Greeting
 

Happy Easter.............

You may want to post your concerns in the "Medical and Health Discussions" forum.

https://www.talkofthevillages.com/fo...discussion-94/

thanks

This is a very important and relevant topic. Inferior medical care is the number one reason we are reluctant to become full timers. It’s a difficult situation to resolve, a large population of senior citizens predominately on Medicare is a health care nightmare. The population requires a significantly higher amount of health care than the general population. Additionally, the low Medicare reimbursement rates make quality health care providers reluctant to work in a market serving that demographic. It’s not a good situation with a simple solution.

What are you basing your “ sub standard” hospital rating on?

Not much that can be done about the Medicare situation, unfortunately. Medicare D is the same quagmire that it has been since it's (ill-advised) inception and Medigap policies to help cover what Medicare doesn't, aren't free--or even in many cases, reasonable. The only consolation, if you can call it that, is that that particular situation is the case, more or less, no matter where you live. But when it is concentrated, such as it is here in TV, the problem is much more apparent, if only because it affects a large majority of the population here.

I've never been in the hospital here and hopefully never will be, so I can't say that the observation that the hospital here is sub-standard. Suffice it to say that I've heard the precise same thing from a lot of people here. But, again, The Villages isn't alone in that particular boat. Back in Minnesota hospitals are far from full, but in many cases cannot provide the care that is needed because of a chronic nursing shortage. Same thing in Nevada: my sister living there was recently hospitalized and her bed was in the hall, even though there were unoccupied rooms. Made it easier for the caregivers to monitor the patients, and of course unoccupied rooms don't have to be cleaned on a daily basis. Seems like a throwback to maybe 1880.

Our health care system in my opinion has declined overall.

We are here two years and so far so good with medical care.

Only concern we have our specialists based on a group practice and so far two have left the area and hope replacements are as good.

I am not retired and have a policy through a state instution. The policy is Florida Blue.

When I mention it to the different medical offices around the Villages, they act like they haven't heard the words before. I'm thinking Florida, check, the name of the state and Blue, check, color of the sky and basic color in spectrum. Put those two together and get blank stares.

I've checked around and Florida Blue is no small insurance program. It is a Blue Cross and Blue Shield varient for Florida.

Anyway, I've found that the local area mostly wants to deal with Medicare and the various backing plans, and not the standard fair that working adults would be provided by an employer. It kind of makes sense, but there are more than retirees in the area.

I did find a Villages Health doctor who was taking my insurance and saw her at Lake Deaton Villages Health. She was fine. I think I can now see more members of that local practice now that I am a patient.

This is totally different than the mid-atlantic experience with doctors, dentists, and specialists.

The medical experience here has been an adjustment for my parents, spouse, and myself.

Leesburg and Spanish spring hospital ratings are very poor look online, Leesburg best on heart issues after that less than 3 out of 5, I had kidney stone attack and was taken to spanish springs, it took 3 hours to get medication and checked out, way too painful, truly a shame for this area full of people with issues

Your policy is not Florida Blue. That is the name of the insurance company that issues your policy. It's Florida's branch of Anthem/Blue Cross-Blue Shield. That's the company name. My plan is Blue Select 1443. Insured by Florida Blue.

Everyone medical practitioner in Florida has heard of Florida Blue. But it doesn't mean a thing if you don't know what your policy is. Florida Blue offers HMOs, PPOs, some other thing, Dental plans, and a variety of each. Most doctors in the Villages area are participating providers to one extent or the other, though it really depends on the plan you have.

Also - The Villages Health is the actual provider for MOST Florida Blue plans, not the individual doctors. If you were to do a provider search on the FL Blue website and plug in The Villages Health it should show up.

Only three hours, consider yourself lucky. When I had to go there I was close to my death bed, waited 12 hours, was misdiagnosed and sent home to die. Fortunately, my wife brought me to a real hospital in Gainesville, where I was admitted to the ICU within a half an hour and properly cared for. There isn’t a grade low enough that I could give to the Villages hospital in Spanish Springs.

We have not restricted our providers to those in TV.
Between Ocala Orlando and the surrounding areas there are outstanding specialists.

20 years on medicare with no problems ever getting specialists or facilities we have needed.....whoever or wherever they may be!

I was aware of the difference between a brand and a model.

I have been rejected by saying Florida Blue, long before I was asked to read off my member ID and Group Number on the card. To be absolutely fair, I have been told by most that they will see me if I pay out of pocket and I can work with my insurer for any reimbursement. Having lived in the Mid-Atlantic states most of my life, if you have good insurance, you would never agree to this -- you would just find another practice -- most of which would take your insurance and write-off the difference.

I just looked up your plan. Did you buy this on the market? While it gives good coverage, the co-pays and other fees seem quite onerous.

