Mulgrew wrote to retirees today about the Aetna Medicare Advantage Plan. Or Mulgrew and Tom Murphy did. Or someone did, and put Murphy and Mulgrew’s names on top.*
An Overview
It has been a long road of intense, hard-fought negotiations. This is largely due to you goddamn retirees dragging our asses to court all the time. Well, we're gonna steamroll right over you, because we don't want in-service members to squawk when we raise their copays and reduce their benefits.
If you had any brains you'd have gotten cushy gigs sitting around 52 Broadway doing Whatever. Too late for that. As you know, those of us making triple your meager wages and getting two pensions can afford any damn thing we like, including standard Medicare with all the fees you'll now be stuck with, so what the hell do we care?
We have said from the beginning that any new premium-free health plan must be as good as or better than GHI Senior Care, and some of you even believed us! While that’s never gonna happen, today Aetna gave the city and the Municipal Labor Committee (MLC) a comprehensive overview of what we’re gonna vote yes for, no matter what.
Our commitment to you includes keeping track of every aspect of the plan going forward and contending it's as good as the standard Medicare you all know and love. Whenever Aetna commits an atrocity, we pledge to do all we can to keep it from you. We were able to secure systems for monitoring and evaluating noisy retirees, and we also developed procedures for suppressing member concerns. We are committed to ensuring our members continue to get whatever we give them, while cutting the budget a relatively insignificant amount for Mayor Adams.
We are aware of and monitoring ongoing lawsuits on health care, but we made a deal in 2018 to save the city money so we support the city continuing to move forward with a Medicare Advantage plan. The 100-plus unions in the MLC will vote on the proposed plan next week. Some will vote no, but screw them. When UFT and DC37 leaders rubber stamp the plan with no input from you, it will take effect on Sept. 1, 2023.
Keeping Your Doctors
The proposed plan is a Preferred Provider Organization (PPO) plan built specifically to give members the best choice they can get for the pittance we’re spending. Our retirees will have access to Aetna’s network of more than 1.2 million providers and 4,900 hospitals nationwide. They will decide what you need, within the parameters of their budget, and make big bucks for CVS to continue printing out yard-long receipts. Most importantly, this proposed plan allows you to continue to see the doctors you know and trust. Maybe.
At this moment, we know that 96% of doctors who take GHI Senior Care are already either in Aetna’s network or accept payment from Aetna. Too bad for the other four percent. You are shit outta luck.
And if you live outside the NYC area or Florida, you’re screwed because no worthwhile doctor will have even heard of this plan.
Prior Authorization
We heard you loud and clear about your concerns about prior authorization. Just like last time, we chose to ignore them. Aetna denies twice as many procedures as other providers.
Only a limited list of services requiring prior authorization remain, such as acute long-term care, acute hospital inpatient care (not ER), acute physical rehabilitation, admission to a skilled nursing facility and home care services. And hey, you’re never gonna need any of that stuff.
But if you do, tough noogies.
New Benefits
You will now have copays! The rump retirees went to court to stop them, but we're bringing them back!
An annual out-of-pocket maximum — the most you have to pay for covered services (including deductibles and copays but not prescription drugs) — of $1,500. Once you reach that maximum, you will not have any more out-of-pocket costs for the year. That's only 1500 more than zero!
No copays for many common services including primary care visits, radiation therapy, ambulances, durable medical equipment and Medicare Part B generic drugs. If Aetna deems them uncommon, too bad, pal.
No copays for routine hearing and vision exams, unless Aetna says they aren’t routine. Then, you know, screw you and the 1992 Hyundai you rode in on.
New Joe Namath-style services at no cost including:
Hearing aid reimbursement
Transportation to doctor's appointments
Delivered meals post-hospital stay
An over-the-counter allowance for wellness products
No disruption in your care or medical supply
Aetna has committed to us that there will be no interruption in your ongoing or complex care that goes beyond September 2023. And we believe everything they say, because they're a great company, Just ask the slaveowners who insured their human chattel with them.
Aetna will also ensure a seamless transition from ExpressScripts to its Medicare Rx administered by SilverScript. So if you like Express Scripts, too bad for you. We're all about choices and making them for you whether you like it or not.
Aetna also has a dedicated hotline ready to assist with any questions you may have. You will be able to sit on hold and wait until they direct you to CVS, which owns them, us, and now, you.
Keeping You Informed
Again, what Aetna presented today was its proposed plan, which the MLC will vote on next week. We will vote yes no matter what the frigging thing actually says.
If you have not already registered, we urge you to attend the upcoming RTC membership meeting, either virtually or in person, on Monday, March 6, so you can hear the facts about the plan and get answers to your questions. But if you’re a troublemaker or rabble-rouser, stay home because we’ll mute, insult and ignore you anyway.
That will be all, dues-payers.
*Introductory note from Jonathan Halabi
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