LOCH SHELDRAKE, NY — If you retired from SUNY Sullivan and are getting Medicare Advantage through NYSHIP, college president Jay Quaintance has a suggestion that could save both you and the …
LOCH SHELDRAKE, NY — If you retired from SUNY Sullivan and are getting Medicare Advantage through NYSHIP, college president Jay Quaintance has a suggestion that could save both you and the college some money: Switch to Aetna.
“We’re offering an alternative plan to retirees,” said SUNY Sullivan President Jay Quaintance at the November 5 Sullivan County Government Services Committee meeting.
When the college first offered the Aetna plan last year, concern erupted. It was new and people seemed attached to the health plan they had and understood.
But what a difference a year makes. Many of those who switched, Quaintance said, “are very, very happy.”
There are about 55 retirees left in the college’s NYSHIP (short for the New York State Health Insurance Program) Medicare Advantage program.
This year, SUNY Sullivan is offering inducements: premiums paid for a time and health savings accounts (HRAs) funded at $2,500 for both the retiree and their spouse, Quaintance said in an interview. “We’ll be able to substantially reduce out-of-pocket expenses.”
Yep—the pandemic. Not only is the college trying to save money, but insurers are eyeing the future. They’re starting to factor in costs, especially when it comes to older people who are more likely to be hospitalized with COVID-19. While few changes are expected in 2021, according to the Centers for Medicare and Medicaid Services, costs for Medicare Advantage and Part D will go up 4.55 percent in 2022, and revenue only 2.82 percent.
Legislator Nadia Rajsz emphasized at the meeting that the Aetna plan, like the NYSHIP plan, is supplemental to Medicare, not in place of it. It’s only available to retirees from SUNY Sullivan.
“We think NYSHIP will negotiate its network differently, with more out-of-network providers,” Quaintance said then. “That’s how NYSHIP is going to balance its books.”
NYSHIP hasn’t released its plans for 2021 yet, so this is guesswork, but insurers have few ways to manage costs. Cutting back on in-network providers, aka limiting network adequacy, is one of them. (Along with raising premiums and raising co-pays.) Using an out-of-network provider means higher copays and coinsurance for the patient, but the insurance company pays out less. Of course, you can choose to travel to the nearest provider in-network. Wherever that is.
With the Aetna plan, Quaintance said, “we devised one that is identical or superior to NYSHIP’s [current] Advantage plan. Copays are significantly less.”
The college is trying to lock in premiums for two years.
The change would save the college upwards of $600,000, Quaintance said. But it’s not just benefiting the college, it’s helping retirees. “It’s a great plan,” he said.
Want more information about Medicare Advantage, the problems retirees face, and the college’s Aetna policy? Of course you do! See our Senior Living section on Thursday, November 19.
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