For the last 20 years I have worked for state and county governments across multiple states that provided several tiers of insurance as a benefit of employment. I always go for the one that is neither free, nor the pricey option -- the one in the middle usually offered the best price and risk for the dollar spent.

Up north, most practices participate in most insurances. This has not been my experience here.

The Villages Regional Hospital is rated, using various statistics collected by Medicare, and compared to all other hospitals in the state. It has consistently been rated in the lowest quality class. If you’ve ever had the need to be treated there, particularly in the Emergency Room, you will have no reason to disagree with those ratings.

I had to visit their ER last week for the simple infusion of a couple of units of blood components. After checking in the ER, I waited 2 hours for the required “cross and match “ blood test. Then I was directed to sit in the waiting room until called. I sat there another 7 hours until finally called for the simple 30-minute procedure. The halls inside the ER were lined with patients on gurneys or beds awaiting admission to the hospital. After completion of the procedure I asked the nurse whether she had used the proper number of units ordered by my doctor. No, they had gotten that wrong during admission. Then after finally getting the proper amount of blood—at 3 AM—I had to wait another 1-1/2 hours for a doctor to sign my discharge paperwork. It turned out that there was no doctor on duty, he didn’t start his shift until close to 5 AM.

NEVER AGAIN WILL I USE THE VILLAGES REGIONAL HOSPITAL! When I related my experience to my doctor, he shook his head saying that he had hoped that the University of Florida’s ownership would have made a difference, but it has not. Later I had a conversation with a senior rep of a healthcare company doing business with TVRH. He said, “It’s simply a bad hospital. It’s understaffed and badly mismanaged and continues to make the same life-threatening mistakes that should have been corrected years ago. I also questioned a friend who had been a nursing supervisor at TVRH. Her reply? “Don’t go there. It’s a bad hospital—that’s why I quit.”

There are better hospital choices in Ocala. Even Leesburg Hospital, with the same U of FL ownership is better. BEWARE OF TVRH!

Agree! I made the mistake of switching from a United Healthcare Medicare Advantage plan to one offered by Florida Blue. My first three months experience with them were awful! No point in going into detail. What most people don’t know is that you can switch plans during the January to March time period each year, not just the heavily-advertised November-December enrollment period. The insurance reps refer to that period as “do over” time. I switched back to United Healthcare and am back to the type of service I had become accustomed to. I have no idea why I switched to Florida Blue, but it was a terrible mistake!

Their performance in the ER…….is worse then just okay

Hospitals all over the country are struggling....due to staff shortages, thanks to Covid. What folks here don't understand is we're living in a mostly rural area that is struggling to catch up due to the rapid growth in the area and not just The Villages. It's NOT a metro area but folks moving here expect it to be or at least just like they were used to back ___________(fill in the blank). I have stories I could share here from my friends and family up north---all are similar to the ones here and they live in large cities.

We've had to experience BOTH hospitals here---granted the ER's need some help (a lot of help) but the care, once on the floor has been great. My other half "got to" experience Shands this winter and from our perspective the care wasn't stellar. Our feeling was---if it's so great, how did he slip between the cracks?? He came home with a wound that was festering (the dressing had been changed only once) and NO antibiotics. Thank God for Home-Health-Care workers!!!

People who are seasonal who say they won't become full-time---I can somewhat see their point but what IF you get sick here and you don't have a primary??? When we first came as seasonal, my pcp back home told me to get established here with someone so my health could be monitored. IF you say you're healthy and rarely see a doctor that can change very quickly. Just some things to think about.

When we arrived in Florida about seven hears ago we were shocked and outraged by the local medical care and billing practices. It seemed to us the providers were preying in the older population. We now go to U of F in Gainesville for all our "serious" medical care, and have been very satisfied. We are hoping over time the University will staff the Villages facilities and oversee care and services the same way they do in Gainesville. Just hope it happens sooner than later.

I switched from United Healthcare to Florida Blue and found it to be equally as good as United Healthcare with far LOWER copays on every specialist etc…I only switched because Florida Blue includes Moffitt in their coverage and United Health does not and because of the lower copays. Am very satisfied and happy I did!

The health care system in this country is very broken.

The ACA made healthcare unaffordable for me.

If you are a single 64 year old in Florida and don't qualify for a subsidy (or a group plan) , the cheapest ACA plan available is through Ambetter and has $710/mo premiums with a deductible of $8600.

A Florida Blue HMO plan with an $8700 deductible is $786/mo.

A Florida Blue plan EPO is $833/mo.

There are only those two companies available to pick from.

A few preventive services are available at no cost such as colonoscopy and mammogram. Other health care costs, including prescription medications, must be paid for by the insured until the astronomical deductible of $8600 is met.

Prescription drugs can be extremely expensive and one can sometimes take an inferior generic for a lower cost and still wind up paying hundreds of dollars for one of these.

