State retirees must research ‘monstrous’ health care situation


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.

By Sandy Penrod Wootten

Looming behind the backs of more than 30,000 Delaware state retirees is a gigantic monster called Medicare Advantage. It’s big, it brings rejections and denials, and it’s making its way across the United States with lightning speed. Delaware state retirees are caught in the grips of its fingertips now, and we are fighting back!

There’s a problem, though. Unfortunately, too many state retirees are unaware of what’s happening.

Looking back into 2022, the governor and several politicians formed a committee to “explore” how they could reduce health care costs for Delaware. Last January, they chose an insurance company aimed at saving money. Were there representatives from the retired sector? No! Were there union representatives? No! Unfortunately, they proceeded anyway with Medicare Advantage. To them, it seemed to offer all the options wanted, plus save dollars for Delaware. Medicare Advantage would simply take over the health care business for state retirees.

Now, Medicare Advantage had its grips on the political arena. Retired senior citizens would have to give up on their current state plan of Medicare that they worked so hard for and earned. Secrecy was the name of the game at first. Although the governor started this in January 2022, it wasn’t until July that the state retirees heard anything about this change to their health care. Get this: The retirees were due to sign up in early October! They were to make educated decisions on their health care without any knowledge of the looming monster, the loss of their benefits, and features that were downright problematic.

As more information came out regarding the monster lurking about, the retirees went to work. Research was done about Medicare Advantage. Folks met; options were discussed; a support group formed called RiseDelaware, with the website; lawyers were hired; and rallies were held. All this was done in a matter of a few weeks. To be prepared, research was essential. Groups read every journal, newspaper, magazine and review they could get which described the pros and cons of Medicare Advantage. Having done much research myself, I found Kiplinger, Consumer Reports, Forbes, AARP and a variety of reviews to be helpful. Basically, if you are in a health crisis, the last thing you want is a denial, rejection or long wait. Medicare Advantage can be great for the healthy human being. Senior citizens don’t usually fall in that category, unfortunately.

We interviewed people with Medicare Advantage, asked doctors if they took the insurance program (many said no) and listened to the sad stories from patients of denials, rejections and delays.

We met with the politicians, rallied, and the case was brought before a judge. The retirees were given an extension of one year on their original state health benefits. We rejoiced, but we knew in our hearts that we would be fighting the battle again very soon.

That’s exactly what happened. Move now to 2023. On Jan. 18, a Senate committee session was called at Legislative Hall in Dover to introduce Senate Bill 29. In this bill, a new committee will be formed which will include representatives from several retiree groups. Finally, we will have representation! Another positive condition is the decision must be completed by May 1 in order to give retirees plenty of time to explore and make choices without being coerced in a short time span. (As it stands now, the retirees will have until January 2024 to make a decision on their health care.) The bill was passed on to the House, which approved it Thursday. It was signed by the governor the same day.

So, now, the retirees must prepare again. There has been so much legwork in a very short time, but what we need now is for all state retirees to be aware of this situation. Some people are asking who the warriors are in this fight against the giant monster. State retirees are anyone who worked for a state agency and earned a pension. Yes, this does include the branches of government, as well. Are you asking yourselves, why would the government take away a system that was working? Yes, we are, too.

They say curiosity killed the cat, but, in this situation, it was important to find out what the pensioners were thinking. I contacted approximately 200 educators, secretaries and administrators about their feelings regarding last year’s shenanigans and what is coming for 2023. It was interesting to find that 100% said they were against Medicare Advantage as a choice. They wanted no part of it. Many of those who responded were suffering severe illnesses. They explained in detail how they currently never have to wait for a referral, test or procedure. They were free to choose their own doctors. A major positive attribute was retirees with the current plan are able to cross state lines from Delaware. They are free to go to Johns Hopkins, the University of Pennsylvania hospital, Temple, Jefferson, Sloane Kettering and more. With a monster like Medicare Advantage, why would we choose a plan with tight grips that prevent using the best hospitals?

A lot of the retirees are in favor of a grandfather clause. With this, retirees would keep their benefits as they are. It is a good answer for the 30,000 senior citizens. Basically, the current state retirees would be exempt from the new health care regulations. That would certainly keep the giant beast from attacking the senior citizens at a time when they need health benefits most.

So, if you are a state of Delaware retiree, make sure you know what is coming your way. Join for up-to-date information.

Banding together and learning all there is to know will keep the Medicare Advantage monster away. Be prepared before July. You deserve it.

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