[AZ SLIM]

Being new here I'm checking out The Villages Health System. I would need to join the Florida Blue Advantage plan and suspend my Federal Retiree Blue Cross coverage. I have no experience with an HMO system. Three questions come to mind.
1. If you have experience with Villages Health would you be willing to share any thoughts or experiences about it?
2. Have you suspended your federal retiree coverage to do this and are you satisfied with that decision?
3. If I keep my federal retiree coverage does this area provide enough adequate health care providers outside the TV HMO system without traveling to the cities?

[OBRight]

Hi, I'm not exactly in the same position as you, I'm a Federal Employee still working (out of a guest room in my CYV) remotely. I'm enrolled in the Villages Health System and have FEP Blue insurance and they (Villages Health) just bills BC/BS for any services. Are you sure you would have to suspend your BC/BS? For what its worth, I've been happy with all the doctors I've seen here.
Good luck!

[villagetinker]

OP, contact SHINE, SHINE - Home, they have local face to face meetings and they give unbiased information on health care. IMHO, ADVANTAGE plans are medical MANAGEMENT (your health is under the control of others), MEDICARE and a supplemental is an INSURANCE program and you are in charge of your health. We were in the Villages system until we started to experience some problems with specialists, we were able to get our and back into Medicare. Please review these options carefully. Also, there are major differences if you are under 65 or 65 and over.

[LuvtheVillages]

Originally Posted by AZ SLIM

Being new here I'm checking out The Villages Health System. I would need to join the Florida Blue Advantage plan and suspend my Federal Retiree Blue Cross coverage. I have no experience with an HMO system. Three questions come to mind.
1. If you have experience with Villages Health would you be willing to share any thoughts or experiences about it?
2. Have you suspended your federal retiree coverage to do this and are you satisfied with that decision?
3. If I keep my federal retiree coverage does this area provide enough adequate health care providers outside the TV HMO system without traveling to the cities?

3. This area provides plenty of health care providers outside of the TV HMO system. Unless you have something extremely rare, you will find any generalist or specialist you need.

My two cents: With an HMO, you have to use their docs and specialists. If something big happens and you want to go to Mayo, or Shands, or another center of excellence, you can't. With original Medicare, you can go anywhere you want.

[Mortal1]

Contrary to some responses who don't actually have FEDERAL blue cross/shield(your first response)if you give up fed bcbs then you no longer have "worldwide coverage". We used our fed blue here since 2013 and were fine with docs, etc. while just using fedblue. once 65 we kept our fedblue and paid for part b of medicare. all good.

no idea how a supposed fed employee doesn't have either fedblue or mail handlers, but I would wonder about their advice if they didn't differentiate between fedblue and regular bcbs. in order to use the village health care system you'd have to do away with it.

[champion6]

Originally Posted by AZ SLIM

<snip>
3. If I keep my federal retiree coverage does this area provide enough adequate health care providers outside the TV HMO system without traveling to the cities?

Here is a list of primary care groups in the area.

[OrangeBlossomBaby]

I don't qualify for medicare yet, not old enough. But we have Florida's version of BC/BS, which is called Florida Blue. Every state calls it something different, but it's all Anthem-BC/BS of one variety or another. I do -not- have an HMO, I have a PPO (Preferred Provider). All my doctors are part of the Villages Health, which is a huge convenience for me since it means I take the golf cart across the street and voila - everything I need all on a single campus (except the dentist and eyeglass folks). Even my hearing is checked and aids maintained through VHS.

VHS is the provider for the HMO, but they are not exclusively an HMO. They accept other insurance. I know that doesn't answer your question, but it did seem like you were assuming that VHS was strictly an HMO for Advantage, and that just isn't the case.

[rustyp]

Originally Posted by OrangeBlossomBaby

I don't qualify for medicare yet, not old enough. But we have Florida's version of BC/BS, which is called Florida Blue. Every state calls it something different, but it's all Anthem-BC/BS of one variety or another. I do -not- have an HMO, I have a PPO (Preferred Provider). All my doctors are part of the Villages Health, which is a huge convenience for me since it means I take the golf cart across the street and voila - everything I need all on a single campus (except the dentist and eyeglass folks). Even my hearing is checked and aids maintained through VHS.

VHS is the provider for the HMO, but they are not exclusively an HMO. They accept other insurance. I know that doesn't answer your question, but it did seem like you were assuming that VHS was strictly an HMO for Advantage, and that just isn't the case.

Nice post - please let me add.

