Talk of The Villages Florida

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-   -   Villages Healthcare eligibility (https://www.talkofthevillages.com/forums/medical-health-discussion-94/villages-healthcare-eligibility-91101/)

Bob45 10-10-2013 01:17 PM

Villages Healthcare eligibility
 
Just talked to the Villages healthcare folks about joining their program. They told me they will only accept United Healthcare Advantage plans. I have Aetna Advantage and my wife has Humana Advantage plan. Therefore we can't join. I was excited when I first heard of the program, just to be let down. I am wondering how many others are in the same situation.

Bob

Avista 10-10-2013 02:27 PM

Quote:

Originally Posted by Bob45 (Post 760887)
Just talked to the Villages healthcare folks about joining their program. They told me they will only accept United Healthcare Advantage plans. I have Aetna Advantage and my wife has Humana Advantage plan. Therefore we can't join. I was excited when I first heard of the program, just to be let down. I am wondering how many others are in the same situation.

Bob

Can't you change after Jan 1 2014? There is no premium for the new Villages Plan.

gomoho 10-10-2013 05:01 PM

If you wish to change your medicare plan it must be done between Oct 15 and Dec 7 and will effective Jan 1. The information they gave you is correct - if you wish to stay on a medicare advantage plan it has to be the United Health one to be accepted at The Villages health.

NotGolfer 10-10-2013 09:44 PM

Quote:

Originally Posted by gomoho (Post 761001)
If you wish to change your medicare plan it must be done between Oct 15 and Dec 7 and will effective Jan 1. The information they gave you is correct - if you wish to stay on a medicare advantage plan it has to be the United Health one to be accepted at The Villages health.

Just as gomoho says! They will accept some other plans that aren't an advantage plan but you'll have to do your homework via an independent insurance agent.

tommy steam 10-10-2013 10:39 PM

I have a really great plan , a bluecross blueshield PPO Medicare advantage plan. The villages new healthcare system won't accept it.

gomoho 10-11-2013 06:12 AM

Quote:

Originally Posted by tommy steam (Post 761123)
I have a really great plan , a bluecross blueshield PPO Medicare advantage plan. The villages new healthcare system won't accept it.

That is correct.

billethkid 10-11-2013 11:32 AM

Quote:

Originally Posted by Bob45 (Post 760887)
Just talked to the Villages healthcare folks about joining their program. They told me they will only accept United Healthcare Advantage plans. I have Aetna Advantage and my wife has Humana Advantage plan. Therefore we can't join. I was excited when I first heard of the program, just to be let down. I am wondering how many others are in the same situation.

Does the above imply that they do not accept regular medicare and a supplemental?

btk

bimmertl 10-11-2013 11:42 AM

Quote:

Originally Posted by billethkid (Post 761309)
Does the above imply that they do not accept regular medicare and a supplemental?

btk

From their site.

Accepted Insurance by The Villages Health

ilovetv 10-11-2013 12:05 PM

Reason to keep our eyes wide open with respect to United Healthcare's alliance with TVHealth:
NEW HAVEN, Conn. (WTNH)-- In the midst of major changes in health care, UnitedHealthCare has sent thousands of pink slips to Connecticut doctors.

Termination letters went to physicians caring for Medicare patients. Those letters were sent out to doctors caring for 'Medicare Advantage' patients. It's a plan, marketed to Seniors to provide additional services through UnitedHealthCare.

A mix of primary care and specialty doctors are affected by it. And it comes at a questionable time.

Open enrollment for Medicare starts next Tuesday, and it's still not clear at this time as to which doctors are still in the United network.

The Connecticut State Medical Society is fighting back. The biggest concern is patient access to healthcare.

