Health Insurance Update
Click on TRIP/TRAIL Information above for the latest information on the change to Aetna.
More Information About Changes to TRAIL
Dave Davison’s previous email sent to you by WCRTA regarding the decision of the Illinois CMS to change our health insurance carrier from United Health Care to Aetna came as a surprise to some of our members. Below, Dave shares additional information about that change provided by our parent organization, IRTA. It is long, but well-worth the read.
The decision to change TRAIL insurance providers was made in Springfield by Central Management Services (CMS). It is function of the Governor’s Office. CMS provides the following explanation of why the change was made and the process involved in making the decision of what insurance program to use:
Why Are We Changing Providers?
On December 31, 2022, the current MAPD contracts will expire. Because of this, the State of Illinois was legally required to enter a request for proposal (RFP) process. During this process, we reviewed all the documents provided by each bidder, and found that Aetna offered the richest, low-cost plan, tailored to the needs of you—our retirees. Several factors contributed to our decision to change MAPD providers: • The Aetna MAPD PPO Plan offers lower premiums for coverage—saving both you and the State of Illinois money. In other words, you’ll pay lower monthly contributions for coverage. You’ll see these lower costs in your Open Enrollment Decision Guide. • In addition, the Aetna MAPD PPO Plan has been designed specifically for State of Illinois retirees—offering another wellness benefit. This new plan will offer wellness programs, through Be Well Illinois and SilverSneakers.
The decision was not made by the Winnebago County Retired Teachers Association nor the Illinois Retired Teachers Association. WCRTA agrees that it would be better to not have to go through the process of changing. We all wonder what we are getting into. Many people are bound to be concerned. The email I put out was designed to alleviate some of the concern while emphasizing neither IRTA nor WCRTA knows for sure at this time if the change will ultimately be good or bad. It would be much better if we did not have to be worried about it.
The Illinois Retired Teachers Association (IRTA) forwarded the following message from CMS to its members. If you are a member of IRTA, you should already have received this. IRTA is putting out a lot of information to try to help its members with this change. I hope the information I’ve provided is helpful.
David Davison
Dear TRAIL Participant: September 2022
Beginning January 1, 2023, your new medical and prescription drug plan will be the Aetna Medicare Advantage Prescription Drug (MAPD) PPO Plan. This new plan will replace your current plan, whether you’re currently enrolled in the UnitedHealthcare MAPD Plan or one of the MAPD HMO Plans (Aetna, Health Alliance or Humana). While your carrier for medical and prescription drug coverage is changing, your dental carrier—Delta Dental—and vision carrier—EyeMed, if applicable, will remain the same.
No action is required unless you want to opt out of the Aetna MAPD PPO Plan. If you and your Medicare-eligible dependent(s) are currently covered under the UnitedHealthcare MAPD Plan or a MAPD HMO Plan, you and your Medicare-eligible dependent(s) will be automatically enrolled in the Aetna MAPD PPO Plan with coverage beginning January 1, 2023.
Why Are We Changing Providers?
On December 31, 2022, the current MAPD contracts will expire. Because of this, the State of Illinois was legally required to enter a request for proposal (RFP) process. During this process, we reviewed all the documents provided by each bidder, and found that Aetna offered the richest, low-cost plan, tailored to the needs of you—our retirees.
Several factors contributed to our decision to change MAPD providers:
• The Aetna MAPD PPO Plan offers lower premiums for coverage—saving both you and the State of Illinois money. In other words, you’ll pay lower monthly contributions for coverage. You’ll see these lower costs in your Open Enrollment Decision Guide.
• In addition, the Aetna MAPD PPO Plan has been designed specifically for State of Illinois retirees—offering another wellness benefit. This new plan will offer wellness programs, through Be Well Illinois and SilverSneakers.
How Will the Plan Change?
Before making this decision, the State of Illinois compared all requests for proposal. We found that with the Aetna MAPD PPO Plan, there should be little to no disruption with your current providers:
• It’s unlikely you’ll have to change providers under the new the Aetna MAPD PPO Plan. You’ll be able to use any doctor, hospital, or specialist in or out of the Aetna Medicare Advantage network, without paying more for out-of-network services, as long as the provider has accepted the plan and has not opted out or been excluded from Medicare.
