Talk of The Villages Florida

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-   The Villages, Florida, General Discussion (https://www.talkofthevillages.com/forums/villages-florida-general-discussion-73/)
-   -   Villages health care (https://www.talkofthevillages.com/forums/villages-florida-general-discussion-73/villages-health-care-361401/)

RoseyRed 09-21-2025 10:12 AM

Quote:

Originally Posted by Mrprez (Post 2462041)
TVH only accepts Medicare Advantage plans from UVH, Florida Blue, and Humana. No supplement plans are accepted. What happens next year is anyone’s guess. If you are not yet on Medicare they do take commercial insurance. Lastly, you do not have to live in The Villages in order to go to TVH.

I respectively disagree with the statement that TVH accepts patients not on Medicare with commercial insurance. I tried late last year to make an appointment with TVH and was denied because I am NOT on Medicare.

kaseydog 09-21-2025 10:20 AM

Tvh allowed non residents of tv to join as long as they had medicare advantage. Wonder if there will be an changes to this policy.

biker1 09-21-2025 11:05 AM

That might be a relatively recent change. In the past, they accepted those under Medicare age as PCP patients. I was one of those. I suspect demand forced a change.

Quote:

Originally Posted by RoseyRed (Post 2462325)
I respectively disagree with the statement that TVH accepts patients not on Medicare with commercial insurance. I tried late last year to make an appointment with TVH and was denied because I am NOT on Medicare.


Mrprez 09-21-2025 12:28 PM

Quote:

Originally Posted by RoseyRed (Post 2462325)
I respectively disagree with the statement that TVH accepts patients not on Medicare with commercial insurance. I tried late last year to make an appointment with TVH and was denied because I am NOT on Medicare.

That must have changed at some point. I do see where they only take MA plans.

retiredguy123 09-21-2025 12:35 PM

Quote:

Originally Posted by kaseydog (Post 2462328)
Tvh allowed non residents of tv to join as long as they had medicare advantage. Wonder if there will be an changes to this policy.

I am pretty sure that this would be illegal. Medicare advantage plans have a specified service area, and they are required to serve all patients who are enrolled in the plan and who live in the approved service area.

MSGirl 09-21-2025 01:24 PM

Quote:

Originally Posted by Rainger99 (Post 2462052)
I am trying to get information on the 2026 plans. I talked to an agent and was told that the plan details will come out on October 1 and the enrollment period for 2026 is from October 15 to December 7, 2025.

Plans should be coming out now. I received my changes this past week

LoriAnn 09-21-2025 01:35 PM

Typical sale
 
When a healthcare company that bills Medicare/Medicaid or any other private insurance company sells the business, all the debts transfers to the new buyers. That includes known repayments and future repayments that might arise after the sale is completed. That is why there is a very thorough due diligence process before an offer to purchase is put forward. When there is a repayment such as the 340 million dollar amount The Villages Healthcare owes, it is the company that owes the debt, not the owners. The debt will be negotiated in the sale price. It looks like Humana purchased The Villages Healthcare for the 340 million dollar debt repayment plus a 64 million dollar payout totaling 404 million dollars. Considering their total billing a year is around 400 million, the sale is exactly what I would expect for that revenue size. Healthcare business generally sell for one time gross sales. I’ve sold 4 healthcare companies during my 30 year career and each time a 20% indemnity basket was withheld from the sale price for 3 years to cover any insurance repayments that might arise. That is common procedure. All current debt, repayments and future repayments transfer to the new owners. It’s appears to have worked out for everyone. Humana got a thriving medical practice at a fair price, Medicare got their 340 million dollars back, the Morse family got the heck out of healthcare where they didn’t belong and the Patients will continue getting healthcare close to home. Yay for everyone.

MSGirl 09-21-2025 01:36 PM

Quote:

Originally Posted by Rainger99 (Post 2462052)
I am trying to get information on the 2026 plans. I talked to an agent and was told that the plan details will come out on October 1 and the enrollment period for 2026 is from October 15 to December 7, 2025.

