Our annual luncheon will take place on Monday, May 13 at 11:00 at Highland House Restaurant, 2630 Highland Road, Highland, Michigan 48356, There will be updates on the March MEA Retired annual meeting and the Spring R.A. RSVP to [email protected]. Note: You will need to purchase your own meal. Please join us!
0 Comments
The keynote speaker for our February meeting was, Rachel Saputo Abarca from Blue Cross Blue Shield of Michigan. Rachel explained that many key points of her presentation are available online at bcbsm.com in a virtual seminar format which can be downloaded as a PDF. She explained this year’s health insurance costs are the same as last year’s. Our co-insurance is $900 and deductible is $800 per person for Medicare Advantage members. The total out-of-pocket maximum remains at $1,700. After this is met, members are covered at 100% through the remainder of the year. Non-Medicare members have a $1,000 deductible. 2014 Updates: An ER visit is up to $135 co-pay per visit and $65 for an urgent care visit. Non Medicare members now are able to get free mammograms, cancer screening (PAP smear), a screening colonoscopy and also retail health clinic visits are now free (i.e. CVS Minute Clinic). Medicare advantage members already have this. On-line virtual care is now provided by Teledoc Health (download the app). Changes effective March 1st are: ORS will now cover dependent students up to age 26 (not just 24). The lifetime maximum cap for organ transplants has been removed. Vaccinations will be covered free of charge by either Optum-RX or BCBSM (show either card). Choices for Care: There is a free 24 hour Nurse Line 1-800-775-2583 available 24 hours a day 7 days a week. Non Medicare members are encouraged to fine a primary care provider who is a member of the patient centered medical home (PCMH). These doctors have to spend more time with you and can refer you to other specialists within the PCMH network. Call 800-810-2583 to find a participating doctor or visit 222.bcbsm.com/find-a-doctor. The cost for a Teledoc visit is typically around $60 but it depends on the co-insurance amount, deductible and the doctor’s specialty. Question asked: Can you have all your prescriptions reviewed by these nurses? No, you would use Optum-RX nurses for this, not BCBSM. Coordinated Care – You can reach a nurse manager who can help you coordinate your care and treatment plan for chronic conditions. This is free. Call 1-800-775-2583. Question about being denied coverage: Answer, if you are denied coverage, you can appeal. Call customer service and file an appeal. Issues with denied appeals was discussed and it was asked if you can appeal to the board. Yes, but if it is not a covered benefit, the appeal would be denied. Question re prior authorization for a necessary surgery and issues with subcontracting companies denying surgeries. Too often members have to appeal the denial to get their surgery approved. Rachel stated that BCBSM requires your doctor to carefully and thoroughly substantiate the need for the surgery so that it is approved. It should not be the member’s job to be the go-between (though this has been the case in some instances). Getting the Most from Your Plan- Rachel stated there are two free doctor visits offered now through Medicare for Medicare Advantage participants: The annual well visit and the annual physical. She pointed out the free annual physical is much more thorough, the doctor spends more time with you and it includes a lab draw for cholesterol levels among other things. For non-Medicare folks, there is a Living Well Program which will save members $150 toward their deductible if they sign up. It requires you to fill out a survey questionnaire, and to select a primary care provider who is a PCMH approved doctor. Also, through Blue365, a wide variety of discounts are available by showing your BCBSM card such as discounts on car rentals, hotels, etc. One of the popular free programs available to Medicare Advantage members is Silver Sneakers with over 15,000 fitness locations available throughout Michigan. Unfortunately, the YMCA is no long participating in Silver Sneakers as of Jan.1 of this year. Routine Hearing Care is covered for all members by True-Hearing. If you go through Routine Hearing, you can save from 10 to 60% off on hearing care. Call 1-855-205-6305. For basic hearing aids the copay is $499, for premium hearing aids the copay is $799. Helpful Resources: Go to BCBSM.Com/MPSERS click on Resources. You can find a Resource Guide, Member Benefit guide and other helpful information. . New MEA president Chandra Madafferi was the keynote speaker at our October 16, 2023 meeting. She reported that the MEA has been successful in advancing various legislation supporting education. Chandra then explained the MEA is doing extensive training of officers and members regarding legislative updates and different ways this impacts bargaining. This is ongoing on all levels including the Winter Conference.
Chandra reported there has been restructuring of the MEA on two fronts: the corporate side of the organization (including corporate operations, finance, payroll, IT support, buildings, etc.) as well as the member side. The interface with members involves training, ESP, AIM, and communication, among other things. Communication is a key component so that individuals and groups can better understand and work together to resolve issues and promote MEA’s goals and vision. There is a meeting in November 2023 to develop a plan for better communication. Also, part of the restructuring involved removing some redundant positions and streamlining others to allow MEA to be more efficient. There were six high level positions that were deemed unnecessary and were eliminated. Also, the Executive Director position has been changed to Senior Executive Director of MEA. Chandra shared details of personnel changes in the MEA. Question: What happens if a retired teacher wants to go back to a full time position in a district? Chandra explained the MEA pushed for change in this regard. Randy Ston noted that Gov. Whitmer signed House Bill 4752 into law Oct. 10, 2023 allowing school employees to work in public schools after retiring while keeping their retirement benefits as long as they either wait six months, or if they don't wait, then they earn no more than $15,100 in the calendar year. Question: What MEA dues would be required of retirees going back to working full time in teaching? Chandra said MEA is working on this issue including what dues will be required and who will provide liability coverage (MEA or MPPSERS?) It was noted each District is handling what the salary is for these individuals and unfortunately it is often at a starting teacher’s pay rate. Jim Pearson suggested that reinstating educator pensions would help ease the teacher shortage and help attract more people into the teaching profession. Chandra reported that Matt Kolazar is taking up the charge on this. Chandra further reported that the MEA is working with Jocelyn Benson on a bill to bring driver’s education back into high schools. : |
AuthorWest Oakland County Ed. Association Retired Region 7 is a community of retired educators, para-educators, and school personnel who support and advocate for public education. Archives |