• If you’re currently undergoing ongoing treatment, please reach out to Aetna at 1-855-
223-4807 from 8am to 8pm CST to discuss transition of care.
To view the list of covered prescription drugs, visit Aetna’s formulary online at
StateofIllinois.AetnaMedicare.com
About the Aetna MAPD PPO Plan
The Aetna MAPD PPO Plan is a Medicare Advantage Prescription Drug plan that delivers benefits beyond Original Medicare (Parts A and B) and includes basic prescription drug coverage (Part D).
There are several important things to understand about all MAPD plans. The items below are no different than your current plan.
• The Aetna MAPD PPO Plan is not a supplement plan and does not pay secondary to Medicare. All claims are submitted directly to Aetna for payment, not Medicare.
• You can only be enrolled in one Medicare program at a time. This means that you cannot enroll in both the Aetna MAPD PPO Plan and any other Medicare Advantage or Part D plan. This means that if you enroll in another Medicare Advantage plan after enrolling in the Aetna MAPD PPO Plan, you’ll be automatically disenrolled from the Aetna MAPD PPO Plan.
How to Learn More
We’re committed to keeping you informed and making this a smooth transition process. In the coming weeks, there will be many opportunities to learn more about this change:
• We will offer pre-open enrollment virtual seminars and in-person seminars during open enrollment for those that are unable to attend a virtual seminar or have additional questions and provide a medical plan decision guide that provides the details of your new plan. Be on the lookout for more information in the coming weeks.
• You’ll receive a welcome kit in the mail from Aetna with more information about the
Aetna MAPD PPO Plan. You’ll also receive new member ID cards from Aetna, which can be used for medical and prescription drug services.
• You’ll receive materials from the Center for Medicare and Medicaid Services, as required by law. We know that retirees get a lot of promotional materials about Medicare plans. Please note that all communications with specific information about this plan change will include the familiar TRAIL logo.
What You Need to Do
As stated above, no action is required unless you want to opt out of the Aetna MAPD PPO Plan. If you and your Medicare-eligible dependent(s) are currently covered under the UnitedHealthcare MAPD Plan or a MAPD HMO, you and your Medicare-eligible dependent(s) will be automatically enrolled in the Aetna MAPD PPO Plan with coverage, beginning January 1, 2023.
Questions?
If you have questions, contact:
• Aetna at 1-855-223-4807 from 8am to 8pm CST or by visiting StateofIllinois.AetnaMedicare.com to learn about plan benefits, find providers, and look up prescription drugs.
• MyBenefits Service Center at 1-844-251-1777 from 8am – 6pm CT or by visiting mybenefits.illinois.gov to ask about eligibility, make changes to your coverage, or opt out of the Aetna MAPD PPO plan.
• Medicare at 1-800-633-4227 or by visiting www.medicare.gov to ask questions about Medicare Parts A and B.
Your health and well-being are a priority for the State of Illinois. You’ve spent years working and we want you to enjoy retirement knowing that your retiree benefits are here to protect you. We are confident that this change will provide the quality coverage that you expect and deserve
United Healthcare Medicare Advantage Plan Health Insurance Participants
December 13, 2022
IRTA Members,
You may have received in the mail a letter from your insurance provider, United Healthcare (Medicare Advantage Plan), stating that your health and prescription coverage was ending. The information is incorrect. Your coverage is continuing under Aetna. The switch to Aetna is automatic beginning January 1, 2023. The Association recommends disregarding that letter entirely.
Sincerely,
Jim Bachman
IRTA Executive Director
October 22, 2022
FYI – The TRAIL 2023 Open Enrollment Guide was just posted on the TRS web site -- https://www.trsil.org/sites/default/files/documents/23-trail-trip-Open-Enrollment-guide.pdf.
More information is available about procedures, prescription drugs, webinars, etc. -- https://www.trsil.org/health-insurance-trail.
Please feel free to share these links with interested members.