Plans should be coming out now. I received my changes this past week

Happydaz 09-21-2025 02:11 PM

Quote:

Originally Posted by LoriAnn (Post 2462368)
When a healthcare company that bills Medicare/Medicaid or any other private insurance company sells the business, all the debts transfers to the new buyers. That includes known repayments and future repayments that might arise after the sale is completed. That is why there is a very thorough due diligence process before an offer to purchase is put forward. When there is a repayment such as the 340 million dollar amount The Villages Healthcare owes, it is the company that owes the debt, not the owners. The debt will be negotiated in the sale price. It looks like Humana purchased The Villages Healthcare for the 340 million dollar debt repayment plus a 64 million dollar payout totaling 404 million dollars. Considering their total billing a year is around 400 million, the sale is exactly what I would expect for that revenue size. Healthcare business generally sell for one time gross sales. I’ve sold 4 healthcare companies during my 30 year career and each time a 20% indemnity basket was withheld from the sale price for 3 years to cover any insurance repayments that might arise. That is common procedure. All current debt, repayments and future repayments transfer to the new owners. It’s appears to have worked out for everyone. Humana got a thriving medical practice at a fair price, Medicare got their 340 million dollars back, the Morse family got the heck out of healthcare where they didn’t belong and the Patients will continue getting healthcare close to home. Yay for everyone.

This is a very interesting post, thank you. It looks like from what you said that the owners of the Villages Health are getting 64 million dollars for this large practice. That sounded like a very low sales price to many of us. But from what you are reporting is that the buyer of Villages Health is actually paying a total of 404 million dollars, 64 million to Villages Health and 340 million to Medicare. Thank you for this report. It clears up a lot of questions. Medicare gets paid back, the owners of Villages Health walk away, and the many Villagers in the Health Plan get continued health care. Thanks again!

jjombrello 09-21-2025 02:24 PM

If you belong to UHC, the 2026 plan and benefits is available online. I recently reviewed it and there are some changes for 2026, but nothing that would raise too many concerns. The plan we are on will see a premium increase to $62/month from $26/month and there are some changes to what we pay as co-payments, etc. It depends on what plan one is enrolled in.

tophcfa 09-21-2025 03:01 PM

Quote:

Originally Posted by LoriAnn (Post 2462368)
When a healthcare company that bills Medicare/Medicaid or any other private insurance company sells the business, all the debts transfers to the new buyers.

The above statement applies to traditional sales that don’t involve the selling company selling the entity while in bankruptcy. In the case of TVH, the bankruptcy court determines what entity, if any, assumes the creditor claims (debts of the seller). Based on a quick reading of the bankruptcy court settlement, Centerwell (Humana) assumed very little of TVH’s debt, and not any of the Medicare overpayments.

dewilson58 09-21-2025 03:07 PM

Quote:

Originally Posted by tophcfa (Post 2462395)
The above statement applies to traditional sales that don’t involve the selling company selling the entity while in bankruptcy. In the case of TVH, the bankruptcy court determines what entity, if any, assumes the creditor claims (debts of the seller). Based on a quick reading of the bankruptcy court settlement, Centerwell (Humana) assumed very little of TVH’s debt, and not any of the Medicare overpayments.

L A had a long post and I was trying to determine fact vs. fiction.
Came across as fact, but
Most of the post did not seem factual to TV Health transaction.

:thumbup:

retiredguy123 09-21-2025 03:09 PM

Quote:

Originally Posted by RoseyRed (Post 2462325)
I respectively disagree with the statement that TVH accepts patients not on Medicare with commercial insurance. I tried late last year to make an appointment with TVH and was denied because I am NOT on Medicare.

I agree. That was the policy in the past, but it was changed years ago.

Happydaz 09-21-2025 04:23 PM

Quote:

Originally Posted by dewilson58 (Post 2462396)
L A had a long post and I was trying to determine fact vs. fiction.
Came across as fact, but
Most of the post did not seem factual to TV Health transaction.

:thumbup:

Your post has some very good points. LoriAnn’s post sounded good but from what I am hearing now, may not be true in a bankruptcy sale. It would be nice to find someone who could clarify what might actually transpire in this bankruptcy sale of the Villages Healthcare System.

Northwoods 09-21-2025 06:30 PM

Quote:

Originally Posted by Happydaz (Post 2462381)
This is a very interesting post, thank you. It looks like from what you said that the owners of the Villages Health are getting 64 million dollars for this large practice. That sounded like a very low sales price to many of us. But from what you are reporting is that the buyer of Villages Health is actually paying a total of 404 million dollars, 64 million to Villages Health and 340 million to Medicare. Thank you for this report. It clears up a lot of questions. Medicare gets paid back, the owners of Villages Health walk away, and the many Villagers in the Health Plan get continued health care. Thanks again!

I wouldn’t assume that.


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