Blog

27 Oct
0

TRS-Care Communications

Many members of the Texas Retired Teachers Association (TRTA) have contacted us regarding information that appeared in a recent The Inside Line article about opting out of TRS-Care. We have also received many calls about a letter sent out recently by TRS to all Medicare-eligible retirees who currently are not in the TRS-Care Humana Medicare Advantage Level 2 program. The letter is meant as a “guaranteed issue” letter for a participant who needs to purchase a private Medigap supplemental insurance policy. Click here to read an explanation of the letter from the TRS website.

Per the TRS website:

  • “If you’re currently enrolled in TRS-Care Standard 1, 2, or 3 or TRS-Care Medicare Advantage 3, both Federal and Texas law provide a ‘guaranteed issue’ right for individuals whose coverage (that is supplemental to Medicare) has terminated or ceased to provide benefits. TRS will provide you with a letter in October 2017 indicating that your current coverage is ending. You may be eligible to purchase a new Medigap policy without underwriting or preexisting condition exclusions anytime from the date you receive the October 2017 letter from TRS until March 4, 2018. You must provide the insurer with the letter that TRS issues to you in October 2017 in order to enroll in the Medigap policy on a guaranteed issue basis. If you don’t qualify for the guaranteed issue right or you purchase Medigap coverage after March 4, 2018, you may be denied coverage or be subject to underwriting and preexisting condition exclusions.
  • If you’re currently enrolled in the TRS-Care Medicare Advantage 2 plan, you may apply for a Medigap policy at any time. However, the Medigap insurance carrier may decline to cover you or you may be subject to underwriting and preexisting condition exclusions because the 2018 TRS-Care Medicare Advantage plan is similar to your current TRS-Care Medicare Advantage 2 and Medicare doesn’t provide for a guaranteed issue period for Medigap policies if you remain eligible for similar coverage after Jan. 1, 2018.”

Facts for Medicare-Eligible Participants

Health care is a complicated business, especially for Medicare-eligible participants. TRTA understands that many of these insurance changes are confusing, as are all the rules and regulations regarding Medicare insurance options. We want to provide as much clarity as possible. Please read a few facts TRTA has compiled regarding Medicare below.

  • TRS-Care is still a great deal for the majority of Texas retired educators. TRS-Care is a group plan with a relatively rich benefit package, and the price is reasonable when considering the level of benefits. However, as with any insurance program or changes to health care, especially when choices are being limited and costs are increasing, some retirees will look for other options for themselves and their dependents. Many choices are available for Medicare-eligible retirees, while fewer choices are available for retirees under age 65. As with any complicated purchase, please take the time to compare all the benefits and costs on an apples-to-apples basis if you decide to look for other options. Use this TRS document to help you when asking questions.
  • The rule regarding TRS-Care has always been that if you leave the program after the age of 65, you cannot re-enroll in the program. This is common practice with many group insurance plans and is meant to prevent “adverse selection.”  Adverse selection is when the healthiest and least expensive participants in a program leave to pursue less costly insurance options and participants who are less healthy and need expensive care and treatment stay in the program, causing overall program costs to rise quickly. By keeping a large, diverse group in TRS-Care, the plan is better able to provide financial stability for the group of participants as a whole.
  • If you choose to leave TRS-Care, and you are eligible for Medicare, you may need the “guaranteed issue” letter mentioned above if you choose a Medigap insurance supplement. The letter confirms that your current coverage is ending. You should not need the letter if you choose a private Medicare Advantage plan, as these have annual open enrollment periods. Again, please be very cautious when comparing benefits and costs between TRS-Care and alternative programs. Ask yourself if the deal offered in the alternative plan is worth leaving TRS-Care permanently. If you select a private insurance plan, ensure that your new plan begins on January 1, 2018 so you can maximize your current year insurance benefits.
  • If you are staying with TRS-Care, you will be auto-enrolled and sent a new insurance card in November or December of this year. TRS asks that you inform them by November 9, 2017 if you are leaving the program. This request is related to the auto-enrollment process if you are not in the TRS-Care Medicare Advantage 2 plan currentlyYou may still exit the TRS-Care program after November 9, but you may receive health care cards and mailings from TRS because of the auto-enrollment process.
  • In order to leave TRS-Care officially, you must contact them at 888.237.6762 ext. 6 and request a form to be sent to you by mail (no electronic copy is available). The form must be signed, notarized and sent back to TRS to decline the coverage and must be received before December 31, 2017 to avoid possible gaps in coverage or double-billing for insurance premiums.

TRS is attempting to make the auto-enrollment process as seamless as possible and deliver information to all affected members in a timely manner. TRTA will help facilitate information and help TRS in any way we can to provide TRTA members with answers to their most asked questions. Remember, there are still several TRS-Care seminars occurring across the state. To view the seminars schedule and to RSVP, please click this link.