Rich Frankenfeld
Director of Outreach
Teachers’ Retirement System of Illinois
PO Box 19235
2815 W. Washington
Springfield, IL 62794-9253
217-814-2073
September 24, 2022
Please read this message:
If you are a WCRTA member who is covered under the TRAIL Health Insurance plans administered by the CMS, then you probably got an email on, or about, Wednesday, September 20th regarding changes to your health insurance plan. Be sure to read that email. WCRTA would like to offer some valuable perspective about this change from WCRTA member and former IRTA President, Dave Davison, who is the present Region 1 director. In an email written last week, Dave addresses some of the more practical aspects of this change.
There is bound to be concern about CMS changing our TRAIL Health Insurance provider to Aetna Medicare Advantage PPO. I talked to Jim Bachman twice this week. One time on Monday morning before he became aware that CMS had rejected United Health Care’s appeal to CMS, he thought the appeal was ongoing. It sounds like the appeal was officially rejected on the previous Friday.
Jim emphasized on Monday and again last Thursday that Aetna is: “a good insurance company”. Both days he said that the specs in the “request for bids” had not changed this year from the last time they went out, so the benefits should be the same as with our present United Health Care plan. When we first went with the United Healthcare Medicare Advantage PPO, we told people that “If a health provider accepts Medicare, it will accept the United Healthcare Medicare Advantage PPO”. I asked Jim specifically if that statement is true with the Aetna plan and he said it should be. He emphasized that IRTA was not critical of the Aetna Plan, but the concern is that some of our members may get lost in the cracks in the process of changing insurance carriers. I just read the following statement Jim made in a Members Benefit Committee meeting recently:
Jim Bachman addressed the change in the TRAIL Insurance carrier and clarified that IRTA only wanted to inform our members and in no way did IRTA discredit Aetna. The plan should be comparable to the UHC Medicare Advantage PPO. He advises members to check with their healthcare providers to see if they accept Aetna Medicare Advantage PPO.
In summary:
The positives:
--Aetna is a good insurance company.
--The benefits should be comparable to what we have with United Health Care.
--We expect the statement: ”If a health care provider (doctor, hospital, walk in clinic, etc.) accepts Medicare patients, it should accept patients using our new Aetna Medicare Advantage PPO” to still be true. To me, this means we should be able to continue going to the same health care providers we use now. However, it sounds like that may not be true all over the state, especially around Champaign where it seems Aetna and the Carle Clinic have not reached an agreement on a contract.
--Per a change from original information from Jim Bachman, IRTA Executive Director: CMS has now stated that no action will be required to enroll in the Aetna MAPD, unless a participant wants to opt out of the Aetna MAPD PPO Plan. If you and your Medicare-eligible dependent(s) are currently covered under the United Healthcare MAPD Plan or a MAPD HMO Plan, you and your Medicare-eligible dependent(s) will be automatically enrolled in the Aetna MAPD PPO Plan with coverage beginning January 1, 2023.
This is a change from original information we received.
The Negatives:
--To be sure of coverage, we should contact our present health care providers to make sure they accept the Aetna Medicare Advantage PPO. (Note: It is very important that you check with your providers!!)
--We are not going to know for sure how the change will be implemented until either CMS, Aetna, or TRS puts out information. We could hear from multiple sources.
--Losing HMO plans may be a concern to some people.
Other:
--Jim expects specific information to be coming out in a week or two.
--The change goes into effect on January 1, 2023. Therefore, we will still be using United Healthcare until December 31, 2022.
The fact is, we don’t have all the answers yet. But maybe some of the above will alleviate some concern until we have more specific information.
UP TO DATE INFORMATION WILL BE FORTHCOMING. BE SURE TO READ ALL EMAILS AND TEXTS FROM IRTA, CMS, AETNA, AND TRS. KEEP INFORMED.
David Davison, IRTA Region 1 Director
September 22, 2022
IRTA
Central Management Services Highlights:
TRAIL Vendor Change
RFP process for TRAIL MAPD plans has finalized. Beginning January 1, 2023, the new sole medical and prescription drug plan will be the Aetna Medicare Advantage Prescription Drug (MAPD) PPO Plan.
Beginning January 1, 2023, your new medical and prescription drug plan will be the Aetna Medicare Advantage Prescription Drug (MAPD) PPO Plan. This new plan will replace your current plan, whether you’re currently enrolled in the UnitedHealthcare MAPD Plan or one of the MAPD HMO Plans (Aetna, Health Alliance, or Humana).
