[Villageswimmer]

Originally Posted by golfing eagles

I'm not at liberty to say

Seriously?

[justjim]

The only rational reason you would no longer serve "regular Medicare" residents (Thousands) is that under the so called "Marcus Welby" concept they were losing money and apparently a lot of it because of what Medicare would pay under that concept. I am only stating the obvious. Needless to say health care is a top priority for TV residents and to be told you are no longer welcome in the TV health care program was a major blow to many TV residents. Maybe this could have been handled better is an understatement.

[Buffalo Jim]

Originally Posted by manaboutown

Well, since I was born in NJ I can hardly disagree!

Of course you would . And that`s why you chose the handle you are using -- perfect example . Having lived there for several years of my career I hold a much different opinion and now " they " are invading us here --- sadly !

Pushy , loud , over-opinionated , inconsiderate and oh so much more !

I try to live a life that is RESPECTFUL of others in all ways but it is difficult given the species which are growing rapidly in the Villages .

[NYGUY]

Interesting....can anyone post a copy of the letter?

[golfing eagles]

Originally Posted by CFrance

So why say anything at all? I know that when people complain about a company/doctor/dentist, etc., others chastise them for not naming who they're talking about. IMO, this is a similar situation.

If you know something, say something. I think you should tell these people why they should or should not fill out the surveys, based on what you know.

And if you know in advance you can't give an explanation, then maybe don't say anything at all. JMO

Originally Posted by Villageswimmer

Seriously?

Yes, seriously, and no, this is not a know something say something situation, not without betraying a longstanding friend. Also, I didn't want to write a book, but now.......

First of all, NO ONE, NOT ONE PATIENT was "booted" out of TVH. They made a change in the insurance they would accept, and now YOU, THE PATIENT had a choice. You could keep your primary care doc and change to UHC MA, or you could change your doc. YOU COULD NOT HAVE BOTH. This is the same choice millions of Americans have EVERY January 1st, as providers decide which insurers they will continue to accept, and insurers decide which providers they will keep in network. This was not done as a personal affront to Villagers, it was a business decision. For those people who had a supplemental policy as a retirement benefit, there was a financial reason to leave.

The second problem was the misperception that the UHC MA plan had an extremely limited panel of specialists. This was simply not true, with over 20,000 doctors in network and over 150 hospitals. Shands and Moffitt are NOT in network, but there is nothing special that cannot be obtained in network. Also, the insurers are generally very liberal with approving out of network referrals with a good reason and a call from the primary care doctor. If you were already under treatment by a provider out of network, it would almost universally be approved. IMHO, many jumped to conclusions regarding UHC MA and specialty availability.

Third, someone posted that TVH is losing "millions". I'm not sure how this person would know that, I certainly don't. However, they are building a new primary care center at Brownwood and actively recruiting doctors, so that doesn't sound like they are cash poor.

Fourth, I got the same letter, although mine was a thank you for staying with them and an invitation to participate in the survey. I doubt the purpose was to change direction and start accepting traditional MA again; I'm not sure they could if they wanted to depending on the terms of the deal that was made

[Nucky]

Originally Posted by Buffalo Jim

Of course you would . And that`s why you chose the handle you are using -- perfect example . Having lived there for several years of my career I hold a much different opinion and now " they " are invading us here --- sadly !

Pushy , loud , over-opinionated , inconsiderate and oh so much more !

I try to live a life that is RESPECTFUL of others in all ways but it is difficult given the species which are growing rapidly in the Villages .

Being qualified because of 58 years in NJ I do agree with "Pushy , loud , over-opinionated , inconsiderate and oh so much more!" because now I have others to compare us Jorsey people against. We are Crude, Rude and Vulgar not because we want to be it is because it is a survival skill there. Pointing out these shortcomings of others is not being respectful to others. I have no beef with you whatsoever.

Jack Nicholson, "I don't want to be a product of my environment, I want my environment to be a product of me." I want to turn over a new leaf and be a product of my new community but it's a slow process. Someone signs their posts pardon my edge I'm from NJ....I understand.

So far I like my UHC insurance. I had great advisors.

[Bogie Shooter]

Originally Posted by Carla B

Thought I read a couple months ago that they hired a pediactric physician... I couldn't figure out why, since Villagers don't have young children. Then someone said they are taking patients from the surrounding areas. Ironic, since the health system was started for Villagers, and now a large portion of us are excluded.

What about the family villages?

