ATT Retiree plan changing to UHC PPO?

[shir]

I retired with ATT before 65 and I qualify for the ATT retiree health plan. Now that I'm 65, ATT no longer offers the health plan for 65 and over, instead they offer me a subsidy of $2700/yr that they keep in an account for you via AON. I can submit medicare part B, medical, drugs, dental,vision receipts to get reimbursed from this account and the remaining funds will roll over to the next year. Also if you have dependents, ie spouse that is also age 65+, they will subsidize the spouse with $1500/yr (not all retirees get this, you have to have worked for ATT before a certain date). If you qualify for the subsidy, in order to get this sum, you must select your medicare options using AON. If you used a service other than AON to apply for your medicare health plan, or if you directly called the health insurance to apply, ATT will no longer subsidize this health account. So you lost the $2700 subsidy that you qualified for! The new UHC Advantage PPO plan sounds like its too good to be true! The co-pays are very reasonable AND the copays are the same for in-network and out-of-network provider. This means you can go to ANY doctor or hospital and UHC will cover it with the same co-pay. So you get the benefits of an HMO plan without the restrictions of "who's in network". Also for 2021 the out-of-pocket is $900. (one visit to the hospital in January, and pretty much the remainder of the year is 100% paid for by UHC). This is unheard of!!! It is better than my Kaiser in Northern California Senior Advantage Plan. My conspiracy theory is that this is the way ATT gets people off the subsidy and through the coming years, the subsidy will be removed, and this UHC Advantage PPO plan will be changed,,, for the worse. For this special UHC Advantage PPO plan, you must sign up with UHC. This plan is not offered thru AON. So, for me in California, for year 2021, my premium for this plan would be $0.00 per month, and my subsidy of $2700 would be reduced to $300 (and the subsidy can only be reimbursed for dental and vision). My spouses premium would be $98.00 per month and the subsidy would be reduced from $1500 to $200. I did not apply of this during open enrollment,,, but the UHC representative told me I could apply any time of the year. For those of you that already have a GAP plan, if you choose this plan, and over the years it gets to expensive to stay in and you want to go back to the GAP plan,,, you will no longer be able to participate at the same rate you were paying. For those of you that was getting the $2700 subsidy, once you no longer receive the subsidy, you cannot change your mind and go back. Keep in mind, the plan can change from year to year, and ATT may negotiate with another Health care plan. Also with this plan the doctors and hospital must be willing to submit claims to UHC, otherwise the event will not be supported. I chose to remain with my Kaiser and $2700 and $1500 per year, and I will watch this in the coming years.

 

[DonP]

The out of the network is only if the doctors will take the reimbursement fees of United mapd and file the claims . My father has the same gig with Aon but I believe he only has to buy one item with Aon and the remainder of the money can be used elsewhere.

 

[LamarM]

Setting aside the internal pros/cons of the new plan please tell me if I see this wrong so I can decide which way to go.
My hard costs for the new plan:
Medicare part B = -$153/mo
PPO Premium = -$88/mo
HRA (No) = -$225
Total -$466/mo x 12 = -$5,592 ($5,592 out of pocket every year)
No hospital visit for 5 years -$27,960 out of my pocket
Annual plan out of pocket $900

Current AON plan:
Medicare part B = -$153/mo
PPO Premium = $0/mo
HRA (Yes) = $225
Total $72/mo x 12 = $864
No hospital visit for 5 years $4,320 "in" my pocket
Annual plan out of pocket $5,500

Thanks

 

[Jack Lyons]

In Reply to LamarM
In my case, UHC says that ATT pays for the $88.13 PPO Premium, so my scenario is somewhat better than yours. You might want to check with UHC to see if ATT will pay also yours,

Your scenario appears to be a best case because it assumes no hospital in 5 ears. I believe one would have to look at copays, coinsurances, out-of-pocket maximums and a number of other factors to get a more likely case comparison. Maybe throw in one or two hospitalizations where you pay the out of pocket maximums under each plan.

I am sure that ATT would like all of us on the UHC PPO. They pay the PPO premiums ($88.13 x 12 mos= $1057.56) and eliminate the $2,400 payment to you for the reimbursement program.

 

[Jasmine Mello]

Two weeks ago, I received a brochure from AT&T offering the AT&T Group Medicare Advantage (PPO) plan insured by UnitedHealthcare. It states that I can see any doctor, or go to any hospital that accepts Medicare, without a referral. Question...What is the catch? Would I need authorization to go to a premier hospital like Stanford Medical? The monthly premium is $0, with $0 annual deductible. Primary care co-pay is $0, and specialists are $30. Hospital stay is $100, and ER visits are $100. I suspect that authorization would be needed in some cases, which is similar to an HMO. Is this plan too good to be true, or is there a catch. I am 80 years old.

 

[somarco]

insured by UnitedHealthcare.

The plan they have had for years is self funded, not insured. UHC is most likely the plan administrator. Look through the literature and see if it says "insured by UHC" or "administered by UHC".

As a self funded plan they can do pretty much anything they want as long as they do not violate ERISA rules.