No action is required unless you want to opt out of the Aetna MAPD PPO Plan, add or remove dependents, or change dental/life coverage, if applicable. If you and your Medicare-eligible dependent(s) are currently covered under the UnitedHealthcare MAPD Plan or a MAPD HMO Plan, you and your Medicare-eligible dependent(s) will be automatically enrolled in the Aetna MAPD PPO Plan with coverage beginning January 1, 2023.
To learn more about this change, click here.
TRAIL MAPD OPEN ENROLLMENT is November 1-30, 2022
September 20, 2022
IRTA Members,
Central Management Services (CMS) indicated that the current Medicare Advantage Plan (MAPD) contract with United Healthcare is set to expire on December 31, 2022. During this process, CMS chose to end the State’s relationship with United and chose Aetna to become the new, sole MAPD provider. Just like United Healthcare's MAPD plan, Aetna's plan will not include vision or dental. In addition, during this process, CMS chose to no longer provide an HMO option.
Under the new contract, premiums will decrease, while out-of-pocket maximums and deductibles will stay the same. Some aspects of the program may also change such as which drugs are formulary and which doctors are considered in network. Members should discuss these changes with their healthcare team to understand how if at all, these changes could affect them.
CMS also stated that no action will be required unless a participant wants to opt out of the Aetna MAPD PPO Plan. If you and your Medicare-eligible dependent(s) are currently covered under the United Healthcare MAPD Plan or a MAPD HMO Plan, you and your Medicare-eligible dependent(s) will be automatically enrolled in the Aetna MAPD PPO Plan with coverage beginning January 1, 2023.
Sincerely,
Jim Bachman
IRTA Executive Director
September 14, 2022
IRTA Members,
The Illinois Retired Teachers Association would like to make our members aware that according to a recent article, Aetna Medicare Advantage PPO will be the sole insurer offered to Illinois retired state workers and retired teachers. This means that, in addition to removing United Healthcare, the State is also removing all HMO options from retired teachers. IRTA understands that in some areas, members will not be able to continue to see their current healthcare providers at the same cost.
The attached article makes it clear that this will be true in the Champaign area, but your area could be impacted as well. You may want to check with your healthcare providers about how the State’s decision to contract Aetna as the sole provider could impact your benefit.
Open enrollment for retirees has been pushed back to November 1st from the typical October 1st start date. The new plan will go into effect for enrollees January 1, 2023. Communication regarding the change will begin within the next couple of weeks. To read the full article, please click here.
Sincerely,
Jim Bachman
IRTA Executive Director
Note: Open enrollment for state retirees has been pushed back to Nov. 1 from the typical Oct. 1 start date. The new plan will go into effect for enrollees Jan. 1.
A Message from IRTA Executive Director Jim Bachman
To: Total Retiree Advantage Illinois (TRAIL) Eligible – Members
From: Jim Bachman, IRTA Executive Director
Re: Questions concerning TRAIL enrollment
As an individual who is enrolled in Medicare Parts A and B, your Annual TRAIL MAPD Open Enrollment Period will be held in the fall of each year. The TRAIL plan year is January 1 through December 31. The Open Enrollment Period is from October 15 – November 16.
Many enrollees have been calling the IRTA asking questions concerning the open enrollment process. Please read the information sent to you thoroughly.
IMPORTANT INFORMATION
• Materials sent to you from the TRIP - sponsored TRAIL MAPD plan administrators will feature the TRAIL logo.
• If you are currently enrolled in one of the TRAIL plans, your coverage will continue - you do not need to do anything unless you want to make a change.
You can download the guide on TRS’s website: click here
Click on TRIP/TRAIL Information above for the latest information on the change to Aetna.
More Information About Changes to TRAIL
Dave Davison’s previous email sent to you by WCRTA regarding the decision of the Illinois CMS to change our health insurance carrier from United Health Care to Aetna came as a surprise to some of our members. Below, Dave shares additional information about that change provided by our parent organization, IRTA. It is long, but well-worth the read.