"What the government is looking for is to manage better care by adding a patient centered medical home so that you have a doctor who is totally invested with taking care of every aspect of the patient and coordinating it. This [terminating the doctors] is clearly not a patient centered decision," said Dr. Michael Saffir, President of CT State Medical Society......."
WTNH - Thousands of doctors fired by United HealthCare | WTNH.com Connecticut

gerryann 10-11-2013 12:55 PM

it would certainly create a whole lot of chaos if that happened here.

ilovetv 10-11-2013 08:59 PM

....

mac9 10-12-2013 01:26 AM

Untied Healthcare is an HMO. Good luck if you travel!

gomoho 10-12-2013 06:51 AM

Quote:

Originally Posted by gerryann (Post 761350)
it would certainly create a whole lot of chaos if that happened here.

Ask around and you will find many doctors not associated with The Villages Health have received the same letter.

billybye 10-12-2013 07:10 AM

Being a "former" Preferred Care - I will stick with Premiere Medical and Dr. Gejaj, wherever he is.
Probably go with Freedom or someone else that gives you money back each month. United Health does not offer any more than the ones giving money back to you. Had them before TV and they had a poor customer service dept.
You do not need The Villages Health to live the Villages lifestyles, no matter what you are told.

Kdvogras 10-12-2013 07:43 AM

Villages Healthcare
 
Quote:

Originally Posted by Bob45 (Post 760887)
Just talked to the Villages healthcare folks about joining their program. They told me they will only accept United Healthcare Advantage plans. I have Aetna Advantage and my wife has Humana Advantage plan. Therefore we can't join. I was excited when I first heard of the program, just to be let down. I am wondering how many others are in the same situation.

Bob

I asked to join also and I have Blue Cross Blue Shield/Medicare Plus and was told they don't take that either. I guess they only want a select few. So much for all their worry about our health.
Deanna

champion6 10-12-2013 11:07 AM

Quote:

Originally Posted by mac9 (Post 761604)
Untied Healthcare is an HMO. Good luck if you travel!

UnitedHealthcare also offers a PPO Medicare Advantage plan.

Jakel 10-12-2013 03:57 PM

Our former employer switched to Aetna, and we had to stop going to the Villages Health, we did like it there.

tommy steam 10-13-2013 11:04 AM

Quote:

Originally Posted by bimmertl (Post 761316)

Thank you for providing great information.

greenhillsgirl 10-14-2013 05:12 PM

Villages Health Care
 
That's all pretty interesting. I inquired as well...went to the Colony Office...they looked at my husband's & my cards...Medicare & Florida BCBS Plan "F" which is the best. They said that they participate with our plan and our appointments were scheduled and our 'new patient' appointments are next week at the Santa Barbara Office near our home.

gerryann 10-15-2013 01:35 PM

Quote:

Originally Posted by mac9 (Post 761604)
Untied Healthcare is an HMO. Good luck if you travel!

United Heath care has a Medicare advantage plan that is a PPO. You can see any specialist without a referral. You can also see any doctor ANYWHERE and pay the "out of network" fee. No, you do not get any money re-enbursed. You are covered at TV clinics if that is where you choose to go.

Bob45 10-23-2013 11:11 AM

Quote:

Originally Posted by Avista (Post 760917)
Can't you change after Jan 1 2014? There is no premium for the new Villages Plan.

Getting my insurance paid for is part of my retirement package. If I drop it I can't go back. With the uncertainty of healthcare right I'm not making any moves.

ilovetv 10-23-2013 11:15 AM

Quote:

Originally Posted by Avista (Post 760917)
Can't you change after Jan 1 2014? There is no premium for the new Villages Plan.

No premium? I'd stick with the old adage my folks and grandparents taught us, which is....

"There's no such thing as a free lunch".

Pocrunner 10-24-2013 05:01 PM

You are correct about United Healthcare. Check with SHINE.....they are a great source of information.

graciegirl 10-24-2013 06:18 PM

Quote:

Originally Posted by Kdvogras (Post 761663)
I asked to join also and I have Blue Cross Blue Shield/Medicare Plus and was told they don't take that either. I guess they only want a select few. So much for all their worry about our health.
Deanna

Apparently, it is a business. They don't accept our insurance either. It is what it is. We have found someone who I think will be a good PCP for us, he is AMA and board certified and many members of this forum say good things about him. Dr. Agbo.

