Shirlee Zerkel: Info from Sandy Knoesel

From Shirlee Zerkel, March 12, 2010
Subject: Fwd: Doctor office health benefits!

Dear retirees who are on the Aetna Medicare Plan:

Here is the email I sent to Ms. Knoesel and Mr. Nickel at STRS: 'I have a question about a benefit on the Aetna Medicare Plan. My Aetna card reads: Dr. $15 and Specialists $15 and your information passed out at the regional meetings stated that physicians office visits was that "the enrollee pays $15-no deductible." I am asking if there are any types of doctor office visits that the deductible applies to? Also STRS literature given to us during those regional meetings state: "Evidence of coverage-Booklet describing the plan benefits in detail- (will be received)Within 20 days after plan confirmation from CMS." Neither I nor other retirees in Allen County have ever received these benefit in detail booklets which are also our evidence of coverage. We are now 65 days into the plan. We do not have lists of vision, hearing and fitness programs. When will we be receiving this information? The deductible does not apply to any doctor office visits even chiropractors. Also I just received another email from Ms. Knoesel and she asked to tell those retirees that if they did not receive the booklet describing in detail the plan benefits to call her or email her. Her email is KnoeselS@strsoh.org

Click on the attachment to see her answer to my questions. It is of importance to all retirees on this Aetna Plan.

Shirlee Zerkel

Note, since the letter above was received, I have received another email from Ms. Knoesel asking for retirees to call or email her if they do not receive the above mentioned material. Note...the text of her email is below:

(From Sandy Knoesel): Thanks for letting me know. If they call me or send me an e-mail, I can make sure they receive the information.

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Hi, Mrs. Zerkel. We received your e-mail and needed a few days to investigate your concerns. Here is what I learned so far.

1. Aetna mailed the Evidence of Coverage booklets on Feb 8 and 9. We asked Aetna to investigate if there were any issues with the mailing that we did not know about. It will take a few days for Aetna to complete its investigation.

2. The ID cards state $15 for doctor visits and $15 for specialist (just so there is no confusion between a primary care physician and specialist since it is not uncommon for the two to have different copayments). The deductible does not apply to any office visits as questioned.

3. The Health and wellness programs-for the way you live brochure was mailed on January 25th and it goes over the vision savings snapshot, Healthways fitness program, and the Aetna Hearing discount program.

We have requested that the above mentioned documents to be mailed to you.

Sandy Knoesel