Talk of The Villages Florida

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-   -   TVH/Advantage (https://www.talkofthevillages.com/forums/medical-health-discussion-94/tvh-advantage-202003/)

CritterLover 07-19-2016 09:33 AM

TVH/Advantage
 
Please be responsible and proactive and get the facts from United Healthcare instead of jumping on the bandwagon of all the misinformation and TVH-bashing that's running rampant. For as many nasty posts exist here, even more are from happy patients, like me, who have converted to advantage. YOU have to be your own advocate and do the work to get factual information. If your undies are in a bunch, you just MAY be totally misinformed.

Mudder 07-19-2016 10:04 AM

:BigApplause:

Joejohnson 07-19-2016 10:06 AM

TVH is making a move to United Healthcare Advantage for their profits. I must leave, because my current Medicare and Tricare for life is far more a complete coverage than UHC. I have none of the many restrictions and co-pay's with Tricare. My biggest concern is that if I change to UHC I would be restricted to a shortened list of specialist and be required to get a referral that is not required by my current policy.

kansasr 07-19-2016 10:25 AM

I'm glad the UHC plan works for you, but I can assure you that it is a second rate plan at best and certainly not up to par with what many of us have through our various retirement plans.

What is most galling about TVH approach is their assurances when people signed up that they would not be dropped from the plan in the future. Well the future is here and for many, those are now very empty promises. They can choose to continue with a system and providers that has worked well for them and deal with more restrictions and fewer benefits under the UHC plan or uproot their medical care once again to find new providers and keep their existing coverage.

The Villages is often described as a "company town", similar to coal mining towns in the early part of the 20th century, where every decision was made for your by your employer. Here we are asked to rely upon the good will of the developer, but time and time again find that changes are made that affect our lifestyle, but we have absolutely no input into the decision making process.

Rapscallion St Croix 07-19-2016 10:40 AM

Quote:

Originally Posted by Joejohnson (Post 1256251)
TVH is making a move to United Healthcare Advantage for their profits. I must leave, because my current Medicare and Tricare for life is far more a complete coverage than UHC. I have none of the many restrictions and co-pay's with Tricare. My biggest concern is that if I change to UHC I would be restricted to a shortened list of specialist and be required to get a referral that is not required by my current policy.

Why do you have to leave? I also have Medicare and Tricare For Life, and my letter says I can stay.

CritterLover 07-19-2016 10:59 AM

Quote:

Originally Posted by kansasr (Post 1256264)
I'm glad the UHC plan works for you, but I can assure you that it is a second rate plan at best and certainly not up to par with what many of us have through our various retirement plans.

What is most galling about TVH approach is their assurances when people signed up that they would not be dropped from the plan in the future. Well the future is here and for many, those are now very empty promises. They can choose to continue with a system and providers that has worked well for them and deal with more restrictions and fewer benefits under the UHC plan or uproot their medical care once again to find new providers and keep their existing coverage.

The Villages is often described as a "company town", similar to coal mining towns in the early part of the 20th century, where every decision was made for your by your employer. Here we are asked to rely upon the good will of the developer, but time and time again find that changes are made that affect our lifestyle, but we have absolutely no input into the decision making process.

It was not my personal experience to be "dropped" at all; rather I was offered a choice to look in to something which MAY have offered me better coverage, and I'm glad I got the info. Fortunately, it will work for me, but had I not gotten the facts, I, too, would be assuming a lot. I don't feel at all as if I was not made part of the decision-making process. Second rate? I guess it's good enough for who it's for! If it doesn't work, find another good doctor. Life is too short to stress over such.

Joejohnson 07-19-2016 11:53 AM

Quote:

Originally Posted by Rapscallion St Croix (Post 1256271)
Why do you have to leave? I also have Medicare and Tricare For Life, and my letter says I can stay.

I can for now!!! My wife is Tricare standard that will turn into for life in a few months. She has to change to UHC Advantage or leave even after she becomes Medicare and Tricare for life. Well even though we have been with them since they started in the villages, my wife is no longer welcome, so we will both find other options.

2BNTV 07-19-2016 12:10 PM

I believe one must be their own health advocate!!!

This includes choosing a plan that best suits their medical needs and judging what concerns they may have, going forward. Always difficult.

