Official: Opting out a way to keep Carle

Official: Opting out a way to keep Carle

URBANA — State retirees worried about losing their Carle doctors as a result of new state Medicare Advantage contracts have another choice to consider.

They can opt out of their state coverage, keep Medicare and buy a Medicare supplement plan on their own, said Linda Brookhart, executive director of the State Universities Annuitants Association.

However, Brookhart said, her advice to retirees is "sit tight" for about a week and wait for more information to make an informed choice.

The details of the Medicare Advantage plans the state will be offering haven't been disclosed, she said.

"We're sitting here with our hands tied, because we don't know what the Medicare Advantage is," she added. "I think that we actually have to see what the plan is."

The state is poised to sign contracts with four insurers — Aetna Life Insurance Co., Humana Health Plan, Humana Benefit Plan and United Healthcare — for Medicare Advantage coverage for its retirees.

Urbana-based Health Alliance Medical Plans, which currently covers about 15,000 state retirees, was one of the unsuccessful bidders.

Health Alliance said its loss of the state contract will leave 6,000 of those retirees who see Carle doctors without coverage at Carle. That's because Carle physicians don't have Medicare Advantage contracts with the state's newly selected Medicare Advantage insurers.

Brookhart said some people might want to go the easy route and take what the state is offering, but the opt-out is available and some people will find Medicare supplement plans affordable.

Health Alliance offers Medicare supplement (Medigap) plans, and Carle is in network for those plans, Health Alliance spokeswoman Kelli Anderson said.

Brookhart said there are costs to consider with all the options, and she urges weighing all of them carefully.

"They'll have to know the deductibles, out-of-pockets and co-pays, and understand if they go to a Medigap plan, they'll also be buying Medicare Part D, a pharmaceutical plan, but some of those are $18.50 a month."

The cost of the state-sponsored Medicare Advantage plans will be continuing to pay the current cost of Medicare Part B plus 1 percent of the retiree's pension benefits through June 30, 2014, and beginning July 1, 2014, the cost will rise to Medicare Part B plus 2 percent of pension benefits, according to SUAA.

Opting out of the state plan will be affordable for some, she said, but also "for some it's scary to make that determination because they've never had to make that kind of determination before. They've always been comfortable with the state, because the state has provided them good coverage. I'm not saying the state is not going to provide them with good coverage, but it may not be right for everyone."

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