Shirlee Zerkel: Questions for Greg Nickell

From Shirlee Zerkel, September 8, 2009
Subject: Questions prompted by your August 31 email to me

Dear Mr. Nickell:

I have some more questions based on your answers about the Aetna Medicare Plan.

1. Who determines what medical service is covered -- Medicare, Aetna or STRS?

2. What is the STRS definition of covered services?

3. Who determines what the approved costs are for a certain service -- Medicare, Aetna or STRS?

4. If a retiree goes to a doctor who is not in the Aetna Plan, how much of the bill will be covered and can the doctor balance bill the retiree?

5. I have a question concerning the cost of this Aetna Medicare Plan. I see in the STRS information that the premium total cost is $231 (the retirees' portion plus the STRS portion). Why is that cost so high for a large group such as STRS, when some individual advantage plans with much the same benefits cost under $75 a month?
Shirlee Zerkel