Connect with us

Connecticut

Opinion: Good retiree healthcare coverage — a moving target

Published

on

Opinion: Good retiree healthcare coverage — a moving target


A response to Medicare or Medicare Advantage – CT employees want a choice by James W. Russell:

I agree with Russell’s frustration over the increasing privatization of Medicare. The health care eco-system, in Connectiut and nationally, is ever-changing and is now very different today than it was in 2018 when the State of Connecticut implemented a private, customized Medicare Employer Group Waiver (EGWP – pronounced “egg-whip”) plan for its’ retirees.

At that time, providers were generally accepting EGWP Medicare beneficiaries nationwide. Today, in-state and beyond, more providers are rejecting private Medicare, both EGWP plans and individual Medicare Advantage (MA) plans, for all the reasons Russell articulated – high claim denials, delayed payments, and crushing administrative requirements – plus, increasingly, extremely low provider reimbursement rates.

Unlike State of Connecticut retirees, Connecticut teacher retirees are not limited to one Medicare plan. Retired Connecticut teachers may choose between a customized EGWP plan (different from state retirees), or original Medicare with a supplement for out-of-pocket costs.

Advertisement

Only about 10% of retired teachers choose the original Medicare/supplement option. Those who do are typically older individuals with higher health care resource needs who pay dearly for what they get from original Medicare – access to most providers nationwide and for their own treating provider (not an insurance company) to determine their medical needs and amount/length of services.

There’s no perfect solution, and there are unintended consequences for every health care decision balancing access to care, quality, and cost, but the conversation about how best to achieve that balance must be continuous for state retirees, retired teachers, and for one in five state residents insured by Medicare.

In the meantime, the best answer is to fight the fights you can win against private Medicare plans.

A 2018 report by the Centers for Medicare and Medicaid (CMS) Office of the Inspector General (OIG) found that less than one-percent of Medicare beneficiaries appeal a denial, but when they do, 75% of the time, that denial is over-turned on the first appeal.

Challenging insurance companies is critical, even if you do not have the time or energy to pursue a problem yourself. Connecticut has several free insurance assistance options for Medicare beneficiaries, in addition to professional help through the Comptroller’s Office (for state retirees) or the Teacher’s Retirement Board (for retired teachers).

Advertisement

For further help with free insurance appeals, and other health insurance assistance, such as seeking exceptions to insurance company rules, contact the CT Office of the Healthcare Advocate (866) 466-4446, Healthcare.Advocate@ct.gov; or the private, non-profit law organization, the Center for Medicare Advocacy (860) 456-7790, Communications@medicareadvocacy.org.

Kathleen Holt is the Acting CT Healthcare Advocate. She is an appointed public member of the CT Teacher’s Retirement Board, Chairs the Board of Lawrence and Memorial Hospital, and was previously Associate Director of the Center for Medicare Advocacy.



Source link

Advertisement
Continue Reading
Advertisement
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Connecticut

Connecticut intelligence center monitors tips from app, potential threats

Published

on

Connecticut intelligence center monitors tips from app, potential threats


Following the recent events in New Orleans and Las Vegas, state officials say they are not aware of any current credible threat in Connecticut.

But they are constantly monitoring for any suspicious activity.

Following the deadly attack in New Orleans, we got an inside look at how the state works to help keep people safe.

Public safety deputy commissioner Brenda Bergeron gave us access to what’s known as the Connecticut Intelligence Center.

Advertisement

You can find information sharing here between different local, state, federal and private organizations for preventing and responding to possible threats.

“That is the real value of a hub because we can have something can come in on the desk or some other way through the suspicious activity reports or another way, it gets evaluated here,” Bergeron said.

Those suspicious activity reports might be coming from someone who downloads and uses the updated CT Safe Mobile app.

Recently there a surge in people alerting about drone activity.

“Sometimes it’s in response to something that may have just occurred but other times, it’s used exactly as designed. Somebody in their neighborhood noticed something out of the ordinary and wanted to report to us and give us a heads up that something didn’t seem right,” Bill Turner, State Emergency Management director, said.

Advertisement

Authorities say things to watch out for include someone who has an unusual interest in getting key details about security measures or watching them closely.

Also, discreetly using a camera to record.

And finally, trying to access rooftops or other potentially sensitive areas.

“Maybe it’s nothing at all, but maybe it’s something very significant, and there are people now who are trained to put all the pieces together to see if these red flags are an indication that something is about to happen,” Mike Lawlor, University of New Haven criminal justice professor, said.

If there is an emergency, you should still call 911.

Advertisement



Source link

Continue Reading

Connecticut

First $100,000 Cash5 jackpot winning ticket of 2025 sold in New London

Published

on

First 0,000 Cash5 jackpot winning ticket of 2025 sold in New London


Someone won the $100,000 Cash5 jackpot on Thursday night and this was the first jackpot winner of the year for the game.

The winning numbers were 3-4-6-11-25.

>Free 24/7 Connecticut news stream: Watch NBC CT wherever you are

The ticket was sold at Sully`s Mobil Mart at 382 Vauxhall St. in New London, according to the Connecticut Lottery.

Advertisement



Source link

Continue Reading

Connecticut

When could we see our next snowfall?

Published

on

When could we see our next snowfall?


We’re entering our coldest and snowiest time of the year across Connecticut, but are there any snowstorms on the way?

Our NBC Connecticut StormTracker meteorologists say Monday will be our next best chance.

We’ll get to that in a moment, but let’s take a quick glance at our January numbers first.

Advertisement

It’s one of our coldest and snowiest months of the year in the Hartford area, averaging 14 inches of snow, with highs typically around 35 degrees and lows in the upper 10s.

Our next chance of snow will be originating from the Midwest, where a large portion of the area is under a Winter Storm Watch.

Omaha, Wichita, Kansas City, St. Louis, Indianapolis and even Washington, D.C. could be in for a wallop of snow and ice. But what about us?

The chances are low at the moment. The bulk of the snowstorm is expected to pass just to our south.

All hope is not lost, however, as the northern fringe of the snowstorm could graze parts of Connecticut with a glancing blow of snow.

Advertisement

At this time, the chances of snow remain low (20 to 30%), but we’ll continue to monitor any changes to the Monday forecast.

You can get the latest forecast anytime here.



Source link

Advertisement
Continue Reading

Trending