TRTA is cognizant that its members have a wide-ranging interest in many subject areas, including TRS-Care and other issues such as cost-of-living-adjustments and the Windfall Elimination Provision. While many of the recent The Inside Line updates have focused on the plight of retirees affected by the TRS-Care changes, rest assured that TRTA is working to create positive change in all areas concerning retiree benefits.

Thank You

The Inside Line is a free service of TRTA, provided to you to keep you informed on current issues and events that impact your life.  If you value this service, please consider becoming a member of TRTA by clicking here. If you are already a member, thank you!

Be sure to like us on Facebook, follow us on Twitter and subscribe to our YouTube channel.

Read More
20 Oct
0

TRS-Care Seminars Underway

The Teacher Retirement System of Texas (TRS) has completed the first two weeks of seminars regarding the new TRS-Care health insurance plans. TRS has added several new meetings to the schedule. Additional meetings have been added in Austin, the Houston area, Corpus Christi, the Rio Grande Valley, Greenville, Victoria and El Paso. Many members of the Texas Retired Teachers Association (TRTA) have attended these meetings and many will attend the internet webinars.

To view the meeting schedule, including how to RSVP, please click here. This link also includes presentation materials, videos and handouts that describe the insurance changes.

TRS-Care is Still a Great Option

Many members have contacted TRTA with questions regarding enrollment processes, dates and deadlines, as well as processes related to spouses seeking insurance options outside of TRS-Care.

The TRS website has a wealth of information regarding every aspect of the TRS-Care changes and process. Many of your questions are answered in this TRS Q & A, found by clicking here. The most commonly asked questions are related to the Medicare population. Be sure to visit the link to read complete explanations to the questions below.

I am a TRS retiree with Medicare and currently participate in TRS-Care, and I want to remain in the TRS-Care plan. What do I need to do?

If you are currently in TRS-Care and plan to remain with the program, TRS will auto-enroll you in the new TRS-Care Medicare Advantage program as of January 1, 2018.

My spouse is also Medicare eligible and a TRS-Care participant and wants to retain TRS-Care coverage. What does my spouse need to do?

TRS will also auto-enroll your spouse in the new plan if they are retaining TRS-Care coverage.

What about prescriptions for the Medicare-eligible population?

All Medicare-eligible members remaining with TRS-Care will receive a new prescription card before January 1. The prescription vendor will change from Express Scripts to Silver Scripts (through CVS Caremark). If you want to know more about your prescription drug benefits, contact TRS.

Prescription Drug Coverage (Express Scripts Medicare through Dec. 31, 2017): 1-877-680-4881 (TTY Users: 1-800-716-3231)

Prescription Drug Coverage (through SilverScript beginning Jan. 1, 2018): 1-844-345-4577; Option 2

Please be patient and understand that there are many participants in this category. During the month of January, pay close attention to any prescriptions you have had and also any new prescriptions. Check to see that they are filled properly. Call the number on the new prescription card to work through any glitches as this transition takes place.

What if I choose to leave TRS-Care?

If you leave TRS-Care, you may not be able to re-enter the program if you are already age 65 or older in the future, unless you experience a special enrollment event or you turn 65 years of age. Go to the “Leaving TRS-Care” section at the bottom of this webpage to find out about documents you may need and how to obtain them from TRS.

In addition, please read this document for important questions to ask any insurance agent regarding your choice and the process.

Please use caution when comparing costs and benefits of different plans. If you make the decision to leave TRS-Care, here are the steps to take per the TRS website:

“What steps must I take in order to drop my TRS-Care coverage?

We encourage you to carefully consider your decision before leaving TRS-Care.

You aren’t required to be enrolled in TRS-Care Medicare Advantage, but it is your only medical plan option through TRS-Care if you’re eligible for Medicare. If you opt out this plan, you will be disenrolled from TRS-Care. If you don’t want to be in TRS-Care on Jan. 1, 2018, you have until Nov. 9, 2017 to opt out of your coverage by calling TRS Health and Insurance Benefits at 1-888-237-6762 (Dial Relay Texas 711), Monday – Friday 8 a.m. – 5 p.m., Central Time. If you notify TRS after that time, you’ll receive ID cards in the mail that you can disregard. You do have the option to cancel your TRS-Care coverage any time throughout the year.

Please note that you may drop your prescription coverage (TRS-Care Medicare Rx) and continue TRS-Care Medicare Advantage coverage, however, if you purchase an individual Medicare Part D prescription drug plan, you’ll be disenrolled from TRS-Care Medicare Advantage. Medicare may also make you pay a late enrollment penalty if you don’t have other creditable drug coverage.”

