Villages Health changing to Florida Blue?
 

Anyone else hear about this? I wonder how it will affect our coverage, premiums and out of pocket costs?

Not changing, but ADDING a Florida Blue Medicare Advantage plan.

It was in the Daily Sun on July 26, 2019 and is already being discussed here: https://www.talkofthevillages.com/fo...highlight=blue

They have changed management. Understand they will be selling to Optum effective 1/1/20. Hearing they will begin accepting original Medicare at that time. I won’t go back after being “grandfathered in”. And they told “things change”. What has changed is that they had been running negative cash and losing money since kicking us out.

What makes you say that they are "running negative cash"? What does that mean? They can't pay their bills? They are underfunded?

I think those who had to leave were those who didn't have the insurance company they used.

Exactly Graciegirl! Also to be clear...it was UnitedHealth who dictated the changes back in the day, NOT TVHC.

Are you naive enough to believe that the TVHC and UHC did not work in consortium to limit the patients to ONLY UHC?? This is a case of one hand washing the other in pursuit of maximum profitability!! I am not saying this is wrong, just putting the cards in place.:)

Can you explain how that works??? The Villages Health care (TVHC) is the local group of medical centers owned by The Villages and only in The Villages and United Health Care( UHC) is a very large National Insurance company.


Plus being in pursuit of maximum profitability is not necessarily a bad thing in and of itself.

United Healthcare Health Insurance Company Review

Healthcare Providers - The Villages Health


Insurance Plans for Primary Care The Villages Health

There is a thing called reinsurance where an insurance company assumes part of the risk and the employer (this case TVHC) assumes another part. These are custom built policies built between the two parties. I vaguely remember that TVHC was using this model with United thus one reason why only one provider allowed. Anyone else know better ?

Perhaps this is a Trend for Village Health. It would be nice if they accepted more companies IMHO.

I think it isn't that the Villages aren't accepting new insurance companies, but that new insurance companies may not want to be part of this system.

The Villages Healthcare signed a capitated agreement with UHC in which they would be the exclusive providers for the Medicare Advantage plan in our area and Villages Health would not accept other carriers.

It's apparent that the arrangement has not worked well (probably for both parties) thus it is being changed. Agreements such as these have been around since the 70s.

Just wondering...how is it so apparent?

They are desperately advertising for patients. The switch from exclusivity is a sign of a troubled marriage.

Desperately?? I go to the Santa Barbara Clinic and the parking lot was full, as was much of the waiting room yesterday. People standing waiting to check in. This time of year, I think it's common that health-care advertises....OR....in thinking of the ads on t.v. The entities in Orlando are always advertising. I don't think they're desperate there neither. I don't understand why people think there's a vast conspiracy going on here.

Vast conspiracy? This is a normal occurrence in healthcare.

The Villages Health Care System is very, very, good. Very well run and well staffed.

We wanted to join when we moved full time but our company insurance wasn't UHC. Since then the company insurance switched to UHC and we switched to The Villages Healthcare. We really liked our past doctor but his staff were making errors with inputting accurately.

I cannot say how good all supportive staff are at Creekside. They KNOW what they are doing and have background in it.

What you really mean is the you selected UHC Medicare Advantage. Those of Medicare age, with some Tri-Care exceptions, aren’t using VHC unless they were willing to go to Medicare Advantage.

Our company insurance switched from Aetna to United Health Care which also included Medicare Advantage..

Are you happy?
 

Gracie, are you happy with the Advantage plan? We are UHC supplement to our original Medicare and not sure whether we should change.

I believe TVH was losing money because they offered a "Marcus Welby" approach (30 - 60 min. physicals, etc). Traditional Medicare doesn't reimburse enough to sustain that type of model. That is why they only accept UHC Advantage.
I think the contract between UHC and TVH was up so they "opened it up" to other insurance companies. That is why FL Blue is an option next year. Competition is a good thing.
If TVH starts to accept Traditional Medicare you'll see shorter appt. times, etc. It will be like every other physician's office. And they will be expected to make a profit.

The company from which my wife retired used UHC as their retiree health benefit. It was a PPO plan. This year the company decided to change to Aetna. As I remember, when the Company changed to UHC they dropped Aetna. A bit cynical maybe, but it isn't about the patient anymore, about the relationship and profitability. She just spent a couple weeks comparing UHC and Florida Blue HMO plans and decided on staying with UHC/

We were told our insurance was accepted and then about a year later show up for a visit at the desk and told now it is not accepted leaving us adrift. It leaves a bad taste. I don’t care who runs it, it’s called Villages Healthcare and so many of us were booted out.

Does anyone know the difference in coverages between United Health the Villages and Florida Blue? Also are there any advantage plans available in the Villages that don't require a supplement to be fully covered????

Signed confused

All Advantage plans are required to cover everything that Original Medicare does so the basic coverage is the same. Both plans cover 100% of costs for the things that Original Medicare only provides 80% coverage.

What kind of supplemental coverage are you looking for, normally supplemental plans are for Original Medicare, not Advantage plans?

Each plan has a different network of providers, and hospitals, and different "extras", and different co-pays and out of pocket limits.

Both plans include Villages Health in their networks. But, for example, I think that Florida Blue includes Moffit in their network but UHC does not. But there are lots of other detail differences in their networks too.

For most it probably comes down to are you willing to be limited to the provider network of one of these Advantage plans or not (even though both plans in some cases will let you go out of network). If not stick with Original Medicare plus a supplement. However no plan, not even Original Medicare guarantees that you can go to any doctor or hospital.

Unfortunately, there isn't a simple way to compare these two plans.

Have you gone to Shine, SHINE - Home ? What they do is try to help seniors understand the health insurance options that they have.

Desperately? Is Amazon "desperately" advertising for customers because they are running commercials? GEICO? (They have a plethora of commercials... they must be desperate).
Maybe they're just advertising their product.
Troubled marriage? My understanding is that the UHC contract was up... so they opened it up to give their "customers" more options. Now TVH customers have a choice of two different healthcare providers. That' doesn't sound desperate to me.
I've talked to TVH and asked these questions... which is where I get my information. Hopefully, people who are posting aren't just "assuming" or guessing or... just bitter because their insurance is no longer accepted.

I'd be curious to know how you "understand" TVH is selling to Optum? And that once that happens they will accept traditional medicare. People are making important decisions on their healthcare right now. So I'd like to know why you think this is happening.

Social media, at times is a great place for information BUT with something like your insurance coverages---wouldn't it be best to contact their office and ask so you get ALL the information you're needing? That way you'll get what's correct and not just hear-say or rumor.

VHC is not lacking in patients. If you are refering to the recent ads in the air, I am thinking that is Florida Blue looking for customers rather than TVH. I see nothing to indicate that TVH is in any kind of trouble.

Based on trips my wife and I make to VHC they are looking for help, not patients. They are always busy.

As far as advertising goes, in the words of an adman: "You can run your business without advertising just like you can run a car without gasoline... as long as both are going downhill."

Blue Cross includes Shands Hospital and Moffitt Cancer. UHC does not.

We just went to the UHC office today...nothing has changed. We didn't ask about Florida Blue as we're satisfied with what our coverage is. The rep told us of several plans that UHC covers but we didn't ask if all of those refer to TVUHC plan...probably not would be my thought. I would suggest before speculating to go in and ask the folks who really can help you. We won't be changing our coverages that we started back in 2012.