Randi's Major Address On Public Education
On Tuesday, March 28, I’ll be delivering a major address, “In Defense of Public Education,” as the institution comes under renewed attack from extremist, culture war-peddling politicians.
We'll be livestreaming the address on Facebook and on AFT's website.
This is an opportunity to shine a spotlight on how public education provides broad-based opportunity for our children to thrive—even as now, for the first time in decades, its very existence is threatened. I’ll lay down a challenge to lawmakers to promote investment, collaboration, and family and community engagement in public schools instead of tarring them with the politics of division and hate.
We'll be livestreaming the address on Facebook and on AFT's website. I hope you'll tune in.
Get more information On the Aetna plan at our next RTC meeting
At our next general membership meeting of the UFT Retired Teachers Chapter, a representative from Aetna will make a presentation about the City of New York Aetna Medicare Advantage PPO plan. The Aetna rep and UFT President Michael Mulgrew will answer questions about the new plan from members, both in person and remote.
RTC Membership Meeting: Click here:
An Aetna presentation
April 4 2024
Date: Tuesday, April 4
Time: 12:30 P.M Vegas Time
What to expect
A representative from Aetna will give a presentation on the City of New York Aetna Medicare Advantage PPO plan.
UFT President Michael Mulgrew and the Aetna rep will answer questions about the new plan from members.
UFT Secretary LeRoy Barr and UFT Treasurer Debra Penny will bring their greetings.
As always, I will give my report. We will defer all other business to allow more time for this important information and questions about health care.
Retired Teachers Chapter Leader
Need help? We're here.
When you register, you'll have the option to attend either virtually or in person. If you choose to attend virtually, you'll receive a confirmation email with a link to join the meeting on Zoom. Use the same link to enter the meeting on the scheduled date and time. If you have any questions about this event, please call 212-331-6314.
If you would prefer to go to an in person meeting with Aetna Experts consider going to the Tuesday, April 11th meeting, starting at 10 AM located at Green Valley Ranch, 2300 Passeo Verde Parkway, Henderson, NV. You must register first and receive a confirmation.
A meeting link will be sent to your email address prior to the event and will include instructions on how to save to your calendar. Or you can call 1-855-648-0389 (TTY: 711),
Monday–Friday, 8 AM–9 PM ET to RSVP by phone.
Retiree Health Care Update for March 11
News and information for UFT retirees
More information about the new health plan
We are committed to providing you with the most up-to-date resources about the new City of New York Aetna Medicare Advantage PPO plan as it becomes available. Here is the latest information.
Register for an information session with Aetna
Aetna has scheduled webinars and in-person information sessions nationwide to give New York City retirees the chance to learn more about this plan.
Select the kind of meeting you are interested in attending to see the dates and times. Aetna will be adding more dates and locations, so check back frequently.
Register for a virtual information session »
Click here: https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&eventid=4024697&sessionid=1&key=C5F6F9C01046376CD2D450F7CE366B81&groupId=4334242&sourcepage=register&j=880617&sfmc_sub=32982334&l=222_HTML&u=18527099&mid=100022908&jb=31 .
Register for an in-person information session »
See updated comparison charts:
Go to: https://www.nyc.gov/assets/olr/downloads/pdf/health/aetna-ma-docs/plan-comparison-chart-seniorcare-hip-aetna.pdf?j=880617&sfmc_sub=32982334&l=222_HTML&u=18527101&mid=100022908&jb=31 .
The city has updated its side-by-side comparison charts to include HIP VIP Premier Medicare Advantage HMO, the only other premium-free plan that will be offered by the city. The charts now compare the Aetna plan and HIP VIP, the two remaining choices, with GHI Senior Care. Please note that only city retirees who live in the NYC metropolitan area may enroll in HIP VIP.
View the comparison chart for plan benefits »
View the comparison chart for prescription drug riders »
See our new FAQs on the UFT website, which we will update regularly as we receive more information.
Regularly check our Aetna plan info hub, where you can find up-to-date information and resources.
Click here: https://www.uft.org/your-benefits/health-benefits/retiree-benefits/aetna-medicare-advantage-ppo-faq?j=880617&sfmc_sub=32982334&l=222_HTML&u=18527103&mid=100022908&jb=31 .