[gomsiepop]

A previous poster states that patients of The Villages were not "booted" out of The Villages healthcare needs to get off his high horse. My husband and I were skeptical of joining The Villages healthcare. A friend of ours encouraged us to join because of her positive experience. After having The Villages for our care for approximately a year we were given the option to either join Medicare Advantage or leave the network. After careful investigation we opted to leave. That choice was very difficult. We had developed a trust in our Primary Physician that I found difficult to replace. For someone to state that those of us who chose to leave did so easily is to minimize the heartbreak that some of us experienced. My husband and I trusted our Primary Physician. Unfortunately, we were given information that was totally a lie. A year prior to being "booted" out I received a letter stating that because we currently had healthcare through The Villages we were "grandfathered" into their system. I for one am hoping that The Villages is possibly reconsidering their decision and will open the door for all of us to return.

[golfing eagles]

Originally Posted by gomsiepop

A previous poster states that patients of The Villages were not "booted" out of The Villages healthcare needs to get off his high horse. My husband and I were skeptical of joining The Villages healthcare. A friend of ours encouraged us to join because of her positive experience. After having The Villages for our care for approximately a year we were given the option to either join Medicare Advantage or leave the network. After careful investigation we opted to leave. That choice was very difficult. We had developed a trust in our Primary Physician that I found difficult to replace. For someone to state that those of us who chose to leave did so easily is to minimize the heartbreak that some of us experienced. My husband and I trusted our Primary Physician. Unfortunately, we were given information that was totally a lie. A year prior to being "booted" out I received a letter stating that because we currently had healthcare through The Villages we were "grandfathered" into their system. I for one am hoping that The Villages is possibly reconsidering their decision and will open the door for all of us to return.

No "high horse" involved, just reality. YOU WERE NOT KICKED OUT, YOU HAD A CHOICE. What's so hard to understand about that. No one said it was "easy", at least I didn't. In fact, from the other side, the hardest thing we ever did was to drop Empire insurance, because we knew it was the only insurance for a thousand or more of our patients. But Empire had dropped their reimbursement so low that we were actually losing money by seeing their enrollees. It was a BUSINESS decision.

Also, 2 years ago when these threads started, I challenged anyone, ANYONE to produce, in writing, from TVH a letter that essentially said---"No matter what the future brings, no matter changes in insurance company policies, no matter changes in national health care policy, that they would forever in perpetuity accept your specific insurance plan" I'm still waiting. I received that very same letter about "grandfathering", and didn't take it to mean my current insurance was locked in forever. I took it to mean I could be their patient forever, but not as a guarantee that I wouldn't have to change insurance.

You speak of trust in your PCP, and how it was heartbreaking to leave----Are we to take it you had even more love for and trust in you insurance plan???? Because that is the choice YOU made.

[Villageswimmer]

Seems this thread has strayed off topic. Why beat a 2-year old dead horse? (Or a high one)

The OP posted about the survey and the letter of apology. I think the question is: why would they send this letter and survey to FORMER clients for feedback? There's got to be a reason?

Unless I really missed something, this is mystifying (even if they're making tons of $ and don't want anyone back).

Would someone please post the letter? Like the farewell letter of times past, it will probably not be forwarded to us up North.

Namaste.

[jchase]

Yes, yes, I was booted out! If I choose Medicare Advantage I would have to drop my New York State Empire Plan. If I did that, and changed my wife (who is not 65) would be dropped from the Empire Plan, and I would have no secondary insurance. So, saying that, some people don't do their homework or don't know what they are talking about. Do your homework before making a post!

[golfing eagles]

Originally Posted by jchase

Yes, yes, I was booted out! If I choose Medicare Advantage I would have to drop my New York State Empire Plan. If I did that, and changed my wife (who is not 65) would be dropped from the Empire Plan, and I would have no secondary insurance. So, saying that, some people don't do their homework or don't know what they are talking about. Do your homework before making a post!

No, No, you were NOT "booted out" You had a choice, and amazingly, you laid out your choice in your own post! You just didn't like the choice. Speaking of homework---you don't need a secondary insurance with a MA plan, so you should hit the books again. Your problem is that your wife would have to go out and get insurance in the individual marketplace, which would cost $500-900/ month. So, as I stated in the previous post, there are people who have insurance as a retirement benefit and therefore a financial incentive to leave TVH. I happen to think you made the right choice, but it was a CHOICE. Not knowing what I am talking about?---I thank you for a good laugh.

[dbussone]

Originally Posted by golfing eagles

Not a chance.



BTW, you KNOW they are running a negative cash flow and losing millions, how????

Well, GE, he doesn't understand how Medicare Advantage works does he. The economics of healthcare is complicated, and too many pretend to understand it. You are among the few who does.


Sent from my iPad using Tapatalk Pro

[dbussone]

Originally Posted by manaboutown

It's all about the money...

BTW - Where is The Villages Heath?

All over The Villages

Easy to find: The Villages Health | America's Healthiest Hometown

If you don't know where they are, how do you know what "it's all about?"


Sent from my iPad using Tapatalk Pro

[Villageswimmer]

Would someone please post the letter about the survey? I believe that is the topic of this thread.