MAPs are just another way that corporate entities get to fleece one of the country's service sectors.
Think charter schools.
But it’s not a bad idea to remember that most workers don’t get employer retiree coverage at all. Freelancers are also out there on their own.
So who do these people turn to when they have to navigate this minefield of a health care system just when they’re entering the most vulnerable decades of their lives. It's one hot mess of corporate and political interests out there, much of it directed at survival of the fittest.
Social Services mostly don’t have time for any but the lowest incomes. Brokers are of course always looking for your business, and a few communities may actually have some volunteer counselors. The bravest among us will turn to the online plan finders to search for available health plans on their own (you can find them at Medicare.gov and NYS). You need a tutorial and some real patience with all that. All of this to figure out something that matches your current pocketbook and your projected needs. It's the country's self-inflicted form of Russian roulette.
Putting our situation into perspective, Kaiser FF reported that last year that only 13% of large employers (with 200+ workers) were actually offering retiree health coverage at all. Half of that group gave their people Advantage plans, and 44% of that subgroup didn't let them choose between MAP and non-MAP coverage.
Currently the dozen or so plans we've been able to choose from are a mix of HMOs, PPOs and supplemental arrangements like GHI Senior Care (they're listed here on the OLR website). So come September 1st, NYC will be one of the few large employers offering retiree coverage at all, and if they clear the court challenges, they’ll be limiting the choice to a couple of Advantage plans and offering no non-MAP alternative at all. Check those three Kaiser boxes.
More data from Kaiser shows that retiree health plans are more likely to be offered by companies with over a 1000 workers, that they're public employers (63% offer retiree coverage), that they belong to certain industries (government being one of them), and they’re unionized. 88% of these extend coverage to spouses as well. We here in the municipal unions can tick all these boxes too.
I guess you could say we’re lucky – especially since they're reimbursing our Part B premium (including the IRMAA surcharge when our incomes are high enough to get these), refunding us some extra things through SHIP, and keeping up some financially beneficial Welfare Fund arrangements (e.g., dental plans, reasonable drug costs). Few American retirees get what we get.
Yet, I'm still against Medicare Advantage, which has been around under different names since Medicare became law in 1965. That’s because Medicare’s original design was imperfect and people really needed help with the leftover costs, like deductibles and the 20% of Part B we have to pay for ourselves. Private companies stepped into that void pretty quickly, and there they were again in 2006 lobbying their corporate heads off to control the whole of the newly created Part D.
As long as lobbyists and legislators block changes to the tax structure that might get everyone in this country access to the health care they need no matter where they live, work, retire or breathe, this is the system we got.
I’ve been doing Medicare work for almost a decade and am amazed at the new structures corporations have been allowed to design and push through Congress just to keep single-payer from ever happening in this country. How many of these things do you actually recognize?
Accountable Care Organization
Direct Contracting
ACO Reach
Medicare Shared Savings Program
Pharmacy Benefit Managers
etc.
I could go on, but it’s giving me agita. As laymen, we won't be understanding any of these schemes any time soon, but these guys are working overtime to get at our cash reserves.
So best of luck with the lawsuit. The juggernaut has been heading right at us for years, and I hate to say it, but at this point we gotta jump on board or get run over.
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