I'm on a Florida Blue plan and my agent says there is no in network hospital nearby. I look on the "find a doctor" and for many specialist there are none even within an hour drive.

So I pay the astronomical premiums and wind up often going to a doctor that is not in network because I have to pay anyway.

It infuriates me.

I'm hoping when I get to Medicare it will be better, but you have to pay for supplemental plans and pay more based on your income. SMH ������

I am sorry to hear that.

Since my wife and I kept the insurance we had while we were working, we were not affected by the ACA, but I have always wondered how it affected other people.

I did NOT support Obama and Pelosi, but I always suspected, and hoped, that they are good people who did what they thought was best for the American people. Whenever I would ask people about how the ACA affected them, they would usually start talking about how wonderful or horrible Obama was, but would not give a straight answer to my question.

That is why I appreciate your straightforward comments.

Hesitations…
 

Hesitations… I am very close to retirement and would very much like to come to the villages. However as an RN, this is one of my biggest reservations. I am presently in Dallas Texas and the medical care here absolutely cannot be beat. I have a friend who is from Florida, she is also an RN and she did highly recommend the university at Gainesville.I was considering coming back to Texas once or twice a year for medical care but I don’t know how long that my finances could support something like that

ACA age discrimination
 

I believe premiums prior to the ACA took into account preexisting conditions, smoker, gender, and perhaps other things. So the ACA was great in getting rid of a lot of that (one positive outcome - could have just passed that one law IMHO). Why is it that premiums are based on your age? Doesn't seem fair to me to leave just that one discriminatory aspect.

Also plans and premiums are dependent on the state you live in - we could not even get COBRA when we moved out of state because the plan was state based. And our child less than 26 years old could not be covered on our plan because it was not a "stay on your plan situation." It took healthcare.gov weeks to figure that one out. So that messes up family deductible.

Sure, some benefitted from the ACA, but the money has to come from somewhere, and I know where some of it comes from - people like me.

I wish I could purchase a catastrophic plan and pay the first $100k of my own medical expenses or whatever risk I want to pay for. Would make things easier for many. But the government does not allow that.

One year anniversary in the villages. Just had surgery for my first significant medical issue. Went to Advent in Ocala and couldn’t be more pleased with my care. I’m on traditional Medicare with supplement. Have heard the horror stories from others about care in the Villages and hope UF can turn it around. I’m a retired health care professional and throughly investigated my options prior to selecting my providers.

Yup, Obamacare absolutely sucks for those who don’t qualify for subsidies, because a surcharge is cooked into your premiums to pay for the subsidies and free insurance that others get. I retired young and was able to buy very affordable low deductible private insurance before Obamacare. After the so called Affordable Care Act kicked in, my insurance was no longer very affordable. Premiums tripled for insurance with substantially higher deductibles and max out of pocket. I don’t look forward to getting any older, except that I can’t wait for when we shortly will become eligible for Medicare.

You had very good instincts.

Forwarned is forearmed
 

If you understand that the best medical care/hospital here is either in Ocala or Gainesville or Orlando you will be fine. Adjust your doctors accordingly. Most of the healthcare in the villages do not accept medicare, imagine that. ER's do accept medicare, and are good for short term fix, but after that, you are on your own. As long as you know that you will be fine. Weakest link here is hospital care, hopefully it will change. Otherwise place is great..........

I retired this past September following a 44 year R.N. career with the 1st 23 of those years working mostly ER and the last 21 years worked as a primary care R.N. case manager at the VA Hospital in R.I. I met my PCP when she was the chief medical resident at the VA which is affiliated with Brown University and was one of her 1st patients when she went into private practice. And I met my GI and eye doctor the same way when they came through the VA as residents. The several other specialists that I see occasionally were referred by doctor colleagues I worked with that I trusted, so leaving this network of clinicians who have provided me excellent care for many years was not an easy decision to make. But I will admit having had to be an outspoken healthcare advocate for my now late parents who also lived in and received their healthcare in R.I. on several occasions, and additionally myself having had a bad experience following surgery I had 18 years ago in a state magnet status hospital where I was close to signing out AMA, substandard to very poor care can happen anywhere including the most prestigious healthcare institutions. That being said, my husband who is a disabled Vet and receives most of his care from the VA and I after weighing all the pros and cons decided relocating to TV will improve our overall health as it will provide us greater opportunities to be active and socially engaged more of the year due to climate than remaining in R.I. Since I kept my standard option Federal BC/BS coverage when I retired and enrolled in Medicare A & B when I turned 65 in February and my BC/BS now acts as my Medicare supplement, with this coverage I am not eligible for primary care through The Villages healthcare system. Fortunately I have a former retired R.N. colleague who relocated to Leesburg a number of years ago so I will tap her for some advise regarding getting a PCP and other specialists when we relocate to TV which will be at the end of this month. And if need be I will travel to Ocala or Gainesville for routine healthcare services, and if I land in a TV hospital I will hope for the best as I would in any other hospital.

