State of Delaware retirees, retired Delaware teachers, as well as college and university faculty covered through the state of Delaware’s health benefits must act immediately and let their state elected officials know that the proposed move of all these retirees to a Medicare Advantage plan is unacceptable.
What are Medicare Advantage plans? In short, they represent the privatization of one of the most successful federal programs in history and it is an embarrassment that the state of Delaware wants to participate in undermining the traditional Medicare program. Unfortunately, unless you are close to retirement, you are probably unaware as to how this change might affect you. Medicare Advantage plans move you out of the traditional Medicare program and allow a private company to oversee your medical care.
This is not simply an insurance change. It is a program change into privatized medical care. Although Medicare Advantage plans tout many “extras” compared to traditional Medicare, you are giving up the rights encoded in the federal program for a contract negotiated every couple of years. What you have now may not be in the next contract. The lack of transparency in the transition process to these plans is not uncommon. New York City retirees filed a class action law suit to prevent the change and received a stay of implementation until the issue could be fully vetted.
A recent article published by the American Association of Retired Persons (AARP) shows that Medicare Advantage plans, because they have requirements for pre-authorization of services, have a 13% higher rate of denial of services than regular Medicare.
This is because the company receiving the premiums paid is both the provider of the services as well as arbiter of whether those services are to be provided. This is like a fox guarding a hen house. This fact is one of many that has triggered an U.S. Inspector General audit of some of these programs. However, as these Medicare Advantage programs continue to expand, Medicare may lack the ability to monitor these programs.
The reality is that this proposed change in benefits has not been brought before the State Legislature. These proposals have not been vetted nor discussed by the General Assembly, and most of my fellow legislators are completely unaware of this plan and its possible detrimental effect on retirees.
Here are some concrete steps that you can take now to draw attention to this issue:
- Write the governor, lieutenant governor, as well as all state representatives and state senators and protest this change. Ask them to stop the implementation of this contract for a Medicare Advantage plan for at least a year. Ask them to return all retirees to the traditional Medicare program for at least another year.
- Inform your other state retiree friends and colleagues about this issue and ask them to contact legislators as well.
- Ask to meet with your state representative and state senator about this issue.
- Set up a community meeting for state representatives and senators to meet with groups of retirees who are concerned about this issue.
- Ask your union and association representatives what they are doing to stop this from happening.
- Attend information meetings sponsored by the State Pension office and ask questions about this plan.
- Educate yourself about this issue. Read everything sent to you by the State Pension Office. Read the AARP article listed above and go to Medicare.gov and read the material posted. Search for other articles.
- Connect with the grassroots group, RiseDelaware at email@example.com to receive information and updates about this issue.
I call upon my colleagues in the State Legislature to act to ensure that this contract is shelved, and state of Delaware retirees be returned to the current Medicare plan until we have a chance to examine how this decision was made. Medicare Advantage plans are great for healthy retirees. They will fail older retirees who will need to fight battles for medical care while they are ill. We can do better for the people who served this state.
State Rep. John Kowalko
25th District, Newark