Talk of The Villages Florida

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-   Medical and Health Discussion (https://www.talkofthevillages.com/forums/medical-health-discussion-94/)
-   -   Villages Health changing to Florida Blue? (https://www.talkofthevillages.com/forums/medical-health-discussion-94/villages-health-changing-florida-blue-298281/)

jeriteri 09-17-2019 07:24 AM

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?

champion6 09-17-2019 07:53 AM

Quote:

Originally Posted by jeriteri (Post 1682127)
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

trichard 09-17-2019 10:26 AM

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.

graciegirl 09-17-2019 11:51 AM

Quote:

Originally Posted by trichard (Post 1682166)
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.

NotGolfer 09-17-2019 02:16 PM

Quote:

Originally Posted by graciegirl (Post 1682193)
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.

lake5798 09-18-2019 05:09 AM

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.:)

graciegirl 09-18-2019 06:09 AM

Quote:

Originally Posted by lake5798 (Post 1682304)
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

rustyp 09-18-2019 06:59 AM

Quote:

Originally Posted by graciegirl (Post 1682310)
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 ?

justjim 09-18-2019 10:12 AM

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

graciegirl 09-18-2019 10:37 AM

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.

skyking 09-18-2019 10:38 AM

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.

Polar Bear 09-18-2019 10:57 AM

Quote:

Originally Posted by skyking (Post 1682384)
...It's apparent that the arrangement has not worked well (probably for both parties)...

Just wondering...how is it so apparent?

skyking 09-18-2019 03:31 PM

Quote:

Originally Posted by Polar Bear (Post 1682391)
Just wondering...how is it so apparent?

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

NotGolfer 09-18-2019 05:50 PM

Quote:

Originally Posted by skyking (Post 1682450)
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.

skyking 09-18-2019 08:18 PM

Vast conspiracy? This is a normal occurrence in healthcare.


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