It is confusing to a lot of people and some will be upset as changes require, going to another provider, when they have felt comfortable, with their present provider.

One size, does not fit, all!!!

Change is upsetting for some people. IMHO

Joejohnson 07-19-2016 12:26 PM

I found this consumer site that may help some decide

Top 898 Complaints and Reviews about United Health Care

CritterLover 07-19-2016 01:42 PM

Quote:

Originally Posted by Joejohnson (Post 1256332)
I can for now!!! My wife is Tricare standard that will turn into for life in a few months. She has to change to UHC Advantage or leave even after she becomes Medicare and Tricare for life. Well even though we have been with them since they started in the villages, my wife is no longer welcome, so we will both find other options.

Not true. Get the facts about Tricare for life.

CritterLover 07-19-2016 01:51 PM

Still a lot of supposition going on. Make a call and do the work to get the correct information.

Joejohnson 07-19-2016 01:58 PM

Quote:

Originally Posted by CritterLover (Post 1256404)
Not true. Get the facts about Tricare for life.

I can for now!!! My wife is Tricare standard that will turn into for life in a few months. She has to change to UHC Advantage or leave even after she becomes Medicare and Tricare for life. Well even though we have been with them since they started in the villages, my wife is no longer welcome, so we will both find other options.

CritterLover 07-19-2016 02:06 PM

Quote:

Originally Posted by Joejohnson (Post 1256416)
I can for now!!! My wife is Tricare standard that will turn into for life in a few months. She has to change to UHC Advantage or leave even after she becomes Medicare and Tricare for life. Well even though we have been with them since they started in the villages, my wife is no longer welcome, so we will both find other options.

My letter clearly says with Tricare for Life, you DO NOT need to make any changes to remain a patient (but they encourage looking in to advantage.) What am I missing??

Carla B 07-19-2016 02:55 PM

Quote:

Originally Posted by CritterLover (Post 1256428)
My letter clearly says with Tricare for Life, you DO NOT need to make any changes to remain a patient (but they encourage looking in to advantage.) What am I missing??

Maybe the issue is her birth date?

Joejohnson 07-19-2016 03:09 PM

Quote:

Originally Posted by CritterLover (Post 1256428)
My letter clearly says with Tricare for Life, you DO NOT need to make any changes to remain a patient (but they encourage looking in to advantage.) What am I missing??

And I am saying my wife has Tricare Standard what don't you understand about that?

One more time, I can stay, but my wife is being kicked out.
I will not associate with a firm that will not accept my wife's insurance, Tricare.
Gggggeeeeezzzzzz!

Plus, I would never get involved with United health care when I already have a FAR SUPERIOR health insurance. That being Tricare for Life. I even called United Health Care. An agent there told me since I had Tricare, to not even consider UHC.

Joejohnson 07-19-2016 03:24 PM

Quote:

Originally Posted by Carla B (Post 1256485)
Maybe the issue is her birth date?

Yes, it does in a way. Village Health Care has made the call to not allow anyone that turns medicare eligible after 1 Jan 17 to stay unless they convert to UHC Advantage. My wife turns 65 in Aug 2017; hence she is out. She will b allowed to stay until she turns 65 in August 17, but then when she turns Medicare eligible, she is automatically Tricare for Life. As I keep trying to explain to knitter, she would have to give up her Tricare for Life and sign up for UHC. If we had an insurance with co-pays and other high costs, we would consider changing, but even then it would not be for a substandard company like United health care. UHC may be an improvement for many people, but there is no comparison between the benifits of United Health Care and Tricare for life. If she was 8 months older, we BOTH would have been grandfathered in and we would have stayed. The Villages Health is WONDERFUL but not with United Healthcare Advantage.

buckscounty 07-19-2016 03:28 PM

Not true , check into it, I love united

Jayhawk 07-19-2016 05:32 PM

Quote:

Originally Posted by Joejohnson (Post 1256355)
I found this consumer site that may help some decide

Top 898 Complaints and Reviews about United Health Care

Do companies pay you to recommend their products or services?

No. But companies pay us to become an Accredited Member (see below). We also receive compensation (sometimes from the company; sometimes from third party agencies), when we refer a consumer to a company’s site through a link on our site.