Latest Retiree Health Care March 10 '23
News and information for UFT retirees:
City unions approve Aetna's new premium‑free plan
The Municipal Labor Committee, the umbrella organization representing 100-plus city labor unions, voted today to approve the new plan, which will be called the City of New York Aetna Medicare Advantage PPO plan. We said all along that any new premium-free health plan for Medicare-eligible city retirees must be as good as or better than GHI Senior Care. After months of intense, hard-fought negotiations with Aetna, we are proud to announce that the MLC achieved that goal with the creation of a fully customized Medicare Advantage plan that meets our retirees’ health care needs.
As it was just ratified, Aetna needs a few weeks to do its extensive outreach to doctors, including all those who take GHI Senior Care, to educate them about the new plan. Please wait until the end of March to call your doctor to ask if they take the plan.
Our commitment to you includes keeping track of every aspect of the plan going forward and making adjustments and improvements as needed. In our negotiations with the company, we insisted on establishing a strong system for monitoring Aetna’s performance and ensuring the company fulfills all of its commitments.
We understand that the idea of navigating a new health care plan can be daunting. We are here to support you during this transition.
When will the new plan take effect? What steps do you need to take?
The new plan is scheduled to take effect on Sept. 1, 2023. All Medicare-eligible city retirees and their eligible dependents, except those retirees enrolled in the HIP VIP Premier Medicare Plan, will be automatically enrolled in the Aetna Medicare Advantage PPO plan on Sept. 1, 2023. Before that date, you will continue to receive health care coverage from your current city health plan.
What about prescription drugs?
Aetna will also ensure a seamless transition from your current prescription plan to its Medicare Rx administered by SilverScript. If you have the Prescription Drug Rider through GHI Senior Care, you will continue with your prescription drug plan through Express Scripts until Dec. 31, 2023. You will switch to the Aetna Medicare Rx administered by SilverScript on Jan. 1, 2024.
If you are enrolled in any other plan through the City of New York and purchase the prescription drug rider through that plan, or if you currently purchase and are enrolled in an individual prescription drug plan (Part D) in the open market, you will make the transition to the SilverScript prescription plan on Sept. 1, 2023, at the same time you are enrolled in the new Aetna Medicare Advantage PPO plan.
Beginning on Sept. 1, 2023, the cost of the Aetna optional prescription drug rider will be $103.50 monthly. The cost of the rider increases to $135.50 in 2024.
Are there any other health care plans available to Medicare-eligible city retirees?
To continue receiving premium-free health care from the City of New York after Sept. 1, 2023, you must be in this new City of New York Aetna Medicare Advantage PPO plan or the HIP VIP Premier Medicare plan, which is available only to city retirees in the New York City metro area.
In his ruling in the Medicare Advantage litigation, Judge Lyle Frank interpreted the city’s current administrative code to require that any health plans the city offers retirees be premium-free, eliminating the option of pay-up plans. The UFT urged the City Council to amend the administrative code so that other health care plans like GHI Senior Care could continue to be available as pay-up plans, but the City Council did not amend the code.
Due to the high cost of providing GHI Senior Care as a premium-free option, the city has said it will no longer provide GHI Senior Care.The two remaining plans, Aetna Medicare Advantage PPO and HIP VIP Premier Medicare, are Medicare Advantage plans which have federal funding that allows the city to keep them as premium-free options.
Can I opt out of the Aetna plan?
If you do not want to be automatically enrolled in the City of New York Aetna Medicare Advantage PPO plan, you must opt out of the plan between May 1 and June 30, 2023. If you opt out of the Aetna plan, your only option to remain covered through the City of New York is to enroll in the HIP VIP Premier Medicare plan, which is available only to city retirees in the New York City metropolitan area.
Besides these two premium-free city health plans, your only other option is to opt out of City of New York health benefits to maintain traditional Medicare. If you opt out of the City of New York Health Benefits Program, your dependents will also lose their city health coverage and you will not be eligible for the city's annual Medicare Part B premium and/or IRMAA reimbursements (if applicable). If you go with traditional Medicare, you will be subject to Medicare deductibles and coinsurance, and if you wish to maintain prescription drug coverage, you will need to find a Medicare Part D drug plan. If you go this route, we strongly recommend you purchase a Medigap insurance plan to supplement traditional Medicare.