Mine is another vote for Advent in Ocala.
5 star!

And that’s being kind and very overly generous in your review.

What a mess- inexcusable. Thanks for sharing. Sorry you had to go through it, and glad it wasn't worse.

TV Hospital NEEDS FIXING!! They have plenty of revenue! No excuses!

Medical Issue
 

All the talk in the world isn't going to fix the issues.
How to start a citizen group to organize change would be better than just posting words that medical needs fixed.
Or are such committees a big waste of time and frustration for the volunteers?
Has a new Medicare rating number come out for The Villages Hospital since UF take over?
Villager's have waited long enough for these big promised changes to take place at the local hospital as stated in the Villages Sun newspaper.
A new 60 bed hospital is to be built at Trailwinds in Wildwood this year, hoping it gets started soon.

My opinion is that the Villages Sun newspaper needs to take responsibility in presenting the honest medical issue facts, especially about the local hospital issue as presented in this blog/discussion and M.D. quality and overload situation. Probably never going to happen.

Do you notice all the construction in the south part but nothing about the emphasis on medical facilities, a school yes, medical clinics/hospital no. Responsible development for a senior community?

Would be a great opportunity for the Village Sun to take a leadership role in improving conditions at the hospital but apparently that is not what the developers wants the papers role to be.

Surely you jest :super:. The Sun is the mouthpiece of the Developer.

In my opinion .... yes, I am entitled to one :icon_wink::icon_wink:. TV is a great place to retire for as long as you are healthy and active, but when the years creep up on you and you can no longer get around like you used to, or when your body starts to decline, then this is not the place for you.

It would be nice but didnt exactly say I would expect that to ever happen. Would think that it would be in the developers advantage to improve hospitals around here.

Why? He is selling homes as fast as they go up, and I believe he no longer "owns" the hospital. That is now part of Shands.

The Developer is a GREAT businessman, he found his golden goose and as long as people want his product he does not have to be bothered with the minor details such as hospitals.

HCA Florida Ocala Hospital office on 466A - This is NOT an Urgent Care Center
 

I'd like to help others avoid the issues (mostly costs) that I had.

If you're thinking this new facility is for Urgent Care - think again. It is a true Emergency Room and it will cost you MUCH MUCH MUCH (did I say MUCH?) MORE than an Urgent Care center. If you are having life threating injuries and it's the closest place - sure, go there. The facility was very nice, the people were friendly and seemed to know their business - but the costs - I can only say, it's one of the contributing reason our insurance rates are so high. Read on if you'd like to see the details and what Florida Blue had to say.

I recently cut open the tip of my pointer finger and had some difficulty getting the bleeding to stop after about 20 minutes, so I thought maybe I better go somewhere in case I needed stitches, or whatever. Had seen the new HCA Florida Ocala Hospital building near Lowes on 466A - so off I went. As it turns out, all the doctor did was "super glue" the cut, no stitches or butterflies - in/out in under an hour with most time doing administrative things. Now I'm getting the bills! In rough numbers, they billed Florida Blue $5400 for the use of the "facility". Luckily Florida Blue had a pre-negotiated rate of $2200 - which basically I had to pay $1400 of because I hadn't yet reached my deductible. Then I received the doctors bill for another $2800 which insurance covered $2700 of. What was very interesting is that my cut was billed as a Level 5 Service (1 being the most minor and 5 being worst). If my cut finger (only needing super glue is a Level 5, what the heck is level 1 - "thinking about getting hurt next week"?). I have challenged the Level 5 rating and am awaiting HCAs response. I fully realize that it won't make any difference for the $100 I had pay in this case (luckily the first bill took me to my deductible limit), but because it's the right thing to do and one of the reasons I'm sure our insurance rates are so high!

I called Florida Blue to let them know that I think that they and I were being scammed (insert your own descriptor here) for $5000 (or $8200 if the facility usage hadn't been pre-negotiated). The agent was appreciative and understood that I was trying to save them money, but said that it's all up to how the doctor classifies the injury and so they simply accept the categorization. He then informed me that the next time I have a medical injury like this, DO NOT go to an Emergency Facility, but rather find a place that is listed as an Urgent Care Facility. This will result in much less costs - lesson learned (plus I hope to not cut my finger again).

Another problem is that, if you had Medicare and a supplement plan, you would have paid nothing at all. So, a facility like that can locate near The Villages where a lot of people are on Medicare. Those patients can show up and the facility can rip off the taxpayers all they want. The facility, the patients, and the Government don't care. What a system!

We'll be there full time starting early next year. This is a huge concern. I guess we will need to drive a bit for medical care..