The Villages Health Care System
 

I'm really disappointed in the Villages. I moved here with good insurance, but I'm not 65 yet. The villages developed this wonderful health care clinic system and they only take ONE insurance and that is a Medicare Advantage Plan. ONE insurance. How nice for the rest of us that are not 65 or are 65 and do not want an HMO Medicare plan which is what it is. I know they make a bundle of money taking the capitation from the only plan they accept but the system they developed is only accessible to a few villagers. What do Villagers think about this "Villages Health Care system"?
Can anybody recommend a good family or internal medicine primary doctor?

Disappointed Villager

Have you been to the Medicare store in Sumter? Get your questions answered.

I am 55 and I have BC/BS and they accept it.

Yeah. We can't have everything we want sometimes.




Here is a list of doctors and health care folks we see and find to be good;


Dr. Felix Agbo PCP
Dr. Judith Milstead ENT
Dr. Hamilton Fish, Endocrinologist
Dr. Caspar, Dermatologist
Dr. Han, Gastroenterologist
Drs, Rosario and Caylor, Oral Surgeons
Dr. Alex Ghazal, Endodontist
Dr. Wu, Podiatrist
Drs. Jabar and Williams, Dentists
Lake Imaging, Mammography and other imaging.
Publix, Flu Shots and Pharmacy.

I really like The Villages Health. We got in at the start.Their are many health care providers in the area. Like any other city you need to find a provider that takes your insurance.

No need to be upset if your insurance is not accepted at Village Health.
The BEST doctors in this area are not in their system. Look around, TV area has plenty of excellent doctors, and they also do not rush you through an appointment.

Have you tried Premier Medical? They had a full page ad in today's Sun newspaper. My wife used them for 4 years when we came here. They have two locations, one at Lake Sumter and one on Santa Barbara by the hospital. That second location also has an urgent care and lab. Here's their website Premier Medical Associates

http://pma-physicians.com/pmaphysici...1/SBB_HOME.jpg

http://pma-physicians.com/pmaphysici...erior-Home.jpg

Could this be an example of "you can keep your insurance and also your doctors"? Folks all over the country (I know some of them) are not getting the care and coverages they'd been promised. SOME doctors even aren't accepting Medicare and/or some insurances/

I'm not sure that's correct. Have you called to ask them whether your insurance is accepted for those not yet Medicare eligible? Mine was (but admittedly I inquired about it last Spring when I made my first appointment, so things may have changed). That appointment is coming up next week (yes, it was a long wait but it was alright with me as I am fortunate to be generally healthy). I even received an email from them around the time of the announcement of the Medicare Advantage plan being the only plan they accept for Medicare-eligible folk that said not to worry, that that did not apply in my case. I presumed that also applied to everyone not currently eligible for Medicare. Bottom line, don't assume, call and ask.
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bc

I agree. I think the United Heatlh care is the only Advantage insurance they take but they do take many other insurance plans. Please check this out further, you may have been misinformed.

Call SHINE, they will give you the straight scoop. I have posted this info twice, so do a search on the word SHINE and you will get all the contact info. They are very knowledgeable and helpful.

Good doctors and never rushed out during appointments

FOR NEW PATIENTS, they only will accept UHC Advantage plans, both HMO and PPO.

unfortunately that is why I can't use them. I have had too many issues requiring hospitalization, if I was on an advantage plan last year, with villages health care, I would be bankrupt now.

Well there is max out of pocket of $4500.
Their other plan 's out of pocket is about half of that.

Max out of pocket will prevent a bankruptcy in just about all cases.

A friend just told me he was accepted by The Villages Health system just before the cut-off date. His wife, who is on the same insurance policy, was denied acceptance since she did not apply by that date. So, The Villages Health says what they mean and they mean what they say.

Considering they were on the same policy together their decision is heavy handed. If I were the husband I'd withdraw and shop elsewhere. It's not like they're the platinum standard. Are they giving out vanity plates so the members can showboat?

we do too.
no problem.

Sounds like you're grandfathered in.

Full page articles in the Sunday paper are working hard to move people into the UHC Advantage Plan which employs The Villages Health PCPs, specialists and services. It is a very lucrative profit center for TV. That being said, the calibre of docs being brought into TV are better than before. Note that insurance companies take about 17% right off the top of the medical dollar, and compete hard for your business, as do docs, usually. TV is becoming a captive market. I'm continuing to choose my physician/specialists, especially in travel by purchasing a supplement plan and a Part D, which is quite easy to do by calling Medicare. Rather have alittle more control.

If it were me I would appeal that decision to upper management. Finally if Villages Health is not the "platinum standard", what's the big deal?

Consulting the Villages Health System is a choice just like what car you drive and what restaurant you choose.


I wish they would take my insurance. I would use them in a heartbeat. Health care in Central Florida is not as good as where I came from. We lived near to a large teaching hospital with tons of research grant money and doctors who were prestigious in their fields.