Consumer Affairs (the website referenced ) is neither a government agency nor non-profit.

You think this has something to do with the negative slant, since UHC has not paid the extortion fee to be an "accredited member"?

Bonnevie 07-19-2016 05:54 PM

look, The Villages Health is very nice. I liked my doctor and loved the convenience. I just don't want to give up my insurance I got as part of my retirement. For others, the advantage plan may work just great. Health insurance is an every changing nightmare. While I do think Villages Health kind of lured us in hoping we'd be so enamored we'd want to switch to the advantage plan, the bottom line is they can chose to take whatever insurance they want and they have chosen.

cavalier65 07-19-2016 06:21 PM

TVH made a financial business decision, not a customer service one. The real issue is not about providing better healthcare instead it is getting more revenue on the books faster. UHC won the bid based quicker payments to TVH and higher profits. So be it, but please do not lie to residents that running off many of us was about offering better service!

justjim 07-19-2016 06:34 PM

Information
 
Quote:

Originally Posted by CritterLover (Post 1256413)
Still a lot of supposition going on. Make a call and do the work to get the correct information.

I was under the impression that one of the main purposes of this site is to provide information. Just a thought....

Jayhawk 07-19-2016 06:44 PM

Quote:

Originally Posted by cavalier65 (Post 1256632)
TVH made a financial business decision, not a customer service one. The real issue is not about providing better healthcare instead it is getting more revenue on the books faster. UHC won the bid based quicker payments to TVH and higher profits. So be it, but please do not lie to residents that running off many of us was about offering better service!

Weren't you looking for an alternative to TVH last year? It seemed like you were looking to drop them back then.

https://www.talkofthevillages.com/fo...5/#post1130475


Are you sure it was a bid deal? I'd like to read more about that.

ColdNoMore 07-19-2016 06:54 PM

Quote:

Originally Posted by CritterLover (Post 1256413)
Still a lot of supposition going on. Make a call and do the work to get the correct information.

Quote:

Originally Posted by justjim (Post 1256639)
I was under the impression that one of the main purposes of this site is to provide information. Just a thought....

In all honesty, Critter has a point.

The entire health insurance issue is so complicated, has so many facets and there are so many variables, that what applies to one person/couple (even though their situations may seem mostly identical)...won't necessarily apply to the other.

But it is good to hear from both sides (those that are happy and those that aren't), instead of just the usual, primarily pro-developer voice.

Although I haven't been on the site that long, I don't recall so many people willing to speak up and criticize the developer (not to mention posters that have been members for a long time, but haven't posted much)...that are probably mostly pro-developer otherwise. :shrug:

That in itself is educational. :thumbup:

Jayhawk 07-19-2016 06:59 PM

Quote:

Originally Posted by ColdNoMore2 (Post 1256650)
Although I haven't been on the site that long, I don't recall so many people willing to speak up and criticize the developer (not to mention posters that have been members for a long time, but haven't posted much)...that are probably mostly pro-developer otherwise. :shrug:

That in itself is educational. :thumbup:


At least you've softened to calling people "pro-developer" instead of shill as you did in a prior post. I guess we know your position :D

spuds51 07-19-2016 07:00 PM

Quote:

Originally Posted by CritterLover (Post 1256413)
Still a lot of supposition going on. Make a call and do the work to get the correct information.

Just curious, if you don't mind..will you state who you called to get your info?

ColdNoMore 07-19-2016 07:07 PM

Quote:

Originally Posted by Jayhawk (Post 1256651)
At least you've softened to calling people "pro-developer" instead of shill as you did in a prior post. I guess we know your position :D

I only did/do that to those who obviously are. :D

Read my post above again, as I said that I believe some who are otherwise pro-developer (and don't post very much) have come out and actually criticized them on this issue.

Hard to be a 'shill,' if you're not constantly/frequently (like some) blowing their horn for them and always defending the developer...regardless of the issue.

:shrug:

CritterLover 07-20-2016 07:17 AM

Quote:

Originally Posted by spuds51 (Post 1256653)
Just curious, if you don't mind..will you state who you called to get your info?

