Sandy Penrod Wootten is a retired teacher from Dover, where she taught kindergarten through second grades before focusing her career on the gifted and talented ALPHA program for fifth and sixth graders.
As a Delaware teacher, I would often look at my monthly paycheck to see where my money was going. Quite a bit of it went to taxes! Due to the fact that my mom was a senior citizen and in poor health, I knew that Federal Insurance Contributions Act taxes were very important. Someday, I would need Social Security and Medicare, just as my mom needed them.
Although Social Security was certainly helpful to her in paying her bills, it was Medicare that was truly important to my mom. Medicare, which she had earned during her lifetime, helped to pay for her health care that she needed so desperately. I knew, someday, I would be getting Medicare at the age of 65 because all state workers were paying for Medicare, a supplemental policy and a prescription plan.
Then, that time finally came for me. I entered my retirement years and was entitled to a state health care package. That is until this year!
The governor formed a committee to change all state retirees’ health care programs without our knowledge in January of this year. State retirees were certainly shocked when they saw the results in September! We were being offered a plan which wasn’t even voted into place yet? A plan with a contract no one had even seen but the committee who had worked on it? What was the big secret? Not even legislators had seen the contract.
Betrayed, ignored, forgotten and scammed are some of the adjectives that come to mind when thinking about the more than 30,000 state of Delaware retirees that are being forced to make a decision over their health care this month, from Oct. 3-Oct. 24. The benefits of lifelong medical care, including prescription coverage, had been promised to all state employees. These 30,000-plus retirees are now being coerced into a new Medicare Advantage plan.
The retirees have no choice in the matter. It’s either buy your own health care insurance at a high price tag (and hope you don’t have a preexisting condition), only have Medicare or try to get back into the state’s plan during open enrollment a whole year later. To be bluntly honest, it stinks.
What is Medicare Advantage? It is a managed health care program controlled by a private company for profit. Highmark would control our Medicare in this instance. For retirees, there’s a waiting period to get labs, tests, procedures and other health-related features. How long will authorizations for various tests and procedures actually take? This is very worrisome. By the time you wait for that prior authorization, your condition could worsen … or intensify.
Please note: This is not an improvement over what retirees already have. It will not benefit retirees. I see it as a managed-care program aimed at making decisions about the retiree’s health care. What is happening is the state of Delaware will save money at the expense of the retirees and their health care. This is unacceptable!
This means a lot for my family. My husband and I both have serious preexisting conditions. I refuse to sit still and allow this to happen to us. I have been contacting retirees from my school district. They are as furious as I am about the change to Medicare Advantage. I talked to retired friends with heart conditions, cancer and other devastating conditions. I reached out to the insurance commissioner’s office, and I never heard back. Retirees are frightened.
Be aware! Know the difference! Minimal flexibility, limited providers, prior authorizations and medications lists, no Medicare-plus-a-supplement anymore. Don’t be fooled by the sales gimmick that Highmark presents. When something looks too good to be true, it usually is.
This has come down to a “take it or leave it” situation. It’s affecting all state retirees. The best way to know about the change in policies is to share information until every state retiree knows what is happening to their original policy. Do your part by learning all there is to know about Medicare and Highmark’s Medicare Advantage.
This isn’t going away. State retirees are getting ready to rally on Wednesday, Oct. 12, at Legislative Hall. There is a lawsuit in progress, and an advocacy group is available for information. Do your research first and talk to state retirees in the know. The advocacy group can be reached online at risede.com.
I advocate the quote from Benjamin Franklin. He said, “Half a truth is often a great lie.” I do believe Ben’s quote is pertinent here. Good luck!
