Tuesday, August 07, 2007

Shirlee Zerkel to Dennis Leone re: response from Sandy Knoesel

From Shirlee Zerkel, August 7, 2007
Subject: Questions about August Health Care vote
Hello Dennis,
This is the email I received from Sandy Knoesel this morning, Thanks to your pushing them to really answer my question. It looks as if her answer is still vague, for she says it will be up to the board to vote.
I have some very great concerns about the Medicare Advantage Plan after reading articles sent to me by John Curry, my sister's experience with such a plan, and then the newsletter from SERS. SERS newsletter says that the Medicare age SERS retiree who has both Medicare A and B will automatically be put into the Advantage Plan. If they don't want it,then they will not have any SERS coverage even as a supplement. quote: "SERS will be transferring all Medicare retirees and dependents currently enrolled in the Aetna indemnity plan to the Medicare Open PFFS Plan effective January 1, 2008. All those now in the Medical Mutual Plan (MMO) will be transferred to MMO's (PFFS) plan." (The PFFS plans are the Medicare Advantage ones). Also quote: "If you do not want this coverage, then you will not have any medical or drug benefits from SERS and will only have the traditional Medicare benefits."
Dennis, I am upset by such a plan because it leaves the retiree no choice. In the beginning the private Medicare Advantage plans look good, then as the private plans continue, premiums sneak upward, coverage is less, and there surely will be in the future a list of approved providers.
Dennis,One thing to look out for as you go over the material that Sandy says you will have on Friday before the Board meeting. Look to see if they are requesting a Special Needs Medicare Advantage Plan called SNP Plan. If so, that could be even worse for the retirees! The SNP also offers drug coverage, which sounds good. The catch is that this plan, once the private provider is approved by the government, does not have any over site by the federal Medicare Program. The private company can service the retiree any way they want to. That scares me because of the situation two years ago when I helped a retiree here in Lima who had Aetna through STRS instead of Medicare A. STRS was content to let this older couple pay over $21,000 in hospital charges for 2004 when the STRS handbook for 2004 stated that out-of-pocket- max for a retiree was $1,500 per year. I pushed and pushed Mr. Russell and used their handbook to prove what was happening. Finally about 1 year later, all was resolved and it was according to the handbook. No elderly ill (Alzheimers) retiree should have to endure this kind of hassle.
Thanks for listening and please let me know if you do get the information this Friday about the health plans.
I will not be at the meeting next week as our son and family will be here from Kansas and also we have an ill family member (my sister, Donnie) who has stage 4 lymphoma.
Take care and keep you chin up,
Larry KehresMount Union Collge
Division III
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