There wouldn’t be as big a problem if the timeline wasn’t so short. Illinois state retirees feel pressed and pressured to make decisions that have a major impact on their health and health care.
I have been deluged with phone calls and emails and comments.
Trust me. If people are turning to me to get advice on what to do about health insurance, that is a bad sign.
It is simply too short a time frame for people to wrap their heads around such a significant change.
We do know a couple of things.
The cost of the premiums for the new Medicare Advantage plan is relatively low.
We know that for those in TRIP, if you choose to leave, short of a life changing situation, you cannot get back in.
So the choice you make now is the choice you live with.
We know that if you leave, costs in the private insurance market, whether as part of a group or as an individual, will go up as we get older simply because we are getting older.
We don’t yet know what the coverage will look like. The state is claiming savings from the change to Medicare Advantage. But savings are often costs shifted to somebody else. Or in the extent of coverage.
That will be revealed in meetings that Central Management Services will be holding in November.
One point of contention is whether our doctor will take Medicare Advantage. What I have been told is that if our doctor takes Medicare they will take this state retiree specific Medicare Advantage. This is supported by Janice Bonneville, deputy director of benefits for Central Management Services.
In a lengthy story in the Springfield State Journal Republican it is reported that Bonneville assured retirees who are Medicare eligible and presently covered by the Teachers Retirement Insurance Program, that “of the options available — UnitedHealthcare PPO — allows members to see any doctor in the country who accepts Medicare. That’s different from most PPO plans that limit the doctors a person can see to a specific network with whom the company has a contract.”
This has been a sore subject for many who are concerned about doctor choice.
Bonneville offered this advice. “I know the original reaction from a lot of people is ‘I don’t want to do this. I’m just going to stay in (federal) Medicare. I’m going to buy my own plan. Everyone has the right to do that. The request I make to every group I’ve spoken to is at least take a moment to look at what we are sending you.”
I think that is good advice.
Other important points in the Journal story:
- “There’s no doughnut hole in the state plan,” Bonneville said. “We’ve covered the doughnut hole so you will pay your normal pharmacy co-payment from zero to $4,500.”
- The state is moving to Medicare Advantage plans for Medicare-eligible retirees and their dependents. Medicare Advantage is essentially Medicare coverage provided by private health insurance rather than the federal government. The state believes it will save more than $200 million from the switch. But the change has sparked confusion and fear among retirees because it is different from the insurance coverage they’ve known for years.
- A move to Medicare Advantage was part of the latest labor agreement between the state and the American Federation of State, County and Municipal Employees, although it covers retired state workers and teachers who were not part of the union.
- Will Lovett, who handles pension and insurance issues for the Illinois Education Association, said a lack of information about the plans earlier created confusion for retirees. He said they need to “take a deep breath and wait and see what the information looks like when we receive it from CMS. I think as information comes out about premium levels and benefit design, I think they will breathe a sigh of relief to some extent.”
- Bruce Strom, president of the Retired State Employee Association, also said a lack of information about the plans as the state was putting them in place left a lot of retirees confused and frightened. “For the average retiree, the process is viewed as very complicated and having a major effect on their lives,” Strom said. “There have been and continue to be concerns of retirees regarding what is happening to them.”