The decision to change TRAIL insurance providers was made in Springfield by Central Management Services (CMS). It is function of the Governor’s Office. CMS provides the following explanation of why the change was made and the process involved in making the decision of what insurance program to use:
Why Are We Changing Providers?
On December 31, 2022, the current MAPD contracts will expire. Because of this, the State of Illinois was legally required to enter a request for proposal (RFP) process. During this process, we reviewed all the documents provided by each bidder, and found that Aetna offered the richest, low-cost plan, tailored to the needs of you—our retirees. Several factors contributed to our decision to change MAPD providers: • The Aetna MAPD PPO Plan offers lower premiums for coverage—saving both you and the State of Illinois money. In other words, you’ll pay lower monthly contributions for coverage. You’ll see these lower costs in your Open Enrollment Decision Guide. • In addition, the Aetna MAPD PPO Plan has been designed specifically for State of Illinois retirees—offering another wellness benefit. This new plan will offer wellness programs, through Be Well Illinois and SilverSneakers.
The decision was not made by the Winnebago County Retired Teachers Association nor the Illinois Retired Teachers Association. WCRTA agrees that it would be better to not have to go through the process of changing. We all wonder what we are getting into. Many people are bound to be concerned. The email I put out was designed to alleviate some of the concern while emphasizing neither IRTA nor WCRTA knows for sure at this time if the change will ultimately be good or bad. It would be much better if we did not have to be worried about it.
The Illinois Retired Teachers Association (IRTA) forwarded the following message from CMS to its members. If you are a member of IRTA, you should already have received this. IRTA is putting out a lot of information to try to help its members with this change. I hope the information I’ve provided is helpful.
David Davison
Dear TRAIL Participant: September 2022
Beginning January 1, 2023, your new medical and prescription drug plan will be the Aetna Medicare Advantage Prescription Drug (MAPD) PPO Plan. This new plan will replace your current plan, whether you’re currently enrolled in the UnitedHealthcare MAPD Plan or one of the MAPD HMO Plans (Aetna, Health Alliance or Humana). While your carrier for medical and prescription drug coverage is changing, your dental carrier—Delta Dental—and vision carrier—EyeMed, if applicable, will remain the same.
No action is required unless you want to opt out of the Aetna MAPD PPO Plan. If you and your Medicare-eligible dependent(s) are currently covered under the UnitedHealthcare MAPD Plan or a MAPD HMO Plan, you and your Medicare-eligible dependent(s) will be automatically enrolled in the Aetna MAPD PPO Plan with coverage beginning January 1, 2023.
Why Are We Changing Providers?
On December 31, 2022, the current MAPD contracts will expire. Because of this, the State of Illinois was legally required to enter a request for proposal (RFP) process. During this process, we reviewed all the documents provided by each bidder, and found that Aetna offered the richest, low-cost plan, tailored to the needs of you—our retirees.
Several factors contributed to our decision to change MAPD providers:
• The Aetna MAPD PPO Plan offers lower premiums for coverage—saving both you and the State of Illinois money. In other words, you’ll pay lower monthly contributions for coverage. You’ll see these lower costs in your Open Enrollment Decision Guide.
• In addition, the Aetna MAPD PPO Plan has been designed specifically for State of Illinois retirees—offering another wellness benefit. This new plan will offer wellness programs, through Be Well Illinois and SilverSneakers.
How Will the Plan Change?
Before making this decision, the State of Illinois compared all requests for proposal. We found that with the Aetna MAPD PPO Plan, there should be little to no disruption with your current providers:
• It’s unlikely you’ll have to change providers under the new the Aetna MAPD PPO Plan. You’ll be able to use any doctor, hospital, or specialist in or out of the Aetna Medicare Advantage network, without paying more for out-of-network services, as long as the provider has accepted the plan and has not opted out or been excluded from Medicare.
• If you’re currently undergoing ongoing treatment, please reach out to Aetna at 1-855-
223-4807 from 8am to 8pm CST to discuss transition of care.
To view the list of covered prescription drugs, visit Aetna’s formulary online at
StateofIllinois.AetnaMedicare.com
About the Aetna MAPD PPO Plan
The Aetna MAPD PPO Plan is a Medicare Advantage Prescription Drug plan that delivers benefits beyond Original Medicare (Parts A and B) and includes basic prescription drug coverage (Part D).
