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Home » Archive » Adams for Medicare contract, retirees demand Option C

Health

Adams for Medicare contract, retirees

demand Option C
by ARIAMA C. LONG Report for America Corps Member / Amsterdam News Staff
April 6, 2023

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Marianne Pizzitola, president of The New York City Organization of Public Service Retirees, at a city council hearing on Jan. 9
at City Hall (Contributed)

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 being forced or compelled to waive my city health benefits and by doing so
like I’m 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 .

Related

Time to Stand Up and Go

Tell It on the Mountain!
It’s time for us — Black, Indigenous,
People of Color (BIPOC) — to stop
staying back and to stand up joining
our white allies in opposing Mayor
Adams and his administration’s efforts
Retirees want NYC to say December
to transfer 19,
260,000
2022 municipal retirees City and Municipal Labor
no to Medicare Advantage (and"Op-Eds"
In our dependents) to a privately Committee shouldn’t cut
administered Medicare Advantage Plus
January 12, 2023
program that have…
retirees’ health care
In "Union Matters" January 12, 2023
In "Letter to the Editor"

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