New York

Retired city workers recoil with a cost-cutting Medicare shift

This article was published in partnership with New York Focus, an independent research news site covering New York state and city politics.Sign up for their newsletter Here..


Nearly 250,000 retired New York City employees and their spouses have “health insurance”Medicare AdvantagePlans to be managed by a private insurance company as soon as New York Focus learns on July 1.

Retirees who are pushing to delay the switch say they are worried that switching from the current Medicare plan could lead to dramatically higher out-of-pocket costs and a smaller network of providers.

“It’s a little scary,” said retired city administrator Jayne Loader. “The word on the street is that these advantage plans are currently receiving chemotherapy, radiation therapy, IV therapy, or skilled nursing for my friends, unless they get sick.”

The proposed switch continues in June 2018 Agreement Between the City Labor Relations Commission, a group representing retired employees in New York City, and the City’s Labor Relations Department.

Under the agreement, both sides have agreed to reduce retiree health care costs by $ 600 million annually compared to the 2018 forecast starting in 2021. The switch to Medicare Vantage, also known as Medicare Apartment C, was one of the eight possibilities proposed at the time.

Under Medicare Advantage, the city predicts that it will save that amount by paying a private insurer to manage the Medicare plan. Documents reviewed by New York Focus Transactions are being negotiated between the city trying to manage insurance and a private insurance company.

The city is currently reimbursing retirees for the cost of Medicare Apartment B insurance, which covers outpatient care.MedigapPlans to insure services that are not covered by traditional Medicare.

Medicare Advantage premiums are often Lower than traditional MedicareHowever, there are trade-offs that can affect the health and finances of retirees. As the network gets smaller and the out-of-pocket costs increase, Naomi Zewde, a professor of public health at CUNY, a fellow at the Roosevelt Institute, said.

“The city is trying to save money by getting older people to pay more for medical care,” Zewde said. “These are the people who worked their entire career with the promise of good health care later.”

There are few doctors

City retirees are now Majority Of a doctor in New York. Medicare Advantage plans generally have fewer options. Research On average, the Medicare Advantage Plan provided access to only 40% of Queens physicians, according to a Kaiser Foundation study.

Contract-related documents published by the city’s Labor Relations Department suggest that the potential out-of-pocket costs per retiree could increase by as much as $ 6,000 per year. Such costs are currently limited to $ 1,053 per year, according to retired CUNY professor and health policy expert Len Rodberg, who will be affected by potential changes.

Len Rodberg, a retiree from CUNY.
Sammelins / New York Focus

According to the document, the annual out-of-pocket cost can reach over $ 7,000 for an individual. Maximum value allowed by Medicare under the law..

“Basic city workers from $ 30,000 to $ 50,000 [salary] Scope, their social security payments are smaller and their pensions are smaller. They will be hit badly by this, “Rodberg said.

Some budget watchdogs have Highlighting Make medical savings for retirees as needed to curb annual city benefit spending of $ 2.2 billion.

“Savings on medical costs is important. Because of the rate at which these costs increase, they are essential for putting the city on a solid financial base,” said the Financially Conservative Civil Budget Commission’s Urban Studies. Said Anna Champeny, director of the company. “It’s important to reach an agreement on how to manage costs and reduce medical costs for retirees.”

However, retiree advocates say the deal for the work is too expensive for members to pay.

“Somehow you’re going to save $ 600 million and 200,000 Medicare retiree beneficiaries will somehow not get worse and maybe even better service?” City retirees? Stuart Ever, chairman of the Organization Council, said.

“People don’t know”

The city’s Labor Department said it had received eight proposals for the Medicare Advantage program, now narrowed down to two finalists (Aetna and Empire BlueCross BlueShield), and several retirees were notified by the union.

Cost-cutting employers have been drawn to Medicare Advantage, which was founded in 1997 under then-President Bill Clinton. As of 2018 39% Among the Medicare recipients in New York, I was enrolled in the Medicare Advantage Plan.

Triciano Iman, Secretary-General of the Kaiser Family Foundation’s Medicare Policy Program, said: “It’s not just New York.”

Neumann states that the Medicare Advantage plan relies on a list of doctors in the network. “They are more likely to have more restricted provider networks than traditional Medicare in combination with the Medicare policy,” Neumann said.

Some union officials have tried to obtain information about future access to services such as lab tests and rehab facilities, but with little success.

“We haven’t got a concrete answer to these questions, and I’m not familiar with the negotiations, so I don’t know it’s a problem,” said Neil Framkin, a retiree leader at DC37 in the city. The largest civil service union.

“There are few services”

To achieve the $ 600 million savings, certain procedures must require pre-approval from the insurer. “That would potentially mean less service that would be covered by the plan,” Neumann said.

More than half According to Kaiser’s analysis, Medicare Advantage participants are enrolled in plans that require pre-approval for ambulance rides, mental health services, hospitalization, and other services.

CUNY retirees are mobilizing against the Medicare Advantage shift, at least until the details are revealed. At the end of the meeting on April 5, more than 93% of attendees Request a moratoriumRegarding the details of the proposed changes, the retiree said, “We have not been provided with appropriate and timely information.”

None of the unions represented by the officers of the City Labor Relations Commission responded to requests for comment, nor did the City Labor Relations Bureau respond. They include the American Federation of Teachers, the Unified Health Supervisors Association, DC 37, the City Staff Union, the School Supervisors and Administrators Council.

Frumkin said DC37’s president and City Labor Relations Commission co-chair Henry Garrido have expressed support for the changes proposed at the union’s March board meeting.

“Galid’s position is that it must be done because it needs savings to stabilize the health benefits of New York City as a whole. The city must be able to afford to do what they are doing. No, “Frumkin said.

“Galid’s claim is that the city is in a financially dangerous place, so we’re trying to come up with savings to overcome this financial problem they have.”

Retired city workers recoil with a cost-cutting Medicare shift

Source link Retired city workers recoil with a cost-cutting Medicare shift

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