THE VILLAGES, Fla. – When The Villages Health System, the bespoke medical care provider for Florida’s largest retirement community, announced its sale to CenterWell earlier this year, the company’s CEO promised a seamless transition and no change in care.
But patients say they are now scrambling to figure out how to change Medicare plans during open enrollment and keep their doctors, as negotiations drag on between TVH and its largest health insurance provider, UnitedHealthcare.
And as people like Nancy Devlin say, they are finding out, so far, there are few good options.
“I might have to get new doctors and everyone I’ve had a relationship with over the last six years,” she told News 6.
[WATCH: What The Villages Health sale will mean for its patients]
‘Team-based care’
The Villages launched The Villages Health System in 2012, promising a holistic approach to health care, with primary care, specialty doctors and wellness programs, all under one roof. Doctors were supposed to listen to their patients and spend more time with them. Marketing hearkened back to “Dr. Marcus Welby,” a classic television doctor from the ’70s known for his hands-on approach to treating his patients, someone who would resonate with the retirement community’s residents.
The Villages Health System is the largest health care provider in The Villages, with more than 55,000 patients and 10 care centers.
However, in July, the company announced it was filing for Chapter 11 bankruptcy to help deal with the more than $350 million it owed the federal government through Medicare overbilling.
The bankruptcy was part of a deal to sell TVH to CenterWell, a chain of health care centers owned by health insurer Humana.
In September, CenterWell won the auction to buy TVH, paying $68 million in cash, along with the assumption of any cure costs and liabilities.
CenterWell was also supposed to negotiate a new deal with UnitedHealthcare of Florida, using “commercially reasonable efforts.”
UnitedHealthcare had objected to the sale and the bankruptcy terms. In court documents, the company said the bankruptcy plan allows TVH to hide insider dealings. UnitedHealthcare accused TVH of distributing some $183 million, from 2022 to 2024, to the Morse family, to pay down a line of credit.
The Morse family controls The Villages through several companies.
CenterWell is the country’s largest “senior-focused, value-based primary care provider,” according to the company, with 150 centers across Florida alone.
“CenterWell accepts UnitedHealthcare’s Medicare Advantage plans in all of its Florida centers,” a CenterWell/Humana spokesperson told News 6 back in September.
No deal between CenterWell, UnitedHealthcare
The sale closed on Nov. 7. That same day, TVH sent a notice to patients via text to let them know their UnitedHealthcare plans may be rejected soon.
“For UnitedHealthcare members, your health plan will be accepted through December 31, 2025. CenterWell is in ongoing discussions with UHC for a potential agreement for 2026 and beyond. If no agreement is reached, we will be unable to accept UHC plans starting January 1, 2026,” the announcement read.
A spokesperson for UnitedHealthcare sent the following statement to News 6:
“We are engaged in good-faith negotiation and are frequently meeting with CenterWell. Our top priority is to reach a long-term agreement that maintains long-term access to CenterWell for 2026 and beyond for people enrolled in our Medicare Advantage and employer-sponsored commercial plans.”
CenterWell/Humana sent the following statement to News 6:
“CenterWell Senior Primary Care has been engaged in discussions with UnitedHealthcare to retain The Villages Health as a participating network provider for patients in The Villages with UnitedHealthcare health plans. Discussions are ongoing, and we continue to work in good faith toward an agreement.”
‘I have to look at all of my care’
The statements inspire little confidence in Nancy Devlin or the people she knows through the local clubs and sports leagues.
“They duped us,” she said.
The retiree has spent the last week building a spreadsheet to help her find a new Medicare Advantage plan in case the negotiations fall apart.
When she spoke to News 6, Devlin said she had gone through all of the Humana plans and some of the Aetna plans. She said none of the Humana plans were comparable to what her UHC plan covered, and those were the plans the company was hyping to patients.
“Some of them don’t have the doctors or the medications,” Devlin said. “And higher premiums.”
The idea that some TVH doctors may now be out of network, Devlin said, goes against the whole point of The Villages Health System.
A spokesperson for CenterWell/Humana said that all TVH doctors should be operating within the same networks.
Devlin sent us the names of two of her doctors, and we searched for them on Medicare.gov.
Only one Humana plan being offered had both TVH doctors, and Devlin said there were other reasons she couldn’t go with that plan.
“It’s more expensive and doesn’t have my medications, or I have to pay for them, and I don’t pay for my medications now,” Devlin said.
“I’m on limited income,” Devlin added. “About $1,300 in prescriptions, the out-of-pocket max was double in some cases.”
She said she also had other doctors, outside of TVH, who were not on the plans, like her dermatologist, eye doctor, and dentist.
“I know it’s not The Villages Health, but I have to look at all of my care,” Devlin said.
Navigating the Medicare marketplace
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Generally, all Medicare Advantage plans have to cover benefits like doctor’s office visits and hospital coverage, but there are plan variations, especially in terms of things like premiums and copays, according to Jeannie Fuglesten Biniek, a Medicare policy expert with the health policy group KFF.
“It could be more expensive or would be more extensive and substantially more expensive, depending on the plan you have. And that’s a lot harder for people to figure out, which doctors are in-network. There’s been some improvements this year, but it’s still, I think is an area that’s challenging,” Fuglesten Biniek said.
UnitedHealthcare is the largest provider of Medicare Advantage plans in the U.S., with Humana the second largest. Together, they provide 50% of the market.
Fuglesten Biniek says the average beneficiary has 32 Medicare Advantage plans available to them each year, which can be confusing if you’re looking for the best coverage. She also says there is no consumer-friendly system to rank a plan’s quality.
There is Medicare SHIP (State Health Insurance Assistance Program), which offers free counselors and assistance for Medicare beneficiaries. Fuglesten Biniek says they are supposed to provide unbiased information.
There are also Medicare brokers, but they don’t always sell all the plans available.
A TVH spokesperson says there is a chance the system is still updating network doctors, and patients should visit one of the nine Health Insurance Resource Centers in and around The Villages to get help.
Devlin said she looked at the material provided to her by a broker, but did not find it easy because, again, there are so many plans.
“With United, I didn’t have to look much further,” she said.
Fuglesten Biniek says it’s common for patients to stick with the same program year after year and avoid sifting through Medicare.gov to find a new plan.
“It is probably prudent to at least review your- everybody gets an annual notice of changes, review it and just see, is there anything that changed that stands out?” she said.
TVH patients who want to hold out hope that UHC and CenterWell will broker a deal by the end of the year can enroll in a UHC program now during the open enrollment period, which ends Dec. 7.
Then, if no deal is reached, patients can switch Medicare Advantage programs during a second enrollment period between January and March.
“There are a lot of pluses to Medicare Advantage and reasons why they’re good plans for people, but in choosing them, you also accept some uncertainty with respect to what might be available to you,” Fuglesten Biniek said.
Devlin is still holding out hope for a deal.
She sent an email to TVH CEO Bob Trinh, imploring him to do something. She said a TVH representative contacted her and tried to ease her concerns. They asked if she would continue to support The Villages.
Devlin said that’s not the issue. She said she and other TVH patients feel duped, and the company has a moral obligation to make this right somehow.
“Getting older, you want to make sure you’re covered and at a reasonable rate,” Devlin said. “And I like The Villages Health.”