There are several important things to understand about all MAPD plans. The items below are no different than your current plan.
• The Aetna MAPD PPO Plan is not a supplement plan and does not pay secondary to Medicare. All claims are submitted directly to Aetna for payment, not Medicare.
• You can only be enrolled in one Medicare program at a time. This means that you cannot enroll in both the Aetna MAPD PPO Plan and any other Medicare Advantage or Part D plan. This means that if you enroll in another Medicare Advantage plan after enrolling in the Aetna MAPD PPO Plan, you’ll be automatically disenrolled from the Aetna MAPD PPO Plan.
How to Learn More
We’re committed to keeping you informed and making this a smooth transition process. In the coming weeks, there will be many opportunities to learn more about this change:
• We will offer pre-open enrollment virtual seminars and in-person seminars during open enrollment for those that are unable to attend a virtual seminar or have additional questions and provide a medical plan decision guide that provides the details of your new plan. Be on the lookout for more information in the coming weeks.
• You’ll receive a welcome kit in the mail from Aetna with more information about the
Aetna MAPD PPO Plan. You’ll also receive new member ID cards from Aetna, which can be used for medical and prescription drug services.
• You’ll receive materials from the Center for Medicare and Medicaid Services, as required by law. We know that retirees get a lot of promotional materials about Medicare plans. Please note that all communications with specific information about this plan change will include the familiar TRAIL logo.
What You Need to Do
As stated above, no action is required unless you want to opt out of the Aetna MAPD PPO Plan. If you and your Medicare-eligible dependent(s) are currently covered under the UnitedHealthcare MAPD Plan or a MAPD HMO, you and your Medicare-eligible dependent(s) will be automatically enrolled in the Aetna MAPD PPO Plan with coverage, beginning January 1, 2023.
Questions?
If you have questions, contact:
• Aetna at 1-855-223-4807 from 8am to 8pm CST or by visiting StateofIllinois.AetnaMedicare.com to learn about plan benefits, find providers, and look up prescription drugs.
• MyBenefits Service Center at 1-844-251-1777 from 8am – 6pm CT or by visiting mybenefits.illinois.gov to ask about eligibility, make changes to your coverage, or opt out of the Aetna MAPD PPO plan.
• Medicare at 1-800-633-4227 or by visiting www.medicare.gov to ask questions about Medicare Parts A and B.
Your health and well-being are a priority for the State of Illinois. You’ve spent years working and we want you to enjoy retirement knowing that your retiree benefits are here to protect you. We are confident that this change will provide the quality coverage that you expect and deserve
United Healthcare Medicare Advantage Plan Health Insurance Participants
December 13, 2022
IRTA Members,
You may have received in the mail a letter from your insurance provider, United Healthcare (Medicare Advantage Plan), stating that your health and prescription coverage was ending. The information is incorrect. Your coverage is continuing under Aetna. The switch to Aetna is automatic beginning January 1, 2023. The Association recommends disregarding that letter entirely.
Sincerely,
Jim Bachman
IRTA Executive Director
October 22, 2022
FYI – The TRAIL 2023 Open Enrollment Guide was just posted on the TRS web site -- https://www.trsil.org/sites/default/files/documents/23-trail-trip-Open-Enrollment-guide.pdf.
More information is available about procedures, prescription drugs, webinars, etc. -- https://www.trsil.org/health-insurance-trail.
Please feel free to share these links with interested members.
Rich Frankenfeld
Director of Outreach
Teachers’ Retirement System of Illinois
PO Box 19235
2815 W. Washington
Springfield, IL 62794-9253
217-814-2073
September 24, 2022
Please read this message:
If you are a WCRTA member who is covered under the TRAIL Health Insurance plans administered by the CMS, then you probably got an email on, or about, Wednesday, September 20th regarding changes to your health insurance plan. Be sure to read that email. WCRTA would like to offer some valuable perspective about this change from WCRTA member and former IRTA President, Dave Davison, who is the present Region 1 director. In an email written last week, Dave addresses some of the more practical aspects of this change.
