Are you an Arizona State Retiree who gets health insurance through your retirement plan? This year the Arizona State Retirement System (ASRS) announced a change in one segment of its retiree health insurance.
ASRS has traditionally had two plans to choose from: they offered both an HMO Plan (Medicare Part C) and a Medicare Senior Supplement (Original Medicare with Part B Supplement, also called a Medigap plan). If you previously had Medicare coverage through the ASRS HMO Plan, these new changes do not affect you. If, however, you had Original Medicare with a Senior Supplement through ASRS, the 2019 changes will affect your coverage.
Both ASRS plans rely on “passive enrollment,” which is a convenient way for people to keep their current plan from year to year. This year, however, retirees who had the Senior Supplement Plan (not the HMO) were passively enrolled out of Original Medicare and into a Preferred Provider Organization (PPO) through UnitedHealthcare (the same insurer who provides coverage for the HMO beneficiaries).
The “behind the scenes” problem with this change is that retirees were not informed that by enrolling in a Medicare Advantage Plan, they would lose “guaranteed issue” to future Supplement / Medigap policies. Guaranteed issue means that you have the right to buy a policy without medical underwriting, which can lead to denials of coverage or inflated prices based on age and health conditions. Another concern is that the new lower premiums, while attractive, are due to a temporary rate adjustment, and future costs may not remain low.
How might this affect you? Both our contracted outpatient services through OASIS and our Campus Home Health program accept Original Medicare but not Advantage Plans (HMOs or PPOs), with the exception of Home Health accepting UHC community and UHC Dual Complete (AHCCCS). For example, if you are a retired teacher previously on the ASRS Senior Supplement Plan, you are now on a PPO Plan. You may have had physical therapy on campus as an outpatient, or through the campus Home Health service. Now, however, you will not be covered and will need to seek outpatient services off campus, and Home Health from an outside agency.
SHIP Medicare Counselors believe individuals can get better coverage at a better price by remaining on Original Medicare with a Supplement and Part D coverage. The new deadline to change your Medicare coverage from the new PPO to Original Medicare with a supplement is march 3rd, 2019.
If you are affected by this change, and wish to speak to a Medicare counselor about making a change, please let Josephine know no later than February 15th at x16117.
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