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In the City’s new Medicare Advantage Plus Program, a retiree can go to any doctor or hospital that accepts Medicare.
By Forum Staff
Mayor Bill de Blasio and Labor Relations Commissioner Renee Campion recently announced an agreement with the Municipal Labor Committee to implement the NYC Medicare Advantage Plus Program, a custom program for City retirees, beginning Jan. 1, 2022.
The agreement stems from the June 2018 Health Savings Agreement which established a Tripartite Labor Management Task Force to study ways to implement health care cost savings. Implementing the NYC Medicare Advantage Plus Program will produce approximately $600 million annually in health care cost savings for the system, according to the administration.
After consideration, City officials and the Municipal Labor Committee selected an alliance between Anthem Blue Cross and Emblem Health to provide the NYC Medicare Advantage Plus Program. This provides continuity for the majority of employees and retirees who are currently enrolled in the City’s CBP and Senior Care programs. The program is rated four stars by Medicare.
The NYC Medicare Advantage Plus Program replaces the current Senior Care program, which is a supplement to traditional Medicare, as the program that is free to all retirees. Other buy up options, including the Senior Care plan and the HIP VIP program will remain available to retirees.
The NYC Medicare Advantage Plus Program replaces both traditional Medicare and a Medicare Supplement plan with a single integrated program administered by an insurer approved by Medicare. The plan must follow Medicare rules and provide all benefits provided by Medicare. The plan will not only cover all the traditional Medicare benefits as well as the benefits covered by the Senior Care supplemental plan, but will also add some important new benefits including 24 trips to doctors’ offices, home meals delivery for patients after they are discharged from the hospital, a fitness program, a wellness rewards program and telemedicine.
In conjunction with the insurer, the City plans to have an extensive education program in the summer and early Fall that will include virtual and in person meetings, mailings and outreach calls to every one of our 250,000 retirees. Retirees will still be eligible for the reimbursement of the Medicare Part B benefit that they receive today.
A major concern for retirees is whether they can keep their current doctors and hospitals in a NYC Medicare Advantage Plus Program. In the City’s Medicare Advantage Plus Program, a retiree can go to any doctor or hospital that accepts Medicare. It doesn’t make a difference if that provider is in the insurer’s network or not. As long as the provider takes payment from Medicare, they are obligated to accept the NYC Medicare Advantage Plus Program payment. That includes all the hospitals in the NYC area, including those at Memorial Sloan-Kettering and The Hospital for Special Surgery, and almost all hospitals nationally and 99.5 percent of all doctors. The program is a national program so it covers retirees in any State in which they work or reside and when they travel.
“We know that change can be difficult, but we are confident that this will be implemented with little disruption and that the City will continue to provide high quality healthcare to its over 1.2 million active employees, retirees, and dependents,” Campion said.
