Adams for Medicare contract, retirees demand Option C
Mayor Eric Adams has officially decided to ink a five-plus year contract with Aetna to provide a Medicare Advantage plan for the city’s roughly 250,000 retirees and their dependents. The plan aims to save the city $600 million in claims, but some believe the move will cut into retirees’ established healthcare benefits.
“Our administration has never wavered in our commitment to provide retirees and their dependents with high-quality, sustainable coverage while allowing us to rein in the skyrocketing costs of healthcare and the strain it is placing on our city’s budget,” said Adams in a statement.
The mayor’s office said that the new Aetna Medicare plan will provide a lower deductible for retirees and cap out-of-pocket expenses. Additionally, the plan significantly limits the number of procedures requiring prior authorization.
The contract was approved by the Municipal Labor Committee (MLC) on March 9. This September, retirees that have Medicare will automatically be enrolled in the new plan.
President of NYC Organization of Public Service Retiree, Marianne Pizzitola, feels that this will force retired city workers into a plan they don’t want. She was advocating for the mayor to consider Option C, which allows retirees to opt out and receive traditional Medicare or medigap plan.
“It’s like I’m being forced or compelled to waive my city health benefits and by doing so I am losing my Medicare B reimbursements, in some cases my prescription plan,” said Pizzitola.
Pizzitola said that the opt out option that the city went with, HIP VIP Plan, is not available in all counties and some hospitals or doctors don’t accept the Medicare Advantage plan. She’s worried about co-pays for seniors, out-of-pocket costs, and useless perks. And she said, there are retirees with transplant or cancer treatments in facilities where Aetna is not in their network. She called the new plan “disingenuous.”
“We can help [the mayor] find wasteful spending in the city all day long but it should never be on the backs of a retired worker who’s disabled, infirm, who was made promises by the city that we would have premium free healthcare and a choice of our healthcare plan,” said Pizzitola.
She added that it’s especially disheartening considering the city workforce is primarily people of color and women of color and therefore many of its retirees are the same demographic. She said that many on a fixed income can’t pay rent or afford extra costs. “These are your ladies of color, mostly single seniors and are low-income retirees,” said Pizzitola.
Jake Gardner of Walden Macht & Haran, a lawyer who is representing the organization, explained that the public service retiree group has already filed suit against the city three times over healthcare. A little over a year ago, they challenged the city’s initial Medicare Advantage plan. The courts ruled in their favor. In 2022, they sued the city and Emblem Health for charging retirees co-pays for their senior care, which is against the law. That litigation is ongoing, but in the meantime retirees aren’t being charged.
“This is our third time in the last year and a half suing the city for their attempt to deprive elderly and disabled retirees of their healthcare rights and so this is really becoming an assault on their healthcare rights of retirees,” said Gardner.
Gardner said that the retiree group does intend to challenge this Medicare Advantage plan as well but could not reveal details at this time since the lawsuit has not been filed yet.
They are also proposing a bill that mandates a medigap plan to “protect” retirees’ healthcare. Pizzitola said if she can get the bill introduced she’ll name it after former Councilmember Mary Pinkett. In the 1970s, Pinkett championed retired civil servant and city employer healthcare coverage under the 12-126 code.
“With today’s historic award by the city of New York Office of Labor Relations, we’ll offer a customized Medicare Advantage plan that provides high-quality, affordable and convenient health care for City of New York retirees who’ve devoted their careers to serving New Yorkers,” said President of Aetna and Executive Vice President of CVS Health Dan Finke in a statement. “With nearly 60 years of Medicare expertise and experience, we stand ready to serve retirees through our network of primary care and specialty physicians, mental health providers and hospitals they know and trust.”
The contract is valued at more than $15 billion over the course of the first five years and four months. The MLC can negotiate the contract every two years.
Ariama C. Long is a Report for America corps member and writes about politics for the Amsterdam News. Your donation to match our RFA grant helps keep her writing stories like this one; please consider making a tax-deductible gift of any amount today by visiting https://bit.ly/amnews1.
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