In the latest move surrounding the motion to block New York City’s plan to move MA plans of retirees to the new Aetna’s MA PPO (Preferred Provider Organization) plan, a Manhattan judge has issued a preliminary injunction blocking the city’s controversial move!
This divisive dispute over the NYC retirees’ new health plan is a complex concern with a future that is still uncertain, irrespective of the temporary but much-needed victory for retirees.
Let us give you a breakdown of what is happening with NYC retirees’ health plans, why it is so controversial, and how it all began.
Need to know: The NYC retirees’ health plans
Before we begin to dissect the controversial move where the city of New York was in a tug of war with the retirees over the new MA plan, let us look at the existing Medicare Advantage health plan for retirees in New York!
Medicare Advantage plan
The City of New York offers its Medicare-eligible retirees and their eligible dependents the existing health insurance plan. It is also known as the plan is Medicare Advantage plan, which means that it is a private health insurance plan that contracts with Medicare to provide benefits to Medicare beneficiaries.
The benefits of the existing MA plans include:
- Hospitalization: The plan covers hospitalization, including semi-private room and board, meals, general nursing care, and other hospital services.
- Medical care: The plan covers doctor’s visits, preventive maintenance, prescription drugs, and other medical services.
- Dental care: MA plans also cover preventive and primary dental services, helping beneficiaries maintain oral hygiene.
- Vision care: MA prioritizes vision health and covers preventive vision care and some simple vision services, such as routine eye exams and corrective eyewear.
If you did not know, retirees living in home care, assisted living, and nursing homes specifically can take full advantage of the Medicare Advantage plans, as it helps with their activities of daily living.
The proposed Aetna’s MA PPO plan
The proposed Aetna MA PPO plan differs from the previous MA plan in two significant ways. Firstly, enrollees must use in-network providers, ensuring coverage only with network medical providers. Secondly, the MA PPO plan has higher premiums due to its more comprehensive coverage compared to the previous MA plan.
So what is the commotion? Well, retirees fear that the new MA PPO plan will reduce their choice of providers and increase their costs (especially those on a fixed income) due to higher premiums.
How did it start?
In 2022, the city of New York unveiled its proposal to transition Medicare-eligible retirees to Aetna’s MA PPO plan. Aetna is a health insurance company that offers a variety of health plans, including Medicare Advantage plans.
The city’s Department of Health and Mental Hygiene initiated the proposal. The plan requires retirees to use in-network providers and impose limitations on their out-of-pocket costs. The controversy began because of the following:
1. Retiree concerns
Retirees voiced worries about reduced provider options and increased expenses. They claimed that the city needed to effectively involve them in decision-making before opting for the new MA PPO plan.
2. City’s justification
The city continued to defend its decision, citing various cost savings goals and improved care quality as the primary motives.
What is happening with NYC retirees’ health plan?
The city of New York proposed moving its Medicare-eligible retirees to a new Medicare Advantage (MA) PPO plan under Aetna on May 31, 2022. This move for transition left retirees worried about reduced provider options and increased costs (under a higher premium), while the city defended the plan, quoting cost savings and improved care quality.
In December 2022, the plan’s implementation was delayed until September 2023 to address retiree concerns. However, in 2034, a Manhattan judge issued a preliminary ruling blocking the plan.
As a retiree in the NY region, we at BoomersHub advise you to take a look at the following articles to help with future finances!
- Financial strategy: 401k to self-directed IRA
- Nest egg plan for the future
- Always save for retirement
- How to protect assets from nursing home
Latest NYC retirees health plan update
As of the latest development, on July 7, 2023, a Manhattan judge issued a preliminary order blocking the city’s move to move retirees to a new MA plan. This victory has granted retirees more time to evaluate and decide whether to opt out of the city’s plan. The judge’s ruling was based on the retirees’ strong claims that the program violated the city’s agreement and would cause long-term financial harm.
While the city is appealing the decision in court, retirees now have greater control over their healthcare, at least for now. The future of the NYC retiree health design remains uncertain, pending the outcome of the appeal by the city.
In the end, the people won the battle against the city regarding sticking to their existing Medicare Advantage plan. However, the impending atmosphere surrounding the controversial move is uncertain, as the city is appealing the court’s decision.
The future of Medicare and Medicare Advantage begs a bigger question: how will we control costs as the population ages? New York may only be the beginning, and who knows what domino effect it has tipped off already!
1. The controversial decision to shift retirees to the new MA plan began in 2022
2. The city of New York is facing a legal challenge to its plan to move its Medicare-eligible retirees to a new Aetna MA PPO plan.
3. The retirees who are affected by the plan are worried that it will reduce their choice of providers and increase their costs.
4. A Manhattan judge has issued a preliminary sanction blocking the city’s move.
5. The city of New York is now appealing the decision in court.
As you ponder the future of retirees, why take a look at the following articles we think you may enjoy and find helpful?
What is happening with NYC retirees’ health plan 2023?
The city’s plan to move retirees to a new MA PPO plan has been temporarily blocked by a Manhattan judge. The decision to move was initiated back in 2022, and since then, it has caused controversy among the retirement industry, particularly older adults residing in New York!
Did NYC retirees sue over Medicare Advantage?
Yes, a group of NYC retirees sued the city over its plan to move them to a new MA plan. The lawsuit argues that the plan would violate the city’s agreement and would harm retirees in the long run because of the limited choice of healthcare providers and higher premiums. This is due to most of the retirees being on a fixed income.
What was the court ruling on NYC Medicare Advantage?
A Manhattan judge has issued a preliminary ruling that blocks the city’s plan to move retirees to a new MA plan. Supreme Court Justice Lyle Frank ruled that the retirees had a strong prospect of success on their claims and that the city’s plan would cause lasting harm to retirees.
What is the retiree’s lawsuit against NYC?
The retirees’ lawsuit argues that the city’s plan to move them to a new MA plan violates the city’s charter. The lawsuit by the retirees and the union through which they initiated the charge also argues that the plan is arbitrary and unreliable and that the city did not sufficiently consider the impact on the lives of retirees.