TV Healthcare UHC Medicare Advantage
 

In a couple of months I will be turning 65 so need to decide what type of healthcare insurance to switch to. There has been a lot of articles published about TV UHC Medicare Advantage Program and TV Healthcare system. Some of it sounds too good to be true. I would appreciate hearing from anyone who participates if they're happy with the doctors and service provided. I am worried that I will be changing from my current doctors and wondered if there was any particular doctor at Colony or Pinellas that you would recommend.

I am getting inundated with brochures and mail from every insurance provider out there. Whom told them I was turning 65?:undecided:

My wife had Humana for drug coverage and paid $22 a month and she had United Health Medigap plan which was $184.50 a month. Last July I turned 65 and signed up with the Medicare Advantage plan. My wife saw how good and cheap the plan was for me, she dropped those two plans and signed up for Medicare Advantage herself at the Medicare Store at Brownwood.

First off, under her old plan she went to Premier Medical at Lake Sumter and she wasn't crazy about their service and then her doctor left, who she felt wasn't as good as others in the past. She has now been to the Villages Medical at Pinellas twice to see her doctor, who she really likes. She getting drugs at Walgreens in front of Pinellas and not having to go all the way to Walmart and stand in long lines only to have them say their is a problem or they are out. She picked up a drug yesterday for $90 which under the old Humana plan was $140. She's had a mammogram, bone density tests, anything you want. It the best deal ever and we're saving over $200 a month in premiums.

Myself, I went to the dermatologist Dr. Casper today, who many consider the best and paid just a $30 copay. Within 5 minutes they diagnosed my problem which other dermatologist couldn't figure out even after taking a biopsy.

I can't give any recommendations for a doctor down in Colony and or the Pinella's but I just switched to UHC Medical Advantage and I am going to see Dr. Rosenblum in the Santa Barbara health facility.

The good thing about the UHC plan is you see any doctor you wish, without a referral. You must select a PCP but any other doctors/specialists, can be seen without a referral. They have a lot of doctors in their network too!

You can visit their facility and get a tour. They also have a concierge type of system where you can call at any time and get a doctor on the phone. To me, that means a lot.

My former plan needed a referral to any specialists.

Agree. We have been extremely pleased with The Villages Health System. We go to Colony. Go to,their web site. The docs are listed and if you click on them each will say a few words. Each physician is limited to a certain number of patients. You may need to ask and see who,has openings at this time.

I will try to answer your question. Upon turning 65 you will become eligible for Medicare. You can select straight Medicare, or select Medicare and add a Supplement (coverage for uncovered Medicare services) (an additional premium is required for a Supplement) or select a Medicare Advantage Plan (HMO or PPO).

The Villages Health system will only accept you as a new patient if you have chosen a United Healthcare Medicare Advantage Plan (many insurance companies offer Medicare Advantage Plans and Supplements).

My wife and I both are in The Villages Health system with Primary Care physicians. We are both happy with our primary care doctors. Where The Villages Health falls flat, as well as this area in general, is specialists. I believe this is due to the difficulty in recruiting top-notch specialists to our rural area.

I know this it a lot to absorb. I strongly suggest you contact SHINE to assist you. Be aware the the Medicare offices in each town square are run by United Healthcare and therefore have a vested interest in only their products.

Not having specialists is related to United Healthcare's extensive cuts to physicians-specialists in its networks. This is what monopoly control tends to do:

2013 -- "....The Ohio State Medical Association estimates that UnitedHealthcare has canceled contracts with hundreds of Ohio doctors effective Jan. 1. The cancellations include most of the orthopedic surgeons in Dayton, the only hand specialty practice serving the Cincinnati area, a large gastroenterology practice with 2,500 patients that also provides most of the inpatient care at five Cincinnati-area hospitals, and the largest practice of retina specialists serving 600 UnitedHealthcare members, many with macular degeneration, in central and southern Ohio.

In Connecticut, UnitedHealthcare is terminating about 2,250 physicians, including 810 specialists, Feb. 1, said Mark Thompson, executive director of the Fairfield County Medical Association, prompting the medical associations in Fairfield and Hartford counties to file a federal lawsuit to stop the cancelations.

In New York City, UnitedHealthcare's contracts with about 2,100 physicians will be canceled, affecting some 8,000 patients, according to the Medical Society of New York.

In Florida, UnitedHealthcare has dropped the state's only National Cancer Institute-designated cancer treatment facility, the Moffitt Cancer Center, and its 250 physicians in Tampa..."

UnitedHealthcare Medicare Advantage cuts doctors

I was referring to the lack of top-notch specialists in this rural area in general, not just specialists accepting United Healthcare. However, the information you provided is very important.

You couldn't have picked a better doctor! (no, I'm not him).

