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Medicare Advantage in Illinois. Don’t try selling the Brooklyn Bridge to a retiree.

October 21, 2013

Since the letter from CMS regarding the Medicare Advantage details came out I have received lots of comments and emails.

We are a suspicious bunch.

Why on earth would that be?

Experience!

The wording from IRTA Executive Director Jim Bachman that was passed along today was that any doctor who takes Medicare must take Medicare Advantage.

Right away I received messages from retirees who had called their Medicare doctors. They were told that they did not take Medicare Advantage.

Here is what I understand:

The Medicare Advantage plan worked out between the vendors and CMS is a unique plan, customized for Illinois state retirees. Not all doctors who take Medicare patients are aware of it as yet.

But according to what I have been told, doctors who take Medicare patients must take members from this Medicare Advantage plan.

Just as information still needs to get out to all members, doctors may not yet be aware of it.

The plan is called Total Retiree Advantage Illinois.

Trust, but verify.

But also know that the meetings about the coverage options are still to be scheduled and held. And most doctors are not yet aware of the new plan.

That’s not to say we shouldn’t read the small print.

Once again, here is the letter from CMS.

5 Comments leave one →
  1. cswangren@sbcglobal.net permalink
    October 21, 2013 9:37 pm

    Thanks. Excellent clarification. Don’t forget to have people check hospitals too, not just docs. Regards.

    Sent from my iPad

    >

  2. Sharon permalink
    October 21, 2013 10:10 pm

    Under TRIP there was, until very recently, NO deductible. Then suddenly, and quietly, it became $500. Now the new plan says $250. WOW, such a deal…NOT!!!

  3. Leah Shepard permalink
    October 22, 2013 5:50 am

    Just because doctors accept Medicare patients doesn’t mean they are accepting “new” Medicare patients. Usually, if you have been there patient before, they will keep you on as a patient. But their practice may be closed to new patients.

  4. Atkinson permalink
    October 22, 2013 8:44 am

    Fingers crossed and hopes are high but not satisfied yet!! Thanks.

    Sent from my iPad Mca

  5. Opa permalink
    October 25, 2013 10:25 am

    Regarding the statement “But according to what I have been told, doctors who take Medicare patients must take members from this Medicare Advantage plan.”

    That is not my understanding. CMS initially used similar language, as did AFSCME (the negotiator of the contract that is bringing us MA plans). Read the CMS letter again and it very carefully refers to “willing providers” which is pretty weaselly. Healthcare providers don’t yet know about the plan (wonder when they will?) and the efforts of some retirees to ask about United Healthcare produces answers that apply to other plans, but may not apply to the unique Illinois plan. Will it be as good as what we’ve had? Better? Worse?? Just remember, the state went this route to SAVE MONEY. I wonder how that will be achieved??

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