Medicare, Tricare, United Health
 

Does any military retirees over 65 have Medicare, Tricare for Life, and United Health. Villages health does not accept Medicare and Tricare anymore. You must have United Health. I was told by United Health that by enrolling with them I would keep Tricare, and gain better overall coverage and save money?

We have medicare & tricare for life--we dropped out of villages health--IMHO--not good to be married to a plan that restricts who you can use--met a person who said he has to use the Villages Regional Hospital, instead of Advent in Ocala, even though he knows Advent is the best stroke/cardio in the area--United people are salespersons, unless its in writing its useless-have not had a single co-pay in years, actually can't remember when I did--and using Expresscripts for meds with 90 day scripts can't be beat

Contact SHINE, SHINE - Home for impartial information on health care. A point of clarification: TVHC requires ADVANTAGE plans, if you switch to an ADVANTAGE plan, you lose Medicare, and if you stay on the ADVANTAGE plan for 1 year (I think), you could have problems trying to go back to medicare and SUPPLEMENTAL plan. We ended up leaving TVHC because of the change to ADVANTAGE plans only, they were way too restrictive on specialists (4+ years ago), also there were areas of the country where we either were NOT covered or the coverage was very limited. SHINE was extremely helpful, and they have meetings in The Villages.
Hope this helps.

As I understand it, you do get to keep Tricare for Life if you switch from basic Medicare to United.

The problem with this is that you are then constrained to a set of doctors and hospitals. If you travel a lot, this will be a problem since some states don't have any/ a lot of United doctors. So, maybe not good for snow birds. If you have severe or weird problems, it might also be an issue to use just the doctors on the list.

Last, I really don't like how the Villages Health clinics basically turn you over to a United sales rep for information. The information that they give you is not unbiased. They are looking to make a sale. When you read the thick book on the plan, you can see what states have contracts and what drugs they cover. For example, the most important drug that I take is not covered. Whereas, it is $10 for a 90 day supply now.

:agree:

I spent my career working in the health care industry, and have been primary care giver for family members battling cancer.

Maybe not a risk for TVHC, but there can be problems if your Doc/Hospital discontinues supporting an Advantage plan. Imagine being mid treatment in your chemo, the Doc/hospital drops your Advantage plan, and then having just 3 months to find new doc's and infusion nurses/centers to continue your treatment.

If you can afford it, best to keep your options open via Medicare.

As usual a lot of misinformation. From my UHC login site Advent Ocala is included along with multiple Adventhealth and other hospitals within 100 miles of here (did't bother to look farther). There is no reason for anyone enrolled in UHC TV Advantage to be restricted the TV Hospital. Best to get professional help from SHINE.

We have UHC the Villages Advantage plan and checking the list of hospitals available to us I see 11 pages worth of hospitals in 100 miles of us, many of them Advent hospitals including the one in Ocala. My wife just had a procedure a month ago at Largo Medical Center (also on the list) outside of Tampa no problem, approved by UHC. In the past UHC Advantage has approved us using out of network providers too, all we had to do was ask.

Although the Advantage plan has a list of approved providers it must, by law, provide all the services that regular Medicare does.

Researched the villages health plan, said no thanks.:ho:

We also have Medicare/Tricare for life and have not had a co-pay in years including two surgeries with in-patient stays. No reason to pay for additional insurance to be in the TV system. Quality medical care is available very close by and some providers within TV accept Medicare/Tricare for life.

Live in TV and snowbird in northern NY. The Villages Health plan is by far the best we found after much research including Shine (who did a very good job explaining differences but will not give a recommendation). Found that a lot of info about this subject on this website is just plain false. Mostly because of people's reluctance to give up their existing plan. Then the fear mongering starts without facts. Could not be happier with our choice.

I will provide a clarification, there were specialists available in the TVHC system BUT most if not all had very long times for the initial visit (3 or 4 months), and then it was typically another month to actually get an appointment to see the doctor. This was not acceptable as my wife already had specialists that she was happy with, but these would NOT accept the ADVANTAGE plans. You need to do suitable research , what works very well for one person may not work at all for another.

My husband signed up for United Health (a Medicare Advantage plan) six months ago and Tricare For Life works as a secondary payer. So far so good. You just have to remind Specialists and labs that you have TFL as a secondary because they repeatedly try to bill him for the co-pay, which TFL typcially covers. Since there is no premium for United Health, and there are extra benefits like free gym membership to MVP (which he was paying $60 per month for before) and $40 worth of Over the counter medical supplies every quarter, it has worked out well for him so far. However, since the Medicare Advantage plan includes part D (drugs) his Medicare premium went up quite a bit. The amount depends on your income. He can still use Express Scripts as well, though since he is really healthy, he hasnot needed to!!

Found out yesterday that anyone can use The Villages Health Specialty clinics with many different heath care insurances. They just cannot have a primary doctor there without United Health Care. Found that interesting.

I agree, I have used a couple of the TVHC specialists with Medicare and a supplemental plan no problems. We were really annoyed when we had to drop our primary care doctor at TVHC, but we have found another one in Leesburg that we like.

Folks really need to talk directly with SHINE and directly with The Villages Health Care System before doing anything like changing insurance plans. We did not get a hard sell at all about joining "their" insurance plan - they offered us info about UHC and about the Medicare Advantage Plan but didn't push us to sign up before getting served. We had and still have Basic Medicare (NOT an Advantage plan) and we have Tricare for Life with Express Scripts for drugs. We use TVHC and have for several years now - yes, we have a dedicated primary care doctor (well, we share him with a few others). It is true that TVHC will sometimes have to assign you to a different doctor if it's a rush need and your PC doctor is not available for some reason, but we've never had that problem. It's not a perfect system but we had a couple off-campus doctors before joining TVHC and they weren't perfect either. In short, there is some good information on many topics in this forum but please, please, please go to SHINE and to TVHC and talk, question, and think before you make any changes.