My wife and I were also confused about medicare programs when we turned 65. Agents always seemed to have an agenda and created more confusion. Yes, UHC The Villages Advantage plan is a great deal with some caveats. It is a local HMO, so it is not the best for snowbirds. But you have emergency coverage anywhere in the US. You are restricted to doctors in the UHC network, but most people seem to be quite happy with the choices. If you have unique medical condition(s) you should check to see needed specialists are in network, otherwise consider a supplement plan rather than an Advantage plan.
Wife an I have been in 3 Advantage plans due to moves. We have been very pleased with all - Cigna, Humana and now UHC. Medical events have included cataract surgery, knee replacement surgery, hearing aid, dental care.

My wife and I were also confused about medicare programs when we turned 65. Agents always seemed to have an agenda and created more confusion. Yes, UHC The Villages Advantage plan is a great deal with some caveats. It is a local HMO, so it is not the best for snowbirds. But you have emergency coverage anywhere in the US. You are restricted to doctors in the UHC network, but most people seem to be quite happy with the choices. If you have unique medical condition(s) you should check to see needed specialists are in network, otherwise consider a supplement plan rather than an Advantage plan.
Wife an I have been in 3 Advantage plans due to moves. We have been very pleased with all - Cigna, Humana and now UHC. Medical events have included cataract surgery, knee replacement surgery, hearing aid, dental care.

The ONLY medicare advantage plan that The Villages Health participates with for NEW patients is United Healthcare and they have never participated with a BC medicare advantage plan.

You do have to have a referral to see a TVH specialist, but the specialists only see patients of TVH and do not take outside referrals, so the referral process is much more quick and painless :)

The word is, The Villages are invested in UHC, and own part of the business.

Do you think TVH specialists are not top-notch or do I misunderstand?

They obviously have a close business relationship, but I do not believe there is ownership in either direction.

No, you do not misunderstand. I don't think, in general, TVH specialists or other specialists, overall, in the area are top-notch. My theory is that it is very difficult to recruit the best and brightest along with their families to a rural area such as this. It's just my opinion, but I am sure it plays a roll.

I switched from Fl Blue, (HMO). That particular plan requires you to see your PCP first and then get a referral. I don't know about the PPO plan but I assume it's more than 104.90 per month.

The UHC plan had all of the specialists I was seeing without needing a referral. plus it was cheaper co-pay for the specialists.

I didn't see Shands and Moffit in my provider directory but if Shands and Moffit are your biggest concern, then Fl Blue, (PPO), is right for you. Maybe someone who has had UHC for a couple of years could weigh in, on whether they are in the UHC plan.

With United Health, the Villages , you can always apply for a special exemption to see a specialist out of network if there is not one in this area or plan who can deal with your issue.
I have an appt with a special specialist in Boston where there is United Health. All I did was call her office and set the appt up, copy is $15.00. No problem.

You consider this a "rural" area?:1rotfl::1rotfl::1rotfl:
Try central NY.

As far as recruiting goes, there are only so many of what you term "the best and the brightest"; they can't be everywhere. Fortunately, the difference between "average" and "best" is nowhere near as great as you probably believe. The main difficulty in recruiting is getting started--no one wants to be the only physician in a specialty in a given area---they end up being essentially "on call" all the time. Medicine has changed, doctors want a life outside of medicine. Once there are enough in a specialty, recruiting becomes easier. We had 7 physicians in our group in a city with 1/3 the population of TV, but were able to recruit 3 HS Valedictorians, the chief resident from SUNY Upstate and the chief resident from Univ. of Rochester., graduates of Univ. of Michigan and Georgetown Univ. The main reasons were that they knew exactly what to expect, and were only "on call" once a week.

PS: TV Health recruited one of ours, so they're not doing too badly (no, not me)

I am a patient of TVH. My PCP and specialists are as top-notch as they come IMO. I can't imagine being treated better, personally or clinically, anywhere else.

Regarding "not the best for snowbirds", I read something about a so-called "Passport" feature of UHC Medicare Advantage plans that enables members to receive non-emergency care outside their home area as long as there are in-network UHC providers in that area. Is this feature available on either of the two UHC MedicareAdvantage options available in TV? Here's an excerpt from the UHC webpage I found the information on:

UnitedHealth Passport® program – Get non-emergency care in certain areas within the United States for no additional monthly premium. You only pay the applicable co-pays according to your Evidence of Coverage. (UnitedHealth Passport is available on many, but not all, MedicareComplete plans insured through UnitedHealthcare. Note that emergency care is already covered worldwide on all plans.)
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Bob C

I was not aware of the Passport program and I thought emergency coverage was US only. I will be checking into both of those. Thanks for the heads up.