If you opt out or waive coverage but later change your mind, you will be eligible to enroll in either plan during the city’s annual retiree transfer period, which occurs every November. You can also enroll outside the transfer period if you have a qualifying event or use your once-in-a-lifetime option that the city offers.
More information about the Aetna plan:
Between now and Sept. 1, Aetna and the city will be sending extensive information about the new plan and how it works to all Medicare-eligible retirees and their doctors. We have set up an information hub on the UFT website where you can find all the relevant information, too. Aetna will also be holding dozens of in-person and virtual informational sessions about the new plan across the country in the coming months. We strongly recommend that you attend one of those meetings.
Call Aetna’s dedicated phone number for New York City retirees at 855‑648‑0389, 8 a.m. – 9 p.m. ET, Monday–Friday
From the UFT:
Regularly check our Aetna plan info hub on the UFT website, where you can find up-to-date information and resources. Right now, you can read:
Doctors and providers
Copays and out of pocket costs
Benefit Comparison Chart
Prescription Drug Comparison Chart
Please reach out to the UFT by calling our special hotline at 646‑878‑9717 or emailing HealthBenefitHelp@uftwf.org if you have questions about or need assistance with:
What's covered under the new plan
Eligibility for you and your dependents
Checking to see if your doctors are in network and/or willing to bill Aetna (and making sure Aetna reaches out to them if they aren’t set up)
Filing and appealing claims
Programs and services you might be eligible for
A Retiree Health Care Overview:
from March 5,2023
Let’s talk… out-of-pocket costs
In the proposed Aetna Medicare Advantage PPO plan, copays will either remain the same as GHI Senior Care or be eliminated altogether. In no instance will copays go up.
As part of the new plan, the Municipal Labor Committee also negotiated new benefits and services that will further reduce out-of-pocket costs related to your health care.
The MLC is scheduled to vote on Aetna’s proposed plan next week. If you have not already registered, we urge you to sign up for Monday’s RTC membership meeting, which will be both in person and virtual, so you can hear the facts about the plan and get answers to your questions.
Lower copays and deductibles
The following services will have lower out-of-pocket costs than GHI Senior Care:
An annual deductible of $150 with no Part B deductible starting in 2024. The annual deductible for 2023 will be waived for all New York City retirees since most will already have met the deductible by Sept. 1. (In GHI Senior Care, there is a $276 annual deductible – $50 for GHI and $226 for Medicare Part B.)
No copay for primary care physician office visits
No copay for radiation therapy, cardiac rehabilitation therapy or pulmonary rehabilitation therapy
No copay or annual maximum for durable medical equipment and ambulance
Preferred generic drugs for free
No copay for routine hearing and vision exams
An annual out-of-pocket maximum of $1,500 — the most you have to pay for covered services (including deductibles and copays but not prescription drugs). Once you reach that maximum, you will not have any more out-of-pocket costs for the year. GHI Senior Care had no cap.
Be sure to see the plan comparison chart.
New benefits and services
The proposed plan includes these new services and benefits:
Hearing aid reimbursement of up to $500 a year (in addition to your Welfare Fund and SHIP reimbursements)
Teladoc visits (24/7 access to doctors by phone or virtually to get medical treatment for non-emergency conditions) with no cost share
A 24-hour nurse line
Unlimited telemedicine behavioral health visits with no cost share or deductible
A free annual visit by a licensed clinician to provide a health assessment
28 free meals in up to 14 days delivered after a stay at a hospital or skilled nursing facility
24 free one-way rides each year to and from medical appointments
$120 annual allowance ($30 every three months) on health and wellness products including vitamins and over-the-counter pain relievers
Routine podiatry (with $15 copay) now covered
Let’s talk… prior authorization
Prior authorization was one of the main concerns that our retirees raised about using a Medicare Advantage plan. Your concerns were heard. We negotiated aggressively with the company to build a customized Medicare Advantage plan that significantly limits the types of procedures and services that require prior authorization.
