HEALTH BENEFITS UPDATE
The truth about switching to the
Medicare Advantage PPO
There have been a myriad of rumors circulating about the switch to the Medicare Advantage PPO for post-65 retirees in the State
Health Benefits Plan that are nothing less than
inaccurate. Please take note of the information
in this article to understand the changes.
It is important to first understand that this
switch cannot take away any benefit or provider that you currently enjoy. This was memorialized in the resolution that was passed by the
design committee after the Commission voted
to change the contracts for post-65 retirees to
the Medicare Advantage PPO. This is one of the reasons we felt
compelled to insure that there were to be no change in benefit
levels.
The Medicare Advantage PPO is designed to mimic the Direct and Freedom plans. If there is a service that Medicare
does not provide that was previously enjoyed, then the Medicare Advantage portion of the plan will cover that service so
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that your level of benefits is maintained.
If you are currently in the Horizon Direct Plan, then you
should have received information about the plan as well as
educational sessions that are being held throughout the state.
The PBA encourages you to attend one of these sessions so
you can ask questions directly and have your personal concerns addressed by the company directly.
If you are currently in Aetna and are older than 65, there will
be no change as Medicare retirees have been in this type of
plan for several years.
The important thing to remember is that this is not a runof-the-mill Medicare Advantage plan. This was specially designed for members of the State Health Benefits Plan in the 10
and 15 PPO plans. There is no change to present benefits and,
in actuality, the network has been expanded to all doctors that
accept Medicare in addition to your current network.
Please monitor the State Health Benefits website for more
information. d