If, as stated by Secretary of Human Resources Claire DeMatteis in the article on the new state retiree Medicare Advantage plan (“Delaware moving to Medicare Advantage Plan,” Aug. 28), “it’s the same coverage. It’s the same doctors, it’s the same hospitals, it’s the same prescription drug services,” then my question is, if it’s the same, then how are the cost savings magically obtained? How do the annual contributions by pensioners who have retired since 2012 fall over 50% from $459.38 in the current Medicfill plan to $216.18 in the new plan? How can the state “liability” fall 85% from $31 billion to $3.1 billion by 2050?
Does the “magic” come from Highmark’s 8% denial rates? What medical expertise does politically appointed DeMatteis have to declare that the denials will not affect the care received by the patient? Does the Medical Society of Delaware agree with this statement? As a state retiree, I have never had a required medical procedure that a real doctor didn’t request and state was necessary.
One wonders if the new program will impose three- to 12-day delays of services, while Highmark considers approval.
Would delay, appeals and passage of time actually lead to a denial of service … and less payments?
Looks like more transparency is needed! And as soon as possible!