I am over 65 and obviously Medicare eligible. I belong to the VHS and have AARP Medicare Advantage from UnitedHealthcare PPO (not HMO). It is extremely flexible letting one pick their own specialist without referrals and at worst case one can go to other institutions and most likely pay an out of network price up to the OOP. We also have a seasonal home in New York State and summer 2020 my wife had medical issues that tallied up to well over $300K (after their funny math). Every single bill including 3 hospitals, ambulance, specialists. doctors, etc. were in network.

[BlueStarAirlines]

Originally Posted by AZ SLIM

Being new here I'm checking out The Villages Health System. I would need to join the Florida Blue Advantage plan and suspend my Federal Retiree Blue Cross coverage. I have no experience with an HMO system. Three questions come to mind.
1. If you have experience with Villages Health would you be willing to share any thoughts or experiences about it?
2. Have you suspended your federal retiree coverage to do this and are you satisfied with that decision?
3. If I keep my federal retiree coverage does this area provide enough adequate health care providers outside the TV HMO system without traveling to the cities?

I'm a current working Fed living here and there is no difference in our coverage between working and retired. Easiest thing to do is go to our health portal and look up hospitals and doctors ( Find A Doctor – Provider Directory - Blue Cross and Blue Shield's Federal Employee Program ). Click on "Find a Doctor" in the In-Network provider section. Type in Hospital and you'll see all the UF Health take our Federal BCBS. I picked a hospital and then clicked on the "Find Doctors and Professionals that admit here" and used that to find my primary doctor.

I'll admit my doctor is outside of TV, but that is a preference since I like to combine my health care visits with my Costco runs!

[Pairadocs]

Originally Posted by LuvtheVillages

3. This area provides plenty of health care providers outside of the TV HMO system. Unless you have something extremely rare, you will find any generalist or specialist you need.

My two cents: With an HMO, you have to use their docs and specialists. If something big happens and you want to go to Mayo, or Shands, or another center of excellence, you can't. With original Medicare, you can go anywhere you want.

Read, and RE-READ the last sentence... I know it's "if something big happens" so you might think, low chance... but carefully consider that the best of the best in Florida will be cut off to you ...

[rustyp]

Originally Posted by Pairadocs

Read, and RE-READ the last sentence... I know it's "if something big happens" so you might think, low chance... but carefully consider that the best of the best in Florida will be cut off to you ...

For me it's quality of life not quantity. What's the old saying ? Something about careful of what you wish for ? Today with all the communications available the gold standards are pretty much known by all institutions. Be careful of some of these research facilities that some hold in such high esteem. The fine print may say (I stress MAY) you are part of an experimental group. I.E. you may in the placebo group. How does that gold standard look now ?

[OrangeBlossomBaby]

Originally Posted by rustyp

For me it's quality of life not quantity. What's the old saying ? Something about careful of what you wish for ? Today with all the communications available the gold standards are pretty much known by all institutions. Be careful of some of these research facilities that some hold in such high esteem. The fine print may say (I stress MAY) you are part of an experimental group. I.E. you may in the placebo group. How does that gold standard look now ?

That would require informed consent for each incident. You may not be experimented on without you intentionally stating that you wish to be experimented on. (I know this because I'm a lab rat for an RSV vaccine - believe me they jump through hoops to make sure that they know, that I know, exactly what I'm signing up for)

[Mrprez]

Originally Posted by LuvtheVillages

3. This area provides plenty of health care providers outside of the TV HMO system. Unless you have something extremely rare, you will find any generalist or specialist you need.

My two cents: With an HMO, you have to use their docs and specialists. If something big happens and you want to go to Mayo, or Shands, or another center of excellence, you can't. With original Medicare, you can go anywhere you want.

I am on Florida Blue MA and Mayo and Shands are in my network. I have had excellent care at TV Health as well as the specialists.

[AZ SLIM]

Thanks everyone! Great discussion. Helpful advice on SHINE and the pdf with the list of providers. I have decided to keep my BCBS. Just some follow up points for info and I'll be done.
1. I have been using the BCBS provider list for decades. All the TVH doctors are on it. That's how I got into this mess to begin with. A TVH rep at the recent Lifestyle Expo told me that yes they take it, but if you are 65+ you have to be in one of their two programs like FL Blue to be in TVH (I forget the other one).
2. The FL Blue rep (employee of Fl Blue) is the one who called the system an HMO, not me.
3. On the surface, switching to FL Blue and suspending BCBS could save us a $2-3K a year in premiums under normal health issues, but we like the flexibility and international coverage of BCBS.
4. I'm still investigating whether some of the TVH specialists have other practices that do take BCBS as a supplement outside of TVH, but it's not critical to me at this time.
Stay Healthy!

[Avista]

We have been with The Villages’s Health since they started. In these years we could not be more pleased with our care. We never must wait for appointment more than a couple of minutes. Office extremely well run. We routinely have blood work and see our internists every 6 months.