Certainly~ I spoke with the "Patient Services Rep" at my doctor's office. I was told that every office has one, and mine really knew her stuff. PLEASE, as I stated before, MAKE A CALL!

CritterLover 07-20-2016 07:20 AM

Quote:

Originally Posted by justjim (Post 1256639)
I was under the impression that one of the main purposes of this site is to provide information. Just a thought....

YEP! This member's "information" is to urge everyone simply to get the info straight from sources providing FACTS, and not to rely on all the MISinformation flying around.

It's simple, do the work to be your own advocate and do not depend on rumors. Just saying.

Grannygail 07-20-2016 07:41 AM

I would like to hear from UHC Advantage users that have had extensive medical conditions and how the plan worked for them. I keep hearing it works great for healthy people, what happens when you get really sick? I think that will be the key to deciding if a plan is a good purchase.

NotGolfer 07-20-2016 08:50 AM

My spouse had a life-threatening event last year. Spent time in 3 hospitals ALL using TVHC. We were quite pleased with the care and the benefits. I have many health issues and also use TVHC. To date, I have NO complaints on coverage or care. I love my primary! I don't think this whole issue is an issue that reflects on to the developer.

graciegirl 07-20-2016 08:53 AM

Quote:

Originally Posted by ColdNoMore2 (Post 1256657)
I only did/do that to those who obviously are. :D

Read my post above again, as I said that I believe some who are otherwise pro-developer (and don't post very much) have come out and actually criticized them on this issue.

Hard to be a 'shill,' if you're not constantly/frequently (like some) blowing their horn for them and always defending the developer...regardless of the issue.

:shrug:

Gosh. Who wouldn't? This is an amazing place and run exceedingly well. Show me something better.

spuds51 07-20-2016 09:11 AM

This is a 22 min. video all about Medicare Advantage plans. This is by an independent broker that sells Advantage Plans as well as supplements for original Medicare. This is very informative and explains the pros and cons of the two.


[URL="https://medigapseminars.org/medicare-advantage-plans/"

You have to copy and paste the link. I couldn't get it to post the link for some reason

outlaw 07-20-2016 09:22 AM

Quote:

Originally Posted by CritterLover (Post 1256226)
Please be responsible and proactive and get the facts from United Healthcare instead of jumping on the bandwagon of all the misinformation and TVH-bashing that's running rampant. For as many nasty posts exist here, even more are from happy patients, like me, who have converted to advantage. YOU have to be your own advocate and do the work to get factual information. If your undies are in a bunch, you just MAY be totally misinformed.

That's funny.

outlaw 07-20-2016 09:30 AM

There have been articles regarding TVH/UHC cancer specialist deficiencie/issues. You can find these articles if you search.

Carla B 07-20-2016 10:11 AM

Quote:

Originally Posted by Joejohnson (Post 1256519)
Yes, it does in a way. Village Health Care has made the call to not allow anyone that turns medicare eligible after 1 Jan 17 to stay unless they convert to UHC Advantage. My wife turns 65 in Aug 2017; hence she is out. She will b allowed to stay until she turns 65 in August 17, but then when she turns Medicare eligible, she is automatically Tricare for Life. As I keep trying to explain to knitter, she would have to give up her Tricare for Life and sign up for UHC. If we had an insurance with co-pays and other high costs, we would consider changing, but even then it would not be for a substandard company like United health care. UHC may be an improvement for many people, but there is no comparison between the benifits of United Health Care and Tricare for life. If she was 8 months older, we BOTH would have been grandfathered in and we would have stayed. The Villages Health is WONDERFUL but not with United Healthcare Advantage.

So you are saying people who are presently on Tricare for Life are okay to stay with VHS. But anyone after Jan 1 who goes on Tricare for Life when they turn 65 will be dropped. If so, that seems illogical, unless they are just waiting for the present Tricare people to die off or move on. If Tricare is accepted now, why wouldn't it be in one year? If I were in your position, I think I'd just sit tight and see what happens until just before August, 2017. Maybe they'll change their minds yet again.

CritterLover 07-20-2016 12:40 PM

Quote:

Originally Posted by outlaw (Post 1256859)
That's funny.

