To Opt Out or to Not Opt Out

September 1, 2023 most Medicare-eligible UFT retirees are scheduled to be switched to CVS/Aetna, unless they choose to opt out. How do we decide?

There is a cost. ‘Opting out’ means waiving NYC health benefits. We would lose reimbursements. We would lose coverage for dependents.

There is a benefit. ‘Opting out’ means we chose a traditional Medicare plan (but Medigap would cost).

And there is a risk to some members for NOT opting out. Retirees who live in New York, Connecticut, Massachusetts, and Maine are assured they can return from Medicare Advantage and buy a Medigap plan. But retirees in the other 46 states do not have the right of return.

There are reasons to opt out. Unity supporters, including retired UFT officers, testified in front of the City Council about not wanting to go onto a Medicare Advantage program. There are concerns about Aetna.

Questions

The Professional Staff Congress (CUNY’s AFT affiliate) shared with its membership things to consider as they make the difficult choice. Will the UFT leadership publish a guide to members to help us choose whether or not to opt out?

The opt out period opens today, May 1, and closes June 30. But much information (including about doctors) is not yet available. Will the UFT leadership push to delay and extend the opt out period to allow more time for information to get out? Today there is no opt out form on the Office of Labor Relations website. Will the UFT leadership demand that the opt out form be on the OLR website?

We have heard that there are very few prior authorizations. But what are they? What is the complete list of prior authorizations required by the Aetna Medicare Advantage plan?

Most doctors and hospitals are agreeing to accept CVS/Aetna. But some are not. Which doctors and hospitals and hospital networks are saying no to Aetna? Please share what you know.

Why is “Silverscripts” Aetna drug plan $135/month – more than Aetna charges the general public?

Some doctors are telling members that the member will need to pay up front, then try to get money from Aetna (like happens to some of us with Cigna, for dental). But none of the CVS/Aetna presentations has mentioned paying up front. Who is telling the truth – the doctors or Aetna?

Will Mulgrew and the UFT leadership provide needed information… Will they:

  • Produce a guide to help Medicare-eligible UFT retirees decide whether or not to opt out?
  • Push the Office of Labor Relations to delay and extend the opt out period?
  • Demand that OLR place an opt out form on its website?
  • Share the list of prior authorizations?
  • Share the list of doctors and hospitals who announced they will not take CONY PPO (Aetna)?
  • Explain why Aetna plans on charging UFT retirees so much for drugs?
  • Explain under what circumstances will members have to pay their doctors up front?

Or will they continue selling this plan like used car salesmen?


Be the first to comment

Please check your e-mail for a link to activate your account.