NJ Cops Nov18 | Page 16

HEALTH BENEFITS REPORT Endless questions and misinformation about Medicare Advantage Since my last article advising our members about the state contract change to Aetna Medi- care Advantage, we have had hundreds of phone calls inquiring as to the ability to stay in the Hori- zon plan. Unfortunately, there is no other option for Medicare Advantage enrollment for people in the SHBP. So that our retired members understand the Medicare Advantage plan designs for SHBP re- tirees, they must first realize that these Medicare Advantage or “Part C” plans were developed ex- clusively for the state health benefits plan to fulfill all coverage requirements required by the benefits outlined in the SHBP. We are all too often hung up on the brands and not enough on the covered benefits. We need to remember that Horizon and Aetna are networks that the state essentially rents for actives and early retirees. With the Medicare Advantage plans, the network is any provider that accepts Medicare. Almost all doctors accept Medicare, and that percentage is growing, according to recent articles. With this plan, you no longer need to ask if the doctor accepts Horizon or Aetna. If they decline your insurance because it says “Aetna,” ask them to call for approval. Many retirees have asked about staying out of Medicare Ad- vantage, and you do have options. You can do nothing, in which case you will be enrolled in the Aetna Medicare Advantage plan for 2019. You stay in the old-style PPO plan — which will be a 15/25 plan that could subject you to higher copays, deductibles and coinsurance — through an application available through the SHBP web site. (If you are Chapter 330, you will be paying significantly more in premiums as well.) Unfortunately, the entities with a financial stake in your health care are trying to muddy the waters. They want you to stay in their provider network and pay higher premiums so they can make more. When your provider is more concerned with your health benefits than with your health, something is wrong. Many providers have been handing out letters protesting the changes. When was the last time they handed you a letter about wellness or healthier living? Please think wisely about your plan choices. Only you can make those decisions, and they should only be made after ed- ucating yourself. If you want your doctor to make more money, just double your copay when you see them or pay them the out- of-network coinsurance they don’t collect. That is what this is about — providers making more money by getting you to pay higher premiums. The Law Firm of Alterman & Associates, LLC Stuart J. Alterman, Esquire Arthur J. Murray, Esquire Timothy J. Prol, Esquire Proudly representing Law Enforcement and Public Safety for a combined 80 years Contract Negotiation Contract Arbitration Grievances/ Arbitration Discipline Defense Whistleblower /CEPA Hostile Work Environment Pension/Disability Appeals Criminal Defense Workers Compensation Personal Injury Human Resource Issues Civil Rights Litigation Administrative One Stop Shop for Public Safety Alterman & Associates, LLC have been an approved law firm with the PBA Legal Protection Plan since its inception. South Jersey Location North Jersey Location 8 South Maple Avenue, Marlton, NJ 08053 22 Church Street, Haledon, NJ 07508 [phone] [phone] [email protected] www.altermanandassociates.com www.NJPoliceAttorney.com www.NJCorrectionsAttorney.com 16 NEW JERSEY COPS ■ NOVEMBER 2018