The patient profile of a doctor here is going to be reasonably healthy senior citizen, period. Very few doctors want to have a practice of managing our demographic unless they are in geriatrics and enjoy it. Family doctors are trained to treat all ages and spend a little time training in elder care. They would want to see kids, teens, young adults... Specialists may expect to see fewer young people but most can expect good continuity and to be able to manage their patients. We, as patients, often have another set of doctors "back home" and many seem to leave the area when an illness worsens. Combine this with a severe lack of younger adults and kids for the doctor's family social life, and yes it is harder to get doctors to come here other than those into geriatrics and those nearer retirement age themselves.

Well, that's interesting. Do you really think the demographics of a primary care practice here is different than anywhere else, PERIOD? And your insight into what type of patient a doctor wants to see is based on what? The average age of a patient in my NY practice was probably about 45-50, but the average age of the patients that actually came to be seen was in the 70's. Pediatricians want to see kids, that's obvious. Gynecologists want to see women, oncologists want to treat cancer. Family practitioners will see who they want. Specialists want to do procedures. I very much doubt "demographics" in TV has a lot to do with recruiting.

I'm fairly certain that in TV, they fully understand the demographics.

This is where I found that for what its worth:

https://www.uhcmedicaresolutions.com...r-support.html
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Bob C

there's actually a course at Lifelong Learning on understanding Medicare and the various add on plans.

We are all "invested in" the UHC-AARP bed partnership via the federal bedroom:

"“AARP lobbied for the new health care law and now it stands to profit, lawmakers charged Wednesday as they called for the IRS to investigate whether the powerful interest group deserves to keep its federal tax exemption.

“Three veteran representatives released a report that estimates the seniors lobby could make an additional $1 billion over 10 years on health insurance plans whose sales are expected to pick up under the new law. They also questioned seven-figure compensation for some AARP executives.”

Among the key findings from the Ways & Means Committee report are:

As a result of the new health care law, the Administration estimates more than seven million seniors will lose their current Medicare Advantage plans, resulting in a massive migration of seniors to Medigap plans. AARP is the nation’s leading provider of Medigap plans and has a contract in which AARP financially gains for every additional Medigap enrollee.

Based on low, mid and high-range estimates, AARP stands to financially gain, over and above the millions of dollars they currently receive from United, between $55 million and $166 million in 2014 alone as a result of new Medigap enrollees stemming from the health care law’s cuts to MA, which AARP strongly endorsed.

Under the mid-range estimate and under their current contract, AARP’s financial gain from the health care law could exceed $1 billion during the next 10 years. This is because AARP will see their royalty payments increase as seniors are forced out of MA plans and buy AARP Medigap plans instead.

- See more at: AARP Profits from ACA at the Expense of American Seniors, New Report Shows | Speaker.gov

Not only that, "demographics" here is a gold mine of bread and butter procedures if you're a dermatologist, dental implant specialist, ophthalmologist with cataracts done assembly-line, retina-macular specialist, neurologist dealing with stroke and arthritis/syndromes, medical oncologist, radiation oncologist, urologist treating prostate cancer, etc. And the great specialists in these fields want to make money, too, not work for half or a third of the amount as an academic at a teaching/research hospital megaplex in the cities.

LOL.... Doc, I consider both rural....it's no laughing matter....:1rotfl::1rotfl::1rotfl:

[QUOTE=rexxfan;1174360]This is where I found that for what its worth:

I found it in my benefits book. This Advantage program IS good for snowbirds if they live in one of the 34 or 35 states included. The plan can be transferred for up to 9 months. An added plus is the worldwide emergency coverage. Neither of these were included in my previous plans. Thanks for the info,

[QUOTE=GordonL;1174596]Good to know.

United Health Care under the Affordable Care Act is losing money as are other Health Carriers under ACA. What does it mean for the future?

I've been using TV Healthcare for a couple of years with mixed results. The first doc I chose seemed great the first time I saw her for a routine checkup. She seemed concerned and competent. When I saw her a few months later that enthusiasm had vanished. She seemed to be going through the motions. A short time later she left TV Healthcare. The next doc I chose didn't give me a confident feeling from the start. I've seen him twice with the same gut reaction. The 2nd time I saw him he missed a diagnosis that was picked up by another doc at the same site the following day. I had returned because my symptoms had worsened. I realize that no doctor gets the diagnosis right every time but I feel uneasy seeing him again. The last time I needed a doc I asked to see someone else at TV Healthcare. If I stay with TV Healthcare I need to find another doc or I might leave them and go elsewhere for my medical care.

You did not mention if you have the advantage plan or a supplement plan. If you have an advantage plan you may in for a real shock, s there are limited options for doctors not in TV health plan. This is one of the reason we got out of the advantage plan and went with supplement plan. Please check this out.