Wednesday, September 4, 2019
For now, the Runaway Train on retiree healthcare has been put on a siding - Part 5
As we have been emphasizing, the main structural difference between Medicare Advantage and a Medicare supplement plan is that with the former, the private insurance carrier decides eligibility for services, not Medicare. In contrast, with a Medicare supplement, Medicare determines eligibility and the supplement pays for certain costs that Medicare doesn't cover.
Although the notice below does not emphasize that point, it is implicit in the phase "as long as the provider accepts Medicare and is willing to bill UnitedHealthcare." The phrase means the insurance carrier will get the advantage of Medicare reimbursement rates (which tend to be lower than commercial rates) and will be subject to the eligibility policies of the private carrier.
The notice below does not yet provide information on the relative costs of the various options for participants, but it is likely that the Medicare Advantage plan will be relatively cheap. As we have noted, there is evidence that the current cheapness of such plans stems from over-reimbursement by Medicare to the private carrier (something that might go away after the upcoming 2020 election) and the carrier's control of eligibility.
Here is UC's most recent notice:
Introducing UC Medicare Choice: A new option for UC retirees in California
Tuesday, September 3, 2019
UC retirees in California will have a new Medicare plan option next year: UC Medicare Choice — a Medicare Advantage Preferred Provider Organization (MA PPO) plan administered by UnitedHealthcare®.
UC Medicare Choice will replace the Health Net Seniority Plus Medicare Advantage HMO, with lower premium costs for retirees than Health Net Seniority Plus and the ability to see any provider (both in-network and out-of-network) for the same low copay, as long as the provider accepts Medicare and is willing to bill UnitedHealthcare.
During this year’s Open Enrollment (Oct. 31- Nov. 26, 2019), retirees eligible for Medicare and UC retiree health coverage will have the option to enroll in UC Medicare Choice or in any of UC's other Medicare plans — UC Medicare PPO or UC High Option Supplement to Medicare plans (administered by Anthem) or Kaiser Permanente Senior Advantage.
If you are enrolled in Health Net Seniority Plus, you may select any of the above Medicare plans during the upcoming Open Enrollment period. If you do not take action during Open Enrollment, you will be automatically enrolled into UC Medicare Choice for 2020. If you currently cover family members who are not Medicare-eligible, they can remain in UC Blue & Gold HMO, which will be the “partner plan” for UC Medicare Choice in 2020.
The decision to offer an MA PPO plan option for UC retirees was guided by the findings of an evaluation team that included representatives from the Academic Senate, the Council of UC Emeriti Associations, the Council of UC Retiree Associations, and others. That group’s analysis determined that an MA PPO would offer a number of advantages for UC retirees while helping to keep UC’s retiree health coverage affordable and sustainable.
UC retirees: Is UC Medicare Choice right for you?
Systemwide Human Resources is working closely with UnitedHealthcare to help UC retirees make informed decisions about your benefits for next year, and to prepare those enrolling in the new plan for the transition. Here’s what retirees can expect:
Watch your mailbox in the next week or so for a letter from UC introducing you to the features of UC Medicare Choice, with answers to frequently asked questions.
Plan to attend an educational town hall meeting, scheduled from late September through October at locations across California and available online or via teleconference. You’ll receive an invitation for events near you around the middle of this month.
If you’re a current member of Health Net Seniority Plus, you’ll receive a detailed plan guide with a summary of benefits, drug list and guide to what you can expect as a new member.
For plan details, provider search, a schedule of educational town halls, and more, visit UnitedHealthcare’s website just for UC retirees: UHCRetiree.com/uc. If you’d like to speak to a UnitedHealthcare customer service representative dedicated to UC retirees, call 1-866-887-9533, Monday-Friday, 8 a.m.-8 p.m., PT.