Looking for Medicare clarity
 

While seeking to establish myself as a patient with a general practitioner or internal medicine doctor I have found that most of those in TV do not accept Medicare (including Medicare supplement plans), only Medicare Advantage Plans. Why is that when all of the hospitals and specialists take Medicare readily?

The Villages Health doesn't take Medicare but their specialists do. I never really understood why in the biggest retirement community in the country that TV Health doesn't take Medicare.

The Villages Health system employs primary care doctors, and they do not original accept original Medicare. They only accept a few select Medicare advantage plans. But, there are a lot of primary care doctors outside The Villages who do accept original Medicare patients. I think one reason for this rule is that The Villages Health system wants to make the Health facilities, constructed on Villages property, accessible to Villages residents. If they accepted original Medicare patients, they would be overloaded with non-Villages residents, and they would not be able accommodate Villages residents. That is because they could not legally give any priority to Villages residents over non-Villages residents. It would defeat the purpose of building health care facilities on Villages property.

There are a lot of practitioners IN The Villages that take Medicare and a supplement. Only The Villages Health system restricts medicare patients to the Villages United Health Care Advantage Plans. I believe all specialists accept straight Medicare.

The Villages Health System's internal specialists do accept Medicare supplement plans, while their primary care system is limited to Medicare Advantage. I don't know the reason but, after approx. three years of opening their first centers, they stopped accepting supplement plans in 2016. I wonder if it had something to do with a predictable cash flow, in that the government pays a lump sum yearly to an insurance co. for each Advantage patient.

If The Villages health system accepted original Medicare for their primary care doctors, they would be inundated with patients from the surrounding areas, and the health centers would no longer be convenient for Villages residents to use. If you accept original Medicare, you must accommodate all patients who have it.

That's ridiculous.

It's a strictly financial decision. Medicare Advantage Plans are more profitable for providers, under most circumstances. The Provider gets to determine what is necessary & not necessary for a given patient. Advantage Plans promote shoddy medical care, for the sake of profits. Why do you think they all advertise financial incentives to sign onto their plans?

Advantage plans are for folks who can't afford real insurance and are willing to sacrifice their health to save a few bucks.

United healthcare advantage has been wonderful here. Ignore the haters nonsense

My point was that The Villages has constructed 7 health care centers in The Villages that are located to be convenient for Villages residents to use. By limiting the primary care insurance acceptance to a few select advantage plans, they will not be overloaded with patients from outside of The Villages. If that were to occur, it would defeat the purpose of providing convenient facilities for Villagers to use. It doesn't sound ridiculous to me.

Thanks for your insights. We have an advantage plan and very happy with the collection of physicians we have and can see our PCP within a day.

52% of Americans have Medicare Supplemental Insurance. Assuming The Villages falls reasonably close to the "average" ... 1/2 the folks living in The Villages, can't use the medial facilities The Villages supposedly "built to be convenient for Villages residents"

They can if they sign up for one of the accepted Medicare advantage plans. It's their choice.

My employer allows me to take my group BC/BS into retirement so I'll have private insurance as well as Medicare. Will I face the same issues outlined in OP's post? I'm told that even though I'll have BC/BS, Medicare will be my "primary" insurance.

I am a retired Federal employee with the Federal BC/BS standard plan. My employer doesn't require me to have Medicare Part B, so I don't have it. I have saved thousands of dollars by not paying the Medicare premiums. I have no problem finding providers to accept my insurance. So, if you are not required to buy Medicare, you may want to do the math and see if it is worth buying.

You mean television pitchmen such as Joe Namath and Jimmie JJ Walker are not telling the whole story?:)