Thank You

The Inside Line is a free service of TRTA, provided to you to keep you informed on current issues and events that impact your life.  If you value this service, please consider becoming a member of TRTA by clicking here. If you are already a member, thank you!

Be sure to like us on Facebook, follow us on Twitter and subscribe to our YouTube channel.

Read More
13 Oct
0

Aetna Alternative Insurance Plans

The Texas Retired Teachers Association (TRTA) has partnered with Aetna Healthcare to offer TRS-Care participants and spouses alternative health insurance options. To access the alternative options, use the following:

  • Visit the Aetna/TRTA offerings website online at www.healthspire.com/TRTA.
  • Call 1.888.299.0919 (TTY: 711) between 8:00 a.m. and 6:00 p.m. local time, Monday through Friday to speak to a health plan expert who can guide you through your choices between the TRS plan or an Aetna plan. Please note, Aetna’s call center will be open this weekend.
  • This offering is available for TRTA members only. If you need to check or update your membership, please call TRTA at 1.800.880.1650.
  • If you are over 65 years old and decide to leave TRS-Care, you will not be able to return.
  • If you decide to opt out of TRS-Care retiree health insurance benefits, you will still need to inform TRS by calling 1.888.237.6762. Press #6 to get to TRS-Care.

TRS-Care is the Still the Best Option for the Money for Most Medicare-Eligible Retirees

Many TRTA members have contacted us with questions and concerns about their health care coverage. TRTA believes in TRS-Care and wants it to thrive now and in the future. TRTA works closely with the Teacher Retirement System (TRS) to ensure that TRS-Care provides the best service within its legislative funding limits. Even with recent changes, TRS-Care still offers the best benefit for the money for the majority of TRS annuitants.

However, we know that some Medicare eligible members (particularly a spouse) on the plan may opt-out of TRS-Care due to increased expense. As a result, TRTA has contracted with Aetna to provide alternatives to TRS-Care for members who find themselves looking for other options. The TRTA Aetna supplement plans are deeply discounted for TRTA members, and these discounts are only available through the Aetna call center that works with TRTA.

TRTA cannot tell you which insurance product will work best for you and your family. These decisions should be based on your personal health care and financial needs. Our partnership with Aetna will continue to honor the trust relationship we have with TRTA members and retirees across the state.

Use Caution, Take Your Time, and Take Notes

Please use caution as you explore any alternatives to TRS-Care, and make sure you know all of the consequences of leaving a group plan like TRS-Care if you choose to enter the individual health care market. Oct. 15 – Dec. 7 marks the open-enrollment period for the TRS-Care/Humana Medicare Advantage plan and all MA plans. During this time, many insurance sales people will be attempting to sell you into leaving TRS-Care.

Take your time and take notes.

  • Make sure you compare options to all the benefits of your current program, including choice of providers and prescription coverages.
  • Ask anyone who is trying to sell you a product to demonstrate how the benefits of their option may be better than the TRS-Care/Medicare Advantage plan that will be the only options after Jan. 1.
  • If you have a number of prescriptions, make sure you understand the prescription plan and how coverage gaps (the donut hole) may affect you under any plan you buy. TRS-Care/Silver Scripts RX plan does not have coverage gaps and this can be a significant difference.
  • Ask any vendor to explain to you what the timeline is for signing up for Medicare Advantage plans or supplement (Medigap) policies. Have them tell you the last day you can make a decision. Don’t let them rush you.

Our Goal

TRTA’s goal in the partnership with Aetna is to ensure that you are assessing your long-term health care needs, while communicating with knowledgeable vendors who have the ability and the experience to offer quality advice. This partnership also offers quality health care alternatives for Medicare-eligible individuals at a discount for TRTA members who have already made the decision to leave TRS-Care. TRTA’s coordination with both TRS and Aetna ensures that you will be communicating with representatives who are familiar with your current TRS-Care coverage and can answer your questions effectively.

Whether or not you choose the TRTA/Aetna alternative, you need to feel comfortable that the person selling you insurance is as concerned about your long-term health care needs as they are just selling you a policy today. If you talk to someone at the Aetna number 888-299-0919 and you have further questions, contact us here at TRTA. Our mission, our goal and our job is to represent and protect your interests. We believe that this partnership is a part of that mission, and we want to make sure it serves your interests. We will continue to be an advocate for retired educators in future legislative sessions regarding TRS-Care and health care in general.

Thank You

Thank you for your membership to TRTA. If you know a retiree who is not yet a member of TRTA, please encourage them to join.

Be sure to like us on Facebook, follow us on Twitter and subscribe to our YouTube channel.

Read More