I see you are new to the forum.

skip0358 10-24-2013 06:29 PM

This is from their WebSite so what gives ??
 
FAQs


UNITED HEALTHCARE®
ACCEPTED INSURANCE
REGISTER FOR A CLASs
accepted insurance
If you are eligible for Medicare, we want you to know that the only Medicare Advantage plans The Villages Health participates in are those offered by UnitedHealthcare®. UnitedHealthcare® Insurance Company is the same Medicare insurance provider that many Villagers already rely on for AARP® Medicare Plans.
•Traditional Medicare
•UnitedHealthcare® The Villages® MedicareComplete® (HMO)
•AARP® MedicareComplete Choice® (Regional PPO)

We also accept most major health insurance plans:

Accountable Health Plan
AARP
Avmed
Blue Cross & Blue Shield


• Federal
• Blue Options
• Empire
• Health Options
• Preferred Patient Care
• Traditional

BCE Emergis
CCN
CCN/One Source
Champus/Tricare
ChampVA
Cigna
Coventry Health Care/First Health
Evolutions Healthcare
First Health
First Health Mail Handlers
GHI
Great West
Humana
Humana PPO
Interplan
Mail Handlers
Multiplan
NALC
One Health Plan
Pacificare
Private Healthcare System/PHCS
Proamerica
Railroad Medicare
Southcare
Up & Up
United Healthcare

Most major Preferred Provider Organization Plans

Bizdoc 10-24-2013 09:45 PM

You will note that the list of insurance accepted has been growing. Keep in mind that doctors and insurance companies "negotiate" reimbursement rates. In some cases, insurance companies may feel that it isn't worth servicing an area because there aren't enough potential policy holders (Cigna is famous for that - trying finding a Cigna participating provider in a rural area!) In other cases, doctors have negative experiences with an insurance company or feel that the rates are too low and drop out of that insurers network.

I seem to recall that someone commented last spring or summer on the absence of Cigna providers in the area after having used them in Jax. Clearly they are now here (several of the federal plans like NALC and SAMBA are actually administered by Cigna.

If you snow bird, summer travel or whatever, you may want to look at providers at both ends of your travels. DW got sick in AZ and her Kaiser HMO was essentially worthless. ("If you'll drive up to Portland, OR you can be seen in our clinics there...")

shankerman 10-25-2013 09:08 AM

Quote:

Originally Posted by Bob45 (Post 760887)
Just talked to the Villages healthcare folks about joining their program. They told me they will only accept United Healthcare Advantage plans. I have Aetna Advantage and my wife has Humana Advantage plan. Therefore we can't join. I was excited when I first heard of the program, just to be let down. I am wondering how many others are in the same situation.

Bob

Bob,
Are you aware that Gary Morse owns 51% of United Health Care - The Villages? Does that help you understand why The Villages Primary Care Centers, which Gary Morse owns, will only accept United Health Care - The Villages. Coincidence? I think not.

champion6 10-25-2013 09:30 AM

Quote:

Originally Posted by shankerman (Post 768291)
Bob,
Are you aware that Gary Morse owns 51% of United Health Care - The Villages?

WHAT? That's an incredible claim! Do you have a source for this information that is publicly accessible?

Russ_Boston 10-25-2013 10:00 AM

Quote:

Originally Posted by shankerman (Post 768291)
Bob,
Are you aware that Gary Morse owns 51% of United Health Care - The Villages? Does that help you understand why The Villages Primary Care Centers, which Gary Morse owns, will only accept United Health Care - The Villages. Coincidence? I think not.


But what exactly is that? I know that the underwriting INSURANCE agent (United Health care) is a national company that Mr. Morse seems to have nothing to do with if you look at their website. Can you explain the relationship? Are we talking about just the actual health system in tv?

Thanks.