As a result of this bargaining, prior authorization has been removed from the majority of procedures for which Aetna typically requires it. Most tests, including MRIs and CAT scans, will not require prior authorization. Prior authorization will never be required for emergency or urgently needed services.
Every two years, Aetna, the city and the Municipal Labor Committee will review its prior authorization program and will discuss whether changes are appropriate.
We urge you to sign up for Monday’s RTC membership meeting, which will be both in person and remote, to hear more about the proposed plan and get your questions answered.
What is prior authorization?
Prior authorization is a management process used by insurance companies to determine if a prescribed medical procedure or service will be covered in part or in full by the insurance company. It is meant to ensure that these products or services are medically necessary.
What procedures or services would not require prior authorization?
No prior authorization will be needed for the vast majority of services, including:
These services typically require prior authorization in Medicare Advantage plans, but don't need it in the new customized plan.
What procedures or services would need prior authorization?
You would need to get prior authorization from Aetna for the following services:
Acute hospital inpatient care (not ER)
Long-term acute care
Acute physical rehabilitation
Admission to a skilled nursing facility
Durable medical equipment
Home care services
Substance abuse treatment
Any service not covered by Medicare, including cosmetic surgery
Services that could be considered experimental and investigational in nature
Who is responsible for getting prior authorization?
Your in-network doctor, not you, is responsible for reaching out to Aetna to get prior authorization when necessary. When prior authorization is required and your in-network provider does not get the prior authorization, Aetna will hold you harmless.
Out-of-network doctors are not required to get prior authorization. However, if the services they provide are not covered under Medicare or are not medically necessary, there is a risk you will not be reimbursed for the service after Aetna reviews the claim. Like in any Medicare plan, procedures that are not covered or are not medically necessary are subject to denial. In cases that might not fit these two criteria, we strongly recommend that your doctor speak with Aetna in advance to avoid unexpected costs.
What is the timeframe for prior authorization?
Of the limited services that require prior authorization, the majority will be decided within 72 hours or less if it is a nonurgent, scheduled service. If the service or procedure is urgent, a decision will be made in one day or, in many cases, it will be granted the same day. For emergency services, prior authorization is never required.
A “safe harbor” provision
To ensure a smooth transition, for the first 120 days after the new plan takes effect, there will be no denial of any Medicare-covered services by in‑network doctors who do not submit for prior authorization. During this period, Aetna will pay these claims and send a letter to the in‑network provider and the member receiving the medical services to educate them regarding the plan's prior authorization requirements.
Look Over this Preview of what you been waiting for.
An overview of the proposed Aetna plan
It has been a long road of intense, hard-fought negotiations. We have said from the beginning that any new premium-free health plan must be as good as or better than GHI Senior Care, and this has helped us at the negotiating table ensure that the plan would be customized to address what our members need. With those criteria and parameters in place, today Aetna gave the city and the Municipal Labor Committee (MLC) a comprehensive overview of its proposed new premium-free plan for all Medicare-eligible New York City retirees.
Our commitment to you includes keeping track of every aspect of the plan going forward and making adjustments and improvements as needed. In our negotiations with the company, we insisted on a strong accountability system that establishes guardrails to ensure Aetna fulfills all of its commitments. We were able to secure systems for monitoring and evaluating Aetna’s performance, and we also developed procedures for addressing member concerns. We are committed to ensuring our members continue to get the services they need and deserve.
We are aware of and monitoring ongoing lawsuits on health care, but our responsibility to our members was to negotiate a customized plan that would fully meet their needs since the city was continuing to move forward with a Medicare Advantage plan. The 100-plus unions in the MLC will vote on the proposed plan next week. If the plan is approved, it is scheduled to take effect on Sept. 1, 2023.
Keeping your doctors
The proposed plan is a Preferred Provider Organization (PPO) plan built specifically to give members maximum choice when it comes to selecting their health care providers. Our retirees will have access to Aetna’s network of more than 1.2 million providers and 4,900 hospitals nationwide. Most importantly, this proposed plan allows you to continue to see the doctors you know and trust.
