[Singerlady]

Originally Posted by Carla B

Just opened the POA April Bulletin which printed an interesting observation made by UF Health CEO Edward Jimenez who spoke at the March POA meeting and focused on integrating the local hospitals with UF Health Shands.

"Mr. Jimenez was surprised that no one asked about United Healthcare, saying that UF Health does not accept United Medicare because United doesn't want to work with University Hospitals. United has offered to pay only 75% of Medicare (claims)."

So, I suppose this means that patients of TV Health United Health's Medicare Advantage plan will not be going to The Villages Regional or Leesburg Hospitals for treatment in the future?

Sounds like the United Health Care reimbursement rate is miserly, even by Medicare standards. Maybe Moffitt, Mayo and other providers do not accept it for the same reason.

Moved here almost 3 years ago. TV Health sounded restrictive. They stopped accepting other insurances other than UHC. I had Aetna at the time. They then started accepting other insurances again, I think. I now have UHC (not through TV Health) and have no problem. TV Health ‘regional’ plan really scared me.

[kathy1516]

Advent Hospital takes United Healthcare in Ocala and I believe Ocala Hodpital does also. Better care there than Villages or Leesburg hospital.

[jimjamuser]

Originally Posted by WindyCityzen

Nonprofit only means they do not have shareholders ... that profits (if any) are retained not distributed. Nonprofits may or may not pay federal business income tax on their mission-related businesses. (They undoubtedly pay many other taxes on unrelated activities, e.g, renting out office space to doctors.). The profit and tax exempt statuses are technically unrelated. Bottom line: All of this has little if any effect on how they negotiate with insurance carriers. Also, just saying ... if the US had a single payer system like all other first-world nations, none of of this would even occur.

Amen - windy person!!!!!!

[Topspinmo]

IMO it should be against the law for any medical facility to not accept healthcare insurance. IMO that’s why healthcare insurance so ___ —. Lobbyist still own career politicians. This should of been corrected under the ACA. But lobbyist made call to there career puppets and they bowed down to there masters.

[jimjamuser]

Originally Posted by WindyCityzen

I couldn’t agree more. Advantage plans are losing ground. Medigap/Supplemental Plans F or G are the best options.

My wife says that the F plan WAS the gold standard. You can't get it anymore. She says that maybe you can get a G plan?

[jklfairwin]

Nonprofits of all types, including hospitals are also notorious for paying outrageous salaries and perks to Senior executives and directors.

[tuccillo]

Not exactly. Essentially, you can get Plan F if you were eligible for Medicare before Jan 1, 2020. If you have another plan, you may need to go through underwriting in order to change to Plan F. For many people, Plan G is a better deal. Read post #21.

Originally Posted by jimjamuser

My wife says that the F plan WAS the gold standard. You can't get it anymore. She says that maybe you can get a G plan?

[CoachKandSportsguy]

Nonprofit only means they do not have shareholders ... that profits (if any) are retained not distributed. Nonprofits may or may not pay federal business income tax on their mission-related businesses. (They undoubtedly pay many other taxes on unrelated activities, e.g, renting out office space to doctors.). The profit and tax exempt statuses are technically unrelated. Bottom line: All of this has little if any effect on how they negotiate with insurance carriers.

Also technically true. however, many non profits source their large cash flow investment needs from bond holders, as well as are renters from hospital reits. However, both bond holders and REITS have convenants or required payments which the hospital must maintain, or they can be evicted, (does happen) or bonds are called, credit ratings are lowered and the cost of future investment or ownership is less certain.

So there is a relationship between customers served, prices negotiated, government reimbursements, commercial payers, depending upon the type of customers you are accepting, and the bond holders, credit ratings for future investment in upgrading old buildings and equipment, and reits for rental fees.

The finances of large service providers is very, very dependent upon the services provided and the margin of the individual services as well as the mix of services and customers.

Safety net hospitals have a large portion of government payment or uninsured, and therefore rely heavily upon government payments, some with greater than 50% of customers are government or uninsured, based upon population of geography served.

So a single concept might satisfy your belief system, the finance world is always much more difficult to balance all the variables to long term success:

Which is easier? running any large organization successfully for 10 years? or going out of business due to a key strategic miss or financial ineptness?

finance guy

[spk7951]

Originally Posted by mrf6969

This is just another reason why a Medicare Supplement Plan may be the best option when your talking out of pocket expenses. Sure you have a monthly premium with it but you can choose your hospital and doctor and there is no doing the referral dance. You also do not have surprises in the form of co-pays that can add up to many times more than a monthly premium. Plan F/G can give you much piece of mind. Your health care is nothing to roll the dice with.

When my wife first went on Medicare a so called expert told her that her best option was a supplement plan due to her health issues. She even told her an advantage plan would not cover her. Turned out that so called expert was wrong.
We paid the highest out of pocket health care costs we have ever had to pay while under that supplement plan.
After two years we talked to both UHC and Blue Cross. Both advised her she would be covered under an advantage PPO plan with much lower out of pocket costs.
She has been with AARP UHC PPO for about 3yrs and is very happy with them. Visits to Shands and Smilo Yale Cancer Center have been fully covered.

[capecoralbill]

Originally Posted by Villages Kahuna

After several years of subscribing to TVH Medicare Advantage offered by United Health Care, we switched to Florida Blue this year, when it was first accepted by Villages Health.

.

I just came back from the Villages Health at Santa Barbara , They DO NOT accept Florida Blue Supplement Plan F or G if you are over 65 years old.