What, exactly, is funny?? The part about expecting grown, rational, supposedly educated adults to get facts before flying off the handle?

spuds51 07-20-2016 01:58 PM

Quote:

Originally Posted by CritterLover (Post 1256767)
Certainly~ I spoke with the "Patient Services Rep" at my doctor's office. I was told that every office has one, and mine really knew her stuff. PLEASE, as I stated before, MAKE A CALL!

Oh I have made several calls. It sounds like you have made up your mind and I am not trying to change it. Like someone else said it's best not to take any advise too seriously you see on an message board. The thing is your doctors office has an agenda, don't ya think? I'm sure what they told you was true but did they tell you everything. I'm going to give you a number to call, you can call if you want or disregard.

Matthew Claassen ph# 1-800-847-9680 ext-2. He is an independent nation wide insurance agent. He sells all Medicare plans (including Advantage plans..which he gets the most for selling you). Tell him your situation and that you are considering an Advantage plan and see what he has to say. It won't cost a dime and you will never find a more knowledgeable person anywhere when it comes to Medicare. He has been at it for decades and his wife works in Medicare billing. As you said they know their stuff. Either way good luck to ya.

CritterLover 07-20-2016 02:09 PM

Quote:

Originally Posted by spuds51 (Post 1257040)
Oh I have made several calls. It sounds like you have made up your mind and I am not trying to change it. Like someone else said it's best not to take any advise too seriously you see on an message board. The thing is your doctors office has an agenda, don't ya think? I'm sure what they told you was true but did they tell you everything. I'm going to give you a number to call, you can call if you want or disregard.

Matthew Claassen ph# 1-800-847-9680 ext-2. He is an independent nation wide insurance agent. He sells all Medicare plans (including Advantage plans..which he gets the most for selling you). Tell him your situation and that you are considering an Advantage plan and see what he has to say. It won't cost a dime and you will never find a more knowledgeable person anywhere when it comes to Medicare. He has been at it for decades and his wife works in Medicare billing. As you said they know their stuff. Either way good luck to ya.

As I've stated in numerous other posts, my personal research went far beyond the rep in my care center. Yes, I'm switching, after finding that it would be dumb for me not to. Different strokes for different folks. It's what makes the world go 'round!

Mikeod 07-20-2016 04:05 PM

Quote:

Originally Posted by Joejohnson (Post 1256519)
Yes, it does in a way. Village Health Care has made the call to not allow anyone that turns medicare eligible after 1 Jan 17 to stay unless they convert to UHC Advantage. My wife turns 65 in Aug 2017; hence she is out. She will b allowed to stay until she turns 65 in August 17, but then when she turns Medicare eligible, she is automatically Tricare for Life. As I keep trying to explain to knitter, she would have to give up her Tricare for Life and sign up for UHC. If we had an insurance with co-pays and other high costs, we would consider changing, but even then it would not be for a substandard company like United health care. UHC may be an improvement for many people, but there is no comparison between the benifits of United Health Care and Tricare for life. If she was 8 months older, we BOTH would have been grandfathered in and we would have stayed. The Villages Health is WONDERFUL but not with United Healthcare Advantage.

Have you spoken to a Tricare rep? We investigated our options as we expected to have to choose between staying with Tricare for Life or UHC. I spoke to a rep for TFL and was told clearly that going to UHC only affected Medicare and the TFL drug plan. Essentially, TFL was separate from my Medicare coverage and unaffected by choosing an advantage plan (except for the drug coverage). If I left UHC and let TFL know, they would restart my drug plan. I was going to find out if I went with UHC, would TFL cover my co-pays. But before that happened, I found out I could stay with Medicare/TFL, at least for 2017. We'll see what happens after that.

PTennismom0202 07-20-2016 05:52 PM

I started with TVH when I was 63. I have Tricare . They told me I was grandfathered in forever. One month before my 65th birthday I got a call telling me I'd have to change to United HC Medicare Advantage "a la The Villages" or find a new PCP. Oops, they changed their grandfathering policy. My Tricare for Life is better than United HC Advantage so I changed, but I was mad. So yes, they can force Tricare beneficiaries out.

If Tricare for Life beneficiaries opt into United HC Medicare Advantage HMO, the TFL drug benefit is off, and the United HC drug benefit is on.


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