At this moment, we know that 96% of doctors who take GHI Senior Care are already either in Aetna’s network or accept payment from Aetna. Even if the doctor or the hospital you use is not in Aetna’s network, because this is a PPO plan any doctor or hospital you use that accepts Medicare will be reimbursed at the Medicare allowable rate, just like they are today, if they bill Aetna directly. You will pay the same cost, in or out of the network, and referrals are not required to see a specialist. Both Memorial Sloan Kettering and the Hospital for Special Surgery are in Aetna’s hospital network.
If we move forward, Aetna plans to take the time leading up to the plan’s start date to work with the remaining health care providers to get them to join or set up billing with Aetna so that there is no confusion come September.
We heard you loud and clear about your concerns about prior authorization. The MLC fought hard on this issue and ultimately Aetna agreed to significantly reduce the number of services requiring prior authorizations with this new plan. Services not requiring prior authorization include MRIs, CT scans, PET scans, sleep study, radiation therapy, pain management and diagnostic cardiology. Emergency services will never require prior authorizations.
Only a limited list of services requiring prior authorization remain, such as acute long-term care, acute hospital inpatient care (not ER), acute physical rehabilitation, admission to a skilled nursing facility and home care services.
More information will be provided shortly in a subsequent email.
This new plan provides more services than GHI Senior Care was able to offer us and at less cost to you. Here are highlights of the plan benefits:
A lower annual deductible than GHI Senior Care (waived in 2023).
An annual out-of-pocket maximum — the most you have to pay for covered services (including deductibles and copays but not prescription drugs) — of $1,500. Once you reach that maximum, you will not have any more out-of-pocket costs for the year.
No copays for many common services including primary care visits, radiation therapy, ambulances, durable medical equipment and Medicare Part B generic drugs.
No copays for routine hearing and vision exams
New services at no cost including:
Hearing aid reimbursement
Transportation to doctor's appointments
Delivered meals post-hospital stay
An over-the-counter allowance for wellness products
See the plan comparison chart. Go to: https://www.uft.org/sites/default/files/attachments/senior-care-vs-aetna-comparison.pdf?j=871921&sfmc_sub=32982334&l=222_HTML&u=18382606&mid=100022908&jb=7004 .
No disruption in your care or medication supply
Aetna has committed to us that there will be no interruption in your ongoing or complex care that goes beyond September 2023.
Aetna will also ensure a seamless transition from ExpressScripts to its Medicare Rx administered by SilverScript.
Members currently enrolled in GHI Senior Care will be enrolled in the Aetna plan on Sept. 1, 2023, but the switch to Aetna's prescription drug plan will not take place until Jan. 1, 2024. Members in other city plans will completely transition on Sept. 1, 2023.
Aetna also has a dedicated hotline ready to assist with any questions you may have. You will be able to go to your own pharmacy, set up mail-order deliveries or go to one of Aetna’s 65,000 participating retail pharmacies, including CVS, Walgreens, Duane Reade, Rite Aid, Shoprite and many independent pharmacies.
Carmen Alvarez Newest Addition To Las Vegas UFT Retiree Staff
If you were teaching in special education before retirement you might know Carmen Alvarez, UFT VP for special education.
With the growth of our retiree Chapter, the UFT has enlisted the assistance of Carmen, recently retired UFT VP, to support us. She has generously agreed to assist Rich Miller, UFT Retiree Coordinator, from New York City.
Many of your questions or problems that come up require answers from an expert at the UFT offices. If you have a question or need any assistance you now have another contact to lean on. She is readily available by e-mail at: Calvarez@UFT.org and by phone at: 212 598 9546. Please make note of this contact information.
With her years of leadership experience, and proximity to the UFT offices, we are indeed fortunate to have her join the leadership of our Retiree Chapter.
New Dentist Joins UFT Welfare Dental Program
If you are looking for a Dentist accepting the UFT SIDS Program under our Cigna program, take a moment to check our newest listing:
Dr. Vuong Do, DDS
Red Hills Dental
9770 S. Maryland Pkwy #8
Las Vegas, NV 89183
(next to Chase Bank)
Office Ph # 702 463-7300
Fax # 702 754 0229
Note Change Of E-mail Address For Rich
Due to hacking of the account, please note the change of address is now: firstname.lastname@example.org.
If you need to contact him, you still can call his cell# 702 287 7129 and send an e-mail: email@example.com. Please keep these contact numbers handy.