I think, because I am really taken in by the Morse family and think they are great, that they were trying to provide good health care for Villagers, and make money too. That is how it works. It would finish off their fine idea place very well.


But me, I am just a hick from Ohio, what do I know?

check the hospitalization coverage and medical tests outside the routine. the max out of pocket is for medicare covered services and not for tests, treatments or other services not covered by medicare...those you will still pay for after max out of pocket is reached.

Yes, but is that for ALL new patients, or only those who are old enough to be eligible for Medicare?
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bc

Since they only accept UHC Medicare Advantage Plans they will only accept new patients who are eligible for Medicare (I can only think of two categories that are eligible, age 65 and those younger but are on Social Security Disability).

Dr. Delbakhsh and his new partner, Dr. Lorenzo are excellent...smart, thorough, follow-through and an office staff to support the practice!!

I'm too tired from unpacking to make a long dissertation on all the disinformation posted so far, so I'll just say this: If you are under 65 and interested in TV Health, call and ask if they accept your insurance. I very much doubt they are not accepting patients under 65. If you are medicare eligible, they will only accept UHC advantage for NEW patients. If you don't understand $4500 out of pocket max, and some apparently don't, call UHC and ask.

According to the description of SHINE in the Recreation News they only deal with Medicare issues. If that is so they would not be able to help the OP because she is younger than 65.

:agree:

I agree, it doesn't make sense to me that they would not accept new patients under 65, although it is possible, so a clear statement from them on this would be helpful. I'm going in Monday for my first appointment. I'll ask.
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bc

For those on this thread who think the insurance companies are just out to get every penny they can out of your pocket, the following might surprise you:

"UnitedHealth Group has lost $425 million from health plans sold on the Affordable Care Act's marketplaces, which forced the company to lower its profit projections for the rest of the year. The company suggested it may exit the exchanges altogether by 2017.

It's a potentially huge blow to President Barack Obama's healthcare reform law. The exchanges have been viewed as the primary conduit to expand health coverage to middle-class Americans. If a major publicly traded insurer bows out, others may follow and destabilize the entire individual market.

“We cannot sustain these losses,” UnitedHealth CEO Stephen Hemsley said on an investor call Thursday.

The $425 million shortfall from exchange products includes $275 million that UnitedHealth expects to lose from its 2016 plans. There's also another $200 million to $225 million in potential exchange losses that can't be booked until next year, the Minnetonka, Minn.-based health insurer and services conglomerate said.

UnitedHealth will evaluate its public exchange status during the first half of next year before deciding if it will leave the market. It has also “pulled back” significantly on marketing its 2016 plans and cut commissions to insurance brokers to minimize enrollment growth.

It's a swift turn of events for the nation's largest health insurer, which only a month ago touted its exchange strategy and said it was expanding into 11 new markets next year.

Healthcare stocks have been taking a beating Thursday morning in light of UnitedHealth's announcement. UnitedHealth's shares were down 3.6%. Anthem's stock plummeted 6.8%, while Aetna lost 4%. Hospital chains HCA and Community Health Systems were down 5.2% and 8.3%, respectively."

Just released by Modern Healthcare.

The Villages Health Care System
 

Getting real tired of this argument. Health care may not be a right, but it is a necessity. Water, electricity, law enforcement, fire protection, sanitation are all necessities. In many areas of our country these are all public services. Health care needs to be nationalized so as to provide ALL of us with affordable services unencumbered by shareholder greed. Medicare for all and let's see if these companies "pull out". They'll always be money that will operate out of the system but the remaining 98% of us will still generate an effective and productive health care system.

Agree that healthcare needs to be a Medicare for all model.. The ACA was a compromised step in that direction.

Anyone go to Dr. Qamar in Ocala?
Lawsuit continues against Ocala's Dr. Asad Qamar after judge denies motion to dismiss | Ocala.com

Happy Friday morning to me. At 8:00 this morning, I received a call from the Villages Health Care telling me that they will no longer accept my insurance. After over 2 years with them, I now have to find a new PCP. It is difficult to wade through the qualifications of so many physicians who were not educated in our country. Changing plans is not an option since mine is provided by my retirement system. Wish me luck.

Mom uses Dr. Shah at Premier. She likes him, as I do (I take her to all visits).

Hubby and I prefer a holistic approach so we use Healthcare Care Partners and see Dr K - Contact Us | HealthCare Partners Family Medicine, LLC

He accepts our insurance with is United Healthcare.

You can go here to look up doctors background
https://appsmqa.doh.state.fl.us/IRM00PRAES/PRASLIST.ASP

Dr. K went to medical school in the Phillipines - UNIV OF THE EAST, RAMON MAGSAY from 1982-86. That's where he met his wife Dr. Villa.

Villages Health accepted insurance
Accepted Insurance by The Villages Health