bstenon]

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