Retirement insights from a Colorado PERA perspective

Inside Colorado PERA

PERACare Working to Cut Costs as Medicare Advantage Enrollment Grows

Piggy bank, stethoscope and dollar bills

In this story:

  • Enrollment in Medicare Advantage plans has grown steadily in recent years
  • PERACare is changing providers for PPO Medicare Advantage plans in 2022
  • UnitedHealthcare will offer same plan benefits, lower premiums

More people than ever are enrolled in Medicare Advantage plans, and PERACare is making some changes in 2022 to make its plans more affordable and convenient for retirees.

A data analysis by the Kaiser Family Foundation found that enrollment in Medicare Advantage plans – like those offered by PERACare – has been steadily increasing since the early 2000s. In 2020, nearly 40 percent of all Medicare beneficiaries were enrolled in a Medicare Advantage plan rather than traditional Medicare, KFF found.

Colorado was one of 19 states where more than 40 percent of Medicare beneficiaries were enrolled in a Medicare Advantage plan in 2020.

The advantages of Medicare Advantage

Medicare Advantage plans are offered by private insurers and serve as “all-in-one” or “package” plans. They combine the benefits of Medicare Parts A (hospital insurance) and B (medical insurance) with Part D (prescription coverage) into one comprehensive plan. These plans also usually cover extra services that aren’t covered by original Medicare, like dental and vision and even gym memberships.

While Medicare Advantage enrollees pay a premium on top of the Medicare Part B premium, Medicare Advantage plans may have lower out-of-pocket costs for some services. They also have yearly limits on out-of-pocket spending on services that Part A and Part B cover, while original Medicare doesn’t have any limits.

Medicare Advantage plans differ from Medicare Supplement Insurance, also known as Medigap, which supplements the coverage provided by original Medicare. Medigap plans typically don’t offer as much coverage as Medicare Advantage plans and they don’t include prescription drug coverage. A retiree cannot have both Medigap and Medicare Advantage.

PERACare offers three Medicare Advantage plans for PERA retirees, in addition to four pre-Medicare plans for retirees who aren’t yet eligible for Medicare.

Cost-saving changes coming to PERACare

In 2022, PERACare is making some changes to the providers who administer PERACare’s Medicare Advantage plans. UnitedHealthcare will replace Anthem Blue Cross Blue Shield and Silverscript.

One reason for the change is that UnitedHealthcare is able to offer lower plan premiums than Anthem. The new plans will also combine medical and prescription coverage under one company, making for a more streamlined process for enrollees and their providers.

“We have designed the new UnitedHealthcare plans to mirror the current plans as closely as possible; if there are changes to benefits, they are upgrades, not downgrades,” said PERA Director of Insurance Jessica Linart. “Plus, UnitedHealthcare brings an expanded fitness center benefit with access to more gyms, the Real Appeal weight loss program, and a commitment to delivering our retirees a high level of customer service.”

Retirees enrolled in an Anthem plan will be automatically enrolled in a corresponding UnitedHealthcare plan and recently received a letter in the mail with details on their new, lower premiums. Most copays for the new plans will be the same, though some copays will be lower with UnitedHealthcare. Like Anthem, UnitedHealthcare offers nationwide coverage.

Enrollees in PERACare’s Kaiser Permanente HMO plan will also see a reduction in their premiums for 2022.

PERACare open enrollment began Oct. 11 and retirees will be able to sign up for coverage for the first time, or make changes to their existing coverage through Nov. 17. For more information on the changes on open enrollment, including details on virtual meetings, click here.

Comments

  1. Merry Kopelove says:

    We are on a UHC Medicare Advantage plan, with zero premium. Zero. Yet PERACare continues to offer plans with premiums for PERA retirees for these plans. It was this poor plan offering and outrageous premiums for PERACare that made us leave PERACare. Your goal needs to be zero premium, as can be obtained anywhere other than through PERA. Just my 2 cents…

    • PERA On The Issues says:

      Hi Merry, some retirees will see their premiums reduced to $0 with the new UnitedHealthcare plans (and the PERA subsidy, which is set in state law and based on years of service). We encourage retirees to look at all their options and choose the plan that works best for them.

    • John Murphy says:

      I was happy to see there is a 0 dollar premium with United

    • Mnt mom says:

      You might want to check what your maximum out of pocket each year amount is. This new PERA plan offers a lower out of pocket expense and actually is better than most other offers.

    • Caroline Morales says:

      I agree 100%. We worked and paid into retirement our entire work life and PERA still doesn’t take care of retirees. So sad!!!

      • Mark says:

        I am not sure what you are referring to but I feel that PERA does take care of its retirees. PERA provides us the retirement option that we chose. They also provide various OPTIONAL insurance plans. If you don’t like any of the insurance plans that they offer, look elsewhere.

    • Jennifer Singer says:

      I recently retired at 60 and can’t afford PERACare. I make too much to qualify for Obama Care. I’m hoping they lower the Medicare age to 62 with the Biden Human Infrastructure bill. Our country really needs universal health care like all other developed countries have.

      • