Tom Curtis: Letter to retirees

From Tom Curtis, December 2, 2011

Dear STRS Retirees,

I choose to switch my insurance from AultCare to Aetna for the coming year. STRS subsequently made that change effective for me as of 12.1.11, which is the date I became eligible for Medicare. I thought that my Aetna coverage would not be effective until the beginning of 2012, but I was wrong. I received a notice from AultCare on 11.29.11 telling me my coverage with them expired on 11.30.11. Just one more surprise from STRS!

It was my understanding that if retirees chose to go to the Aetna plan, retirees were told that if "ANY" facility excepts Medicare, that they will honor their services.

Well, that is absolutely "not" true for the free fitness membership. I can only imagine when this type of situation will occur with another service I desire and/or require. STRS seems to always have exceptions to the rules as they are presented to us. Gee, does that sound familiar?

Because Aetna has now captured my/our traditional Medicare coverage, we are no longer on a traditional Medicare plan. Thus, we are restricted by whatever STRS has agreed too with that insurer.

We are not permitted to use the Silver Sneakers fitness plan that is offered through the traditional Medicare program. That is because Aetna/STRS have contracted with a subcontractor by the name of Healthway for the fitness membership and they only permit us to use the providers they have on a list.

I will not bore you with but a few more details. I have spent 3 days and 5-10 hours of time on the phone, and going to look at 3 facilities that are close to my home, all of which accept Medicare. Out of those 3, I am only permitted by our contract with Aetna/Healthways to enroll in one of those facilities. The one I am permitted to enroll in, has about 1/4th of the area and equipment that the YMCA has. The YMCA will accept the Medicare Silver Sneakers program, but because Aetna/Healthways does not accept the YMCA, I am not permitted to use that facility. Oh yeah, they are sorry for this inconvenience. Someone telling me they are sorry means absolutely nothing today.

Renee Beckum, in our STRS HC area tells me this is the only glitch in the Aetna insurance program and that no exceptions can be made. WHY do I not believe this will be the case?

I thought my anger with the management and board of the STRS had subsided. I guess I was wrong! Maybe the stress of what the STRS has put us retirees through over the past decade will cause me to have a 2nd heart attack. Why don't they get it? The stress they have placed on retirees because the board and management failed to properly fund our HCSF is making us all sick. I guess that works out for them, we die, they get to stop paying benefits.

Currently, my out-of-pocket HC costs for 2011 is in excess of $20k - over 50% of my pension. My wife is in a nursing home, due to her complications with dementia. I can no longer live within my means, due to my medical costs. This is all making me wonder if having died after my heart attack would not have been the better outcome?

Tom Curtis
Angry again.