July 11, 2023

Brian Lehrer (WNYC) needs to do better

Granted this move to shove all of us retirees into Medicare Advantage is a huge topic, but if you’re going to bother to do a half hour on the temporary hold, please try harder next time.

Lehrer started yesterday’s segment with a sentence filled with disinformation:

“NYC government retirees – 250,000 of them about – have been bracing for, if not dreading, a major change in health care coverage from traditional Medicare with supplemental coverage paid for by the city to a privatized Medicare Advantage plan run by Aetna.”


Not all 250,000 retirees have been “bracing for” or “dreading” this major change, because not all of them have a “traditional Medicare with supplemental coverage” at this time. Just the ones in Senior Care, who don’t want to lose this arrangement where the city picks up the cost of a Medicare supplement and they can stay out of Medicare Advantage. The class action lawsuit says there are 183,000 retirees that have Senior Care, which leaves 67,000 who don’t.

The city actually offers at least seven plans to retirees living in the metro area, and other plans for people who live elsewhere. In the new arrangement, people in one of these, Emblem HIP VIP Premier, would have been allowed to keep it. 

The Emblem plan is already an Advantage plan, the most restrictive kind because it’s an HMO. I’m sure tens of thousands of people are currently enrolled in it, since it’s been around longer than the decade I’ve been retired. Maybe they’re in it because they had a version of it when they were working and didn’t want to change anything once they moved into retirement. Maybe they’ve kept it because Emblem is a private company and not publicly traded like Aetna, relying on its reputation as a non-profit insurer. In any case, I don’t think any of these retirees are doing any “dreading” or “bracing.” They seem to be getting the care they need.*  
*Saying that, I have friends who switched to Senior Care because a specialist they wanted was not not taking the Emblem plan. So, it’s not that these people got delayed or denied service, but they didn’t want the restrictions in choosing a provider or facility and preempted the situation.

The instructions for the July 10th deadline said do nothing if you wanted to keep your Emblem HMO and only let them know if you wanted to switch into the new Aetna PPO. 

Lehrer mentioned that only 1,600 retirees had opted out as of last week, but he did not tell us how many people chose to keep the Emblem HMO they have. Nor did the reporter on the show (Caroline Lewis) correct him, to clarify that a fair percentage don’t have Senior Care, but the Emblem plan. This omission skews the whole issue, because I suspect the thousands who decided to keep the HMO are either happy with it, or didn’t trust the transition to the new Aetna, or were just taking a “wait and see” position until November, when they’d have another chance to make a coverage change. 

Reporting on only part of the whole scenario is kind of like malpractice. The show made it seem like the all the city retirees are in same class action, whereas it’s only the ones who are losing Senior Care. As for the others who have the Emblem HMO, nobody is telling us how many of those people decided to keep what they have. That’s just bad reporting.

There was also some confusion relating to the cost of Medicare and supplements people would have to buy if they opted out. 

Responding to Lehrer’s question “What’s the cost for those additional city health benefits” if people do opt out, Ms Lewis must have just misunderstood the question: 

“Paying for the premium for Medicare Part B on your own and not having it through the city I think starts at around $165 and goes up depending on your income ... people might want to pay for a Medigap plan ...”

He was asking her about the cost of the “additional” benefits, meaning the ones Senior Care gives you, not Part B. Part A is free for most everyone, and she's right that there's a premium of around $165/month for Part B, more when income is higher. It's paid to Social Security and city retirees get that reimbursed if they remain inside the city system. But Lehrer wasn't asking about Part B, he was asking about the "additional" coverage they'd have to get if they were to opt out.

This almost obligatory extra coverage is not something that "people might want to pay for," as Ms Lewis says, but something they'd be a fool if they chose not to. Medicare leaves so many costs on the table that you need to have supplementary coverage, which can come through a Medigap, resembling Senior Care. There are 10 different kinds of these in the open market, with several companies in each zipcode competing for your business. Checking the plan finder at the NYS Dept of Finance for this month's choices in the metro, they range in price from the most comprehensive, never-see-a-bill type at $332/month to a high-deductible kind at around $68/month. (People could also supplement Parts A and B through a premium-free Advantage plan, but why would they want to do that when the city is offering Aetna PPO at no cost. That would be utterly stupid.)

Admittedly the subject is turgid and inscrutable, but the questions and answers on this program showed neither the interviewer or the reporter was up to the task.  So disappointing.

No comments:

Post a Comment