And who really cares if a health company takes your insurance. If they don't find someone else. It's a business and they can do as they please. They obviously feel that they have plenty of patients or they wouldn't keep this insurance model.

ilovetv 10-25-2013 10:37 AM

Quote:

Originally Posted by shankerman (Post 768291)
Bob,
Are you aware that Gary Morse owns 51% of United Health Care - The Villages? Does that help you understand why The Villages Primary Care Centers, which Gary Morse owns, will only accept United Health Care - The Villages. Coincidence? I think not.

Wow. Imagine that. An investor that will make sure the operation earns more than it spends. What a concept!!

rubicon 10-25-2013 10:50 AM

As of now I have no dog in this fight. However it seems that creating such a monopoly would be against public policy. There is something really wrong here???????????????????

Challenger 10-25-2013 11:57 AM

Quote:

Originally Posted by rubicon (Post 768352)
As of now I have no dog in this fight. However it seems that creating such a monopoly would be against public policy. There is something really wrong here???????????????????

There are a multitude of other choices for health care . Where do you see a monopoly that violates public policy?

Russ_Boston 10-25-2013 12:21 PM

And BTW: It's only the Medicare advantage insurance that is limited to UH. If you look at their webpage they take many other insurance carriers.

I know at the hospital we have trouble with many Medicare supplement insurances when we try to place patients in rehab etc. It is NOT an uncomplicated business.

Bottom line: It's a private business - you have plenty of other health care choices in and around tv. Go somewhere else if the money isn't right.

KateNelson 10-26-2013 01:55 PM

Thanks for the info. My husband and I are TRICARE. I saw they will accept that.

Pepperhead 10-26-2013 05:54 PM

I guess this United Health Care must be a pretty big deal.

UnitedHealth unit chosen to fix health care website | Star Tribune

Russ_Boston 10-27-2013 07:39 AM

Quote:

Originally Posted by Pepperhead (Post 769071)
I guess this United Health Care must be a pretty big deal.

UnitedHealth unit chosen to fix health care website | Star Tribune

United has been around a long time and they are growing rapidly. They already have products that reach 70 million Americans in some way. I'm surprised that anyone is surprised. Well known company in the insurance industry.

trichard 10-27-2013 09:23 AM

Check around. Many non-The Villages Health physicians do not accept any Medicare Advantage Plans. The reason is that their payment to physicans is very low compared with traditional Medicare and their "control" over patient care is not acceptable. A group physician practice has more leverage in negotiating a contract and can attract the volume of patients to make a single Medicare Advantage Plan a finacially feasible arrangement.

2BNTV 10-27-2013 09:44 AM

I called Medicare and they informed me that three plans are geared for TV:
1. Blue Medicare HMO Lifetime (855) 601-0446.
2. Freedom Medicare (800) 401-2740.
3. Optimum Gold Rewards (866) 245-5360.

So far I have found the Blue Medicare to contain the doctors I see and their website is easy to use. I will check to see if TV Health Care Centers take this insurance but if not, I feel comfortable using their in network doctors.

Waiting for literature to arrive as I have found it somewhat difficult to get proper information from The UHC PPO Plan that I presently have. It took over a month and a half just to get my insurance card and found their call center to be clueles. Their website site is difficult to navigate as far as finding providers or is it just me........

champion6 10-27-2013 10:29 AM

Quote:

Originally Posted by 2BNTV (Post 769342)
I called Medicare and they informed me that three plans are geared for TV <snip>

Are these Medicare Advantage plans?

Quote:

Originally Posted by 2BNTV (Post 769342)
Waiting for literature to arrive as I have found it somewhat difficult to get proper information from The UHC PPO Plan that I presently have. It took over a month and a half just to get my insurance card and found their call center to be clueless. Their website site is difficult to navigate as far as finding providers or is it just me.

Hmm. Why not go to one the the UHC Medicare offices in TV for face-to-face help?

gerryann 10-27-2013 10:34 AM

I may be wrong but I heard that as of Friday, these offices will ONLY sign you up for UHC.


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