Insurance?
 

HI, If I want to be able to use the Village Healthcare, but still have insurance to cover if something awful goes wrong and I need to go to Mayo or Tampa, is there insurance that covers that? Also, is the Moffit as good as the one in Tampa? I had a terrible experience in Atlanta where Emory basically just licensed its name to a local hospital, and it was awful (and that hospital is now closed). Thanks in advance for any advice!!

There is no longer a Moffit in The Villages so you would have to go back to Tampa anyway. As far as being able to use providers such as Moffit and Mayo I think you would need to talk with whomever sells the United Healthcare Medicare Advantage plan for The Villages Healthcare System. There is a "Passport" option and they could tell you which providers currently accept that plan. Or, of course, if you're under age 65 your present insurance might work.

How timely.. I was just going to ask here on the forum if there were providers that accept the United Health Care Advantage program. When we move there in 3 weeks my wife was wondering if she was going to have to switch off of it...

So I assume some people have this and some providers accept this?

Who do I talk to so that I can verify some questions and concerns that she/we have?

I did not use The Villages United Healthcare’s plans because they can’t seem to find their identity. First allowed UHC supplemental plans then cancelled, leaving many looking for other coverage. Just recently they are adding Florida Blue Advantage to their portfolio for some reason. For myself I have always been with Florida Blue Advantage PPO. With research, mostly on this website,we were able to find our primary physician who has been with us for 12+ years. Turnover of primary physicians in TV UHC has been very high. We also have Moffitt Cancer Hospital in Tampa and great orthopedics with two of the best clinics in Ocala. With a cancer surgery, knee and hip replacements, and a highly recommended neurosurgeon for lower back ( spine issues ) we could no be more pleased with our results and coverage. DO YOUR DUE DILIGENCE.

UHC customer service 866-627-7806

Also, call or visit SHINE, I have posted the info several times, so you can find this with a search, or Google 'Florida SHINE program'. They have meetings locally and provide unbiased info, and may be able to answer some of your questions. As noted above do you due diligence. We had to drop VHS due to a lack of specialists or very long wait times for appointments (this was 4 to 5 years ago).

There are options so make sure you develop a list of questions for which ever coverage you select. I did end up with Villages health care with the United Health Care advantage plan. The cost of this plan is zero for the basic plan. I added the out of network option which cost me $80 a month. And am so glad I did.

The out of pocket maximum for in network is $1900 a year and out of network is $7500 a year. I had prostate cancer and finally chose to have proton radiation at UF Health in Jacksonville FL. This was an out of network provider. UF Health had folks that worked with insurance providers and got my treatment covered in network. So $1900 for $250,000 worth of treatments. There was some ancillary stuff that still fell out of network for some undetermined reason that ended up costing me another $2500, but still turned out to be very cost effective. Something about some codes of service not covered in network. Proton radiation is very expensive and done by very few places around the country. Photon radiation is done everywhere but not what I wanted. There are only 4 proton centers that specialize in prostate cancer. UF Health in Jacksonville happens to be one of them.

Asking questions like this on social media will bring a plethora of answers that may further confuse you. Someone mentioned Shine in their answer and that is an option. You also might speak to an independent ins. person as well. But it's been reported that TVH recently added BCBS or a form of it (Florida Blue ???) to their ins. options. We have the advantage plan and have been satisfied. BUT speaking to an insurance person can alleviate all your questions better than opinions of others.
When Moffit left the Specialty Clinic some of their providers stayed here. I've heard some reports that folks have been happy with their care. Can't speak from personal experience on that.

12ridehd, thank you for your comments, and I hope you are healthy now.

Not sure if I am misreading these comments but Villages Health is not limited to just one United Healthcare Advantage plan.
I am in the process of signing up for Medicare and The Villages Heathcare system has told me they accept all five United Healthcare Advantage plans.

Neither is Florida Blue Advantage limited to one plan. It is more important to find a primary Doctor and research the specialists you need or may need, then match the Provider’s coverage and go with the best fit. Don’t just rely on a sales pitch. It takes a bit of due diligence at first then an annual review because usually these Plans are tweeked every year.

I think TVH understands their identity. They couldn't continue their model of 30 - 60 min.yearly (or 2x/year) patient physical visit if they accepted traditional Medicare. (They couldn't sustain that model.) The only way they could continue to offer the "Marcy Welby" model was to accept an Advantage Plan.
Why are they now accepting Florida Blue? Maybe they negotiated with providers and they are able to offer two plans... because competition is a VERY good thing. Florida Blue accepts Moffitt.
My advice - Do you due diligence and pick the healthcare plan that works for you. There are people who are angry because The Villages Health chose to only accept an Advantage Plan (many claim they were "kicked out"... but in fact they chose to keep their Medicare Plan vs. switching to an Advantage Plan. It was their choice...).
The comment that many physicians are leaving... I have had the same physician for 5 years and so has my spouse (and so have a number of my friends). We are both extremely happy with our PCP. They are outstanding and one of the reasons we stay with TVH.
As far as Othopedics... my spouse just had both knees replaced by Dr. Steven Nguyen in Orlando... renown orthopedic knee surgeon.
My point... pick the healthcare plan that works for you.

I changed from United to Blue Cross. Best move ever. Call Samantha Gump at Mid Florida Insurance located at Palm Ridge Plaza off CR 466. Phone number is
259-0666. Samantha is excellent and will explain all your options.