Giving a voice to retirees on change | Letters to the Editor
(Editor’s Note: The following letter to parties negotiating a transfer of retiree health coverage to Medicare Advantage is posted here at the request of its author.) Dear Commissioner Campion, President Nespoli and Arbitrator Scheinman: The Council of Municipal Retiree Organizations (COMRO) calls on the Municipal Labor Committee and NYC to directly and publicly address the concerns of 200,000 retirees and our 40,000 dependents about the pending proposal to move health care coverage from Medicare / Senior Care retirees at Medicare Advantage Passive PPO. Retirees affected by these proposed changes have not received adequate and timely information and have not had the opportunity to discuss vendor proposals in the context of our current plans.
This is the only way the various steward assemblies can make informed decisions about our health care today and theirs in the future.
The City and the MLC must provide all retirees in writing with a table comparing existing plans to proposed plans. The table should include the following benefits that we already have. These benefits are essential to the health and well-being of New York retirees and their dependents:
- Access to all of our current providers at existing Medicare rates even if they are not part of the provider’s network and at no additional cost to us. (Despite the assurance that any provider who accepts traditional health insurance will be reimbursed by the plan, the reverse is not true. For various reasons, some physicians are unwilling to deal with Advantage plans due to the billing and reimbursement difficulties such as non-physicians’ claims are sent to traditional CMS. Out-of-network physicians should submit claims to Medicare Advantage).
- Access to all hospitals and specialized hospitals in the country that currently accept health insurance. This is particularly relevant for patients at Memorial Sloan Kettering and the Hospital for Special Surgery.
- No custodian is authorized to assess referrals from our doctors to specialists, surgeries from our doctors, doctors’ prescriptions for CT, MRI, ancillary services and other treatment plans between the retiree and doctor. Retirees should maintain control of their own health care and not let it be dictated by an insurance company that requires prior authorization for services. We don’t have these barriers now, and we don’t want them in the future. Guardians can delay or deny our needed health care, interfere with appropriate treatment options, and can cause permanent damage and even death.
- How the City and the MLC will assess the terms of the contract and the quality of care during the term of the contract.
- Guarantees to maintain current charges for retirees.
We look forward to your detailed responses.
Advice from Municipal pensioner
Organizations New York City
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