The Queens Chronicle has a very detailed article on the defeat of Mulgrewcare (Medicare Advantage Plus) in court.
Justice Lyle Frank of state Supreme Court in Manhattan ruled last week that the city could not charge retired city workers who don’t want the new Medicare Advantage Plan $191 a month for opting to keep their current Medicare plans.
Based on the court’s reading of city Administrative Code section 12-126, “so long as the respondent is giving retirees the option of staying in their current program, they may not do so by charging them the $191,” said Frank. “The city will pay the entire cost of health insurance coverage for city employees, city retirees and their dependents, not to exceed one hundred percent of the full cost of HIP-HMO.”
City Corporation Counsel Sylvia O. Hinds-Radix said the city filed a notice of appeal on March 4. “The city ... is seeking a stay at the court’s decision while that appeal is considered,” Hinds-Radix said via email. “As the city considers its options, the Medicare Advantage Plus Plan will not be implemented on April 1.”
The plan, which was negotiated by former Mayor Bill de Blasio and representatives of the city’s unions, was initially set to take effect in January but was stalled until April 1, due to legal action.
The Chronicle explains why Medicare Advantage is not a good health plan:
The city has been paying for those health insurance plans, but they were going to stop as of April 1, but the court held that you cannot discontinue paying for them,” said Jacob Gardener, the attorney representing the retirees. “Anyone who opted out of the plan was going to have to pay a $191 a month premium and no longer has to.”
The plan had a limited provider network and a prior authorization requirement, said the attorney.
“In order for them to get certain services that they need the insurance company has to approve it,” said Gardener. “It creates procedural hoops that could be denied and prior authorization has been associated with all sorts of health risks. The insurance company gets to decide whether the patient gets the services that the doctor orders.”
A retired 30-year veteran teacher of the city Department of Education who lives in Forest Hills, who wishes to remain anonymous, says that he read about at least one retiree dying while waiting for a test to be approved.
“He was waiting for a test and it took so long that he died before the approval came through,” said the source. “That was absolutely horrendous.”
The best way to avert new healthcare concessions is to vote United for Change in the upcoming UFT election. We will draw a line in the sand and say no new healthcare concessions.
Free healthcare with a choice of plans is in the UFT Contract. The city cannot offer less unless we agree to change the Contract. Reducing health benefits for retired teachers in NYS without cutting active teacher health benefits is against state law.
Why Mulgrew agrees again and again to healthcare concessions when the law and Contract are on our side leaves me scratching my head. We can do better.
I agree Medicare Advantage sucks but come on James… an anonymous source read something somewhere???? Not a credible source of info but since you agree with the messenger you lowered your so called fact checking standards. Anon2323 and others you’ve censored deserve an apology now.
ReplyDeleteWhen was the Queens Chronicle not considered a decent source? I have worked with them many times. I don't see an issue here.
DeleteOf course the city is appealing and Mulgrew will waffle again to support the city if it wins. He simply can't be trusted.
ReplyDeleteDepending on what part of the country you live in, it might be cheaper to buy a medicare supplement plan G or N than to pay the $192 for GHI Senior Care.
ReplyDeleteHi James, I was doing some online research about medigap insurance plans. New York is a guaranteed community issue state which means that you are guaranteed to be accepted without medical underwriting to medicare supplement plans at the same rate regardless of age or medical condition. If you don't like the new medicare advantage plus plan you should be able to opt out without incuring a higher rate. Thanks
ReplyDeleteAnonymous 5:20 pm.
ReplyDeleteThé NYS laws that you refer to do not cover group insurance arrangements. Ours is a NYC group plan,
Caprice 240 K
NYC law obligates reimbursement for Medicare Part B and IRMAA for all NYC municipal retirees. NYC a is stating that you MUST have an NYC health insurance plan to be eligible, although we aren’t seeing that in the law. Bottom line you will lose that reimbursement according to NYC if you go for an outside plan. That represents thousands of dollars a year. Thé US screws the elderly, as they are no longer towing the line for the overclass.
fyi, I oppose the NYC Medicare advantage plus program. I opted out last week.
ReplyDelete