There is bound to be concern about CMS changing our TRAIL Health Insurance provider to Aetna Medicare Advantage PPO. I talked to Jim Bachman twice this week. One time on Monday morning before he became aware that CMS had rejected United Health Care’s appeal to CMS, he thought the appeal was ongoing. It sounds like the appeal was officially rejected on the previous Friday.
Jim emphasized on Monday and again last Thursday that Aetna is: “a good insurance company”. Both days he said that the specs in the “request for bids” had not changed this year from the last time they went out, so the benefits should be the same as with our present United Health Care plan. When we first went with the United Healthcare Medicare Advantage PPO, we told people that “If a health provider accepts Medicare, it will accept the United Healthcare Medicare Advantage PPO”. I asked Jim specifically if that statement is true with the Aetna plan and he said it should be. He emphasized that IRTA was not critical of the Aetna Plan, but the concern is that some of our members may get lost in the cracks in the process of changing insurance carriers. I just read the following statement Jim made in a Members Benefit Committee meeting recently:
Jim Bachman addressed the change in the TRAIL Insurance carrier and clarified that IRTA only wanted to inform our members and in no way did IRTA discredit Aetna. The plan should be comparable to the UHC Medicare Advantage PPO. He advises members to check with their healthcare providers to see if they accept Aetna Medicare Advantage PPO.
In summary:
The positives:
--Aetna is a good insurance company.
--The benefits should be comparable to what we have with United Health Care.
--We expect the statement: ”If a health care provider (doctor, hospital, walk in clinic, etc.) accepts Medicare patients, it should accept patients using our new Aetna Medicare Advantage PPO” to still be true. To me, this means we should be able to continue going to the same health care providers we use now. However, it sounds like that may not be true all over the state, especially around Champaign where it seems Aetna and the Carle Clinic have not reached an agreement on a contract.
--Per a change from original information from Jim Bachman, IRTA Executive Director: CMS has now stated that no action will be required to enroll in the Aetna MAPD, unless a participant wants to opt out of the Aetna MAPD PPO Plan. If you and your Medicare-eligible dependent(s) are currently covered under the United Healthcare MAPD Plan or a MAPD HMO Plan, you and your Medicare-eligible dependent(s) will be automatically enrolled in the Aetna MAPD PPO Plan with coverage beginning January 1, 2023.
This is a change from original information we received.
The Negatives:
--To be sure of coverage, we should contact our present health care providers to make sure they accept the Aetna Medicare Advantage PPO. (Note: It is very important that you check with your providers!!)
--We are not going to know for sure how the change will be implemented until either CMS, Aetna, or TRS puts out information. We could hear from multiple sources.
--Losing HMO plans may be a concern to some people.
Other:
--Jim expects specific information to be coming out in a week or two.
--The change goes into effect on January 1, 2023. Therefore, we will still be using United Healthcare until December 31, 2022.
The fact is, we don’t have all the answers yet. But maybe some of the above will alleviate some concern until we have more specific information.
UP TO DATE INFORMATION WILL BE FORTHCOMING. BE SURE TO READ ALL EMAILS AND TEXTS FROM IRTA, CMS, AETNA, AND TRS. KEEP INFORMED.
David Davison, IRTA Region 1 Director
September 22, 2022
IRTA
Central Management Services Highlights:
TRAIL Vendor Change
RFP process for TRAIL MAPD plans has finalized. Beginning January 1, 2023, the new sole medical and prescription drug plan will be the Aetna Medicare Advantage Prescription Drug (MAPD) PPO Plan.
- TRAIL MAPD Open Enrollment Period will run November 1 – November 30, 2022
- An email (shown below which links to the letter which will be mailed) was sent out to all members September 20 explaining the change
- No action is required unless the member needs to add/remove a dependent or wishes to opt out of the Aetna MAPD PPO Plan.
- Member elections go into effect January 1, 2023.
- Members will receive a welcome kit in the mail from Aetna with more information about the plan and will also receive new member ID cards, which can be used for medical and prescription drug services.
- TRAIL seminars will be in-person this year beginning November 1-18, 2022, except for the Nov. 8 and 11 state holidays. Dates and locations are still being finalized. This information should be available in early October and will be sent out to all members on a “save the date” mailer. CMS will provide Advisory Board members the listing of events once it is available.
- There will be three virtual high-level webinars beginning October 25-27. Members can attend these first and decide if they want or need to attend the live seminars in person.
Beginning January 1, 2023, your new medical and prescription drug plan will be the Aetna Medicare Advantage Prescription Drug (MAPD) PPO Plan. This new plan will replace your current plan, whether you’re currently enrolled in the UnitedHealthcare MAPD Plan or one of the MAPD HMO Plans (Aetna, Health Alliance, or Humana).
No action is required unless you want to opt out of the Aetna MAPD PPO Plan, add or remove dependents, or change dental/life coverage, if applicable. If you and your Medicare-eligible dependent(s) are currently covered under the UnitedHealthcare MAPD Plan or a MAPD HMO Plan, you and your Medicare-eligible dependent(s) will be automatically enrolled in the Aetna MAPD PPO Plan with coverage beginning January 1, 2023.
To learn more about this change, click here.
TRAIL MAPD OPEN ENROLLMENT is November 1-30, 2022
September 20, 2022
IRTA Members,
Central Management Services (CMS) indicated that the current Medicare Advantage Plan (MAPD) contract with United Healthcare is set to expire on December 31, 2022. During this process, CMS chose to end the State’s relationship with United and chose Aetna to become the new, sole MAPD provider. Just like United Healthcare's MAPD plan, Aetna's plan will not include vision or dental. In addition, during this process, CMS chose to no longer provide an HMO option.
Under the new contract, premiums will decrease, while out-of-pocket maximums and deductibles will stay the same. Some aspects of the program may also change such as which drugs are formulary and which doctors are considered in network. Members should discuss these changes with their healthcare team to understand how if at all, these changes could affect them.
CMS also stated that no action will be required unless a participant wants to opt out of the Aetna MAPD PPO Plan. If you and your Medicare-eligible dependent(s) are currently covered under the United Healthcare MAPD Plan or a MAPD HMO Plan, you and your Medicare-eligible dependent(s) will be automatically enrolled in the Aetna MAPD PPO Plan with coverage beginning January 1, 2023.
Sincerely,
Jim Bachman
IRTA Executive Director
September 14, 2022
IRTA Members,
The Illinois Retired Teachers Association would like to make our members aware that according to a recent article, Aetna Medicare Advantage PPO will be the sole insurer offered to Illinois retired state workers and retired teachers. This means that, in addition to removing United Healthcare, the State is also removing all HMO options from retired teachers. IRTA understands that in some areas, members will not be able to continue to see their current healthcare providers at the same cost.
The attached article makes it clear that this will be true in the Champaign area, but your area could be impacted as well. You may want to check with your healthcare providers about how the State’s decision to contract Aetna as the sole provider could impact your benefit.
Open enrollment for retirees has been pushed back to November 1st from the typical October 1st start date. The new plan will go into effect for enrollees January 1, 2023. Communication regarding the change will begin within the next couple of weeks. To read the full article, please click here.
Sincerely,
Jim Bachman
IRTA Executive Director
Note: Open enrollment for state retirees has been pushed back to Nov. 1 from the typical Oct. 1 start date. The new plan will go into effect for enrollees Jan. 1.
A Message from IRTA Executive Director Jim Bachman
To: Total Retiree Advantage Illinois (TRAIL) Eligible – Members
From: Jim Bachman, IRTA Executive Director
Re: Questions concerning TRAIL enrollment
As an individual who is enrolled in Medicare Parts A and B, your Annual TRAIL MAPD Open Enrollment Period will be held in the fall of each year. The TRAIL plan year is January 1 through December 31. The Open Enrollment Period is from October 15 – November 16.
Many enrollees have been calling the IRTA asking questions concerning the open enrollment process. Please read the information sent to you thoroughly.
IMPORTANT INFORMATION
• Materials sent to you from the TRIP - sponsored TRAIL MAPD plan administrators will feature the TRAIL logo.
• If you are currently enrolled in one of the TRAIL plans, your coverage will continue - you do not need to do anything unless you want to make a change.
You can download the guide on TRS’s website: click here
