TRTA Working to Help You!
The Texas Retired Teachers Association (TRTA) has coordinated with the Teacher Retirement System of Texas (TRS) and Aetna to assist TRS members eligible for the new TRS Medicare Advantage plan. We have heard from many of our members concerned about whether or not their doctors will take the new plan.
Some of you have experienced difficulty in determining if your doctor is in the network or have been told by your doctor(s) that they are not participating.
TRTA wants to help.
We have created a new email address that you can use to send us the names of your doctors. In order to make the process of determining which doctors are accepting the plan easier for retirees, TRS and Aetna have agreed to review the list of doctors generated through your feedback.
Please send an email to doctorcheck@trta.org that includes the name of your doctor(s), as well as his or her office phone number and office address. Please also include in the email your name and your contact information. It is important that all of this information is included in the email in order to determine accurately if your doctor is a participant.
TRTA will compile a master list and send it to TRS and Aetna. You will receive a response regarding your inquiry within one to two weeks.
TRTA is doing everything possible to answer your questions about Medicare Advantage. Please continue to contact us with your concerns. We do ask, however, that you use the doctorcheck@trta.org email only to provide us with your doctor’s information.
We continue to receive numerous emails from members who have questions about plan coverage, whether or not they qualify for the Medicare Advantage plan, and what the differences are between standard Medicare and the Advantage plan.
If you have a question about the TRS-Care Aetna Medicare Advantage plan, please send an email to plancheck@trta.org.
Utilizing these two email addresses will help TRTA better manage the vast amount of emails we receive and organize them into the appropriate categories.
We continue to encourage our members to call the Aetna customer service line at 1-866-217-2409 (TDD: 711). TRTA staff members tested the number and were able to speak with a representative in less than one minute (our customer service rep was located in the Dallas area, not out of state). If you are experiencing long hold times, please let us know and provide us with details such as the time of day.
Exciting News about Official Aetna Slides
TRTA attended the very first Aetna TRS-Care Medicare Advantage meeting a couple of weeks ago in Austin. Since then, we have been working with TRS and Aetna to provide all of our TRTA members with the presentation slides and special video used during these presentations.
We have great news. TRTA now has the slides and the video is on the way! Below is a link to the official Aetna presentation slides. In addition, there is another link to a video presentation produced by TRS featuring Mr. Brian Guthrie, TRS Executive Director. Next week, we should have the official Aetna video used during the TRS-Care Medicare Advantage seminars.
Official Aetna Medicare Advantage Video—Coming Soon!
TRTA members that have attended a seminar already can now go back and review the information at their own leisure. TRTA members preparing for an upcoming seminar can be better prepared to ask their questions.
We are very grateful to Aetna for providing these materials. Please note, while we are providing these materials now, it is still in your best interest to participate in a workshop (where they are available) or listen to an Aetna conference call.
Many TRTA members now live out-of-state, and these materials will help you receive the same information we are hearing here in Texas!
Click here for a list of the upcoming TRS/Aetna meetings, conference calls, and more (TRS website, about the middle of the page).
Aetna Response to Two Very Involved Questions
More than a few TRTA members want to know how this Medicare Advantage plan can offer a better benefit at a lower premium, and still provide savings to the TRS-Care health care plan.
Additionally, some of you have asked TRTA about a Medicare Advantage video that is circling the internet talking about how the move to MA plans is more than a political “coincidence.”
The real issue with these questions and the internet video seems to be long-term sustainability.
We asked Aetna these questions and this is their response:
Maintaining sustainable Medicare Advantage plans
How is Aetna planning to execute in areas of sustainability?
Aetna has planned and is executing actions in several areas to mitigate these funding cuts:
· Star Ratings: Focused efforts to improve performance across the spectrum of clinical, operational, and member satisfaction measures that drive star ratings and quality bonuses.
· Risk Adjustment: Focused efforts to ensure complete and accurate data that drives member-level risk adjustments to CMS revenue.
· Care Advocacy: Enhanced advocacy and programs for improved plan participant well-being, ensuring the appropriate care at the appropriate place & time, reducing costs to plan participants, their plan sponsors if applicable, and the plan.
· Provider Contracts: Collaborative, performance-based relationships coupled with analytics and data sharing to further improve cost, quality, and utilization outcomes.
· Administrative Expenses: Stable margins coupled with modest efficiency gains will drive stable loss ratios.
· Network Strategy: Continue to enhance our relationships with key, high-volume providers, utilizing our collaborative model and thereby enhance the effectiveness of care management.
Overall, we expect Aetna’s action plans to effective in limiting the impact of CMS funding cuts. This will allow Aetna to maintain stable pricing of rates and benefits, and sustain the Medicare Advantage program’s value proposition.
If the government is cutting back on how much it pays health plans for Medicare Advantage, what will happen to my Medicare Advantage plan?
We know how important it is that our members have affordable, high quality health plans. We’ve been working hard to keep our costs down. Our efforts will help keep your costs down, even if government payments don’t keep up with rising medical costs.
We’re doing a lot of different things. A few important ones are:
· First, we focus on providing you with excellent service and clinical programs. We know how important that is to you. It’s also important to the government. Plans that score well in the government’s ratings also get paid a little bit more. So you win on a few fronts. You are happier with your plan, and you get a little more value for your dollar.
· We work with you and your doctors so you get the care you need, at the right place and at the right time. We help our members understand and deal with chronic conditions like diabetes and heart disease. Our efforts are focused on helping you get the right health care, keeping you healthy, saving you money and keeping your plan costs low.
· We’re working with doctors and hospitals in new and exciting ways. We’re starting to pay more of them according to the quality of care they give – not just how many services they provide. We’re helping them use new tools to make your care more efficient and effective.
· And, of course, we’re always looking for ways to reduce our cost of doing business.
Those are just a few of the things we’re doing. We’re working to keep premiums from rising, even while the government is planning to cut back on funding for Medicare Advantage.
–End of Aetna’s response
TRTA will continue to work with TRS, the Texas Legislature, and Congress to protect your health care plans under Medicare and TRS-Care.
The next TRTA update will provide more information about a recently released TRS benefit study. Look for this update later this weekend!
As always, thank you for being a member of TRTA. Your membership matters to us, and we hope to represent YOUR voice on these issues.
If you are not a member and want to join, please contact TRTA at 1.800.880.1650.
