Mayor Eric Adams officially signed an agreement Thursday sealing the deal on a new supplemental health insurance plan for retired municipal workers.
Aetna will serve as the new provider of the Medicare Advantage PPO plan for the city’s roughly 250,000 retirees and their dependents, according to the March 30 announcement from Adams and the city’s Office of Labor Relations commissioner, Renee Campion.
City retirees will be automatically enrolled in the new, premium-free Medicare Advantage plan starting Sept. 1 this year. Medicare is the federal government’s health insurance program for people who are 65 years old and above.
The Aetna Medicare plan improves upon retirees’ current plans, Adams said, as it offers a lower deductible; a cap on out-of-pocket expenses; and new benefits, including transportation, fitness programs, and wellness incentives.
The mayor further added that “he heard the concerns of retirees and has worked to significantly limit the number of procedures subject to prior authorization under this plan.”
About 99% of Medicare Advantage enrollees were enrolled in a plan that required prior authorization for some services in 2022, according to the nonprofit Kaiser Family Foundation. Under prior authorization, providers are required to obtain approval before a service or other benefit is covered by the insurance plan. Services such as chemotherapy or skilled nursing facility stays usually require prior authorization.
But requiring prior authorization could lead to delays and barriers for patients needing care, as well as their providers, according to the U.S. Department of Health and Human Services.
“Our administration has never wavered in our commitment to provide retirees and their dependents with high-quality, sustainable coverage while allowing us to rein in the skyrocketing costs of health care and the strain it is placing in our city’s budget,” Adams said in a statement.
Aetna president Dan Finke said that the health insurance company is ready to serve retirees with its network of primary care and specialty physicians, mental health care providers, and hospitals.
“We’re honored to offer a customized Medicare Advantage plan that provides high-quality, affordable, and convenient health care for City of New York retirees,” Finke said.
Municipal retirees and the City University of New York union have protested the controversial plan, pointing to concerns of increased out-of-pocket costs and reduced network providers, since 2021 under former Mayor Bill de Blasio’s administration. The then-mayor and the Municipal Labor Committee (MLC) announced the agreement to implement the Medicare Advantage Plus Program on July 14, 2021 as a way to save roughly $600 million a year in healthcare costs for the city.
Retired and active municipal workers are planning an emergency rally scheduled for this Friday, March 31 at City Hall to demand that Adams choose “Option C” in the city’s contract. Option C is an alternative that would maintain premium-free Senior Care as an option for retirees.
The organizers, Cross-Union Retirees Organizing Committee and CUNY’s Professional Staff Congress, insist that doing so will both save access to high-quality healthcare for New York City’s retirees and also save $350 million in healthcare savings for the city.
Marianne Pizzitola, president of The New York City Organization of Public Service Retirees, said the city’s municipal workers will now be forced into a privatized, managed care plan that has strict in-network, pre-authorization, and referral requirements.
“Retirees will now be faced with inhumane decisions about switching their care away from longtime doctors and healthcare providers who accept traditional Medicare, but are not in-network in the restrictive Aetna plan,” Pizzitola said.
The mayor’s signing follows the Municipal Labor Committee’s closed-door vote on March 9 of this year approving the administration’s plan to move city retirees out of the city’s Senior Care plan to the Medicare Advantage plan, which passed with a 79% majority vote.
“For months, the city has worked with the Municipal Labor Committee to diligently negotiate this contract with Aetna to provide a custom Medicare Advantage program to the city retirees,” Campion said in a statement. “We thank the MLC for their partnership throughout this process and Aetna for working with us to provide the best possible plan for New York City retirees.”
Aetna is planning to hold in-person town hall meetings starting next week in the New York metro area and in other states to answer any questions and assist with the transition.
City retirees have the option to opt out of the Aetna Medicare plan between May 1 and June 30 this year by calling Aetna or opting out online. The only other option available is the city’s HIP VIP Premier Medicare plan instead. You must live in the New York City area — Manhattan, Brooklyn, Bronx, Staten Island, Queens, Nassau, Suffolk, and Westchester counties. To opt in to the HIP VIP plan, you must complete a form found on the city’s Health Benefits Program webpage.
City retirees can visit the Aetna website here or call Aetna’s call center at 855-648-0389 (TTY: 711). To view a summary of the Aetna Medicare plan benefits, visit this page. Aetna’s call center is open Monday to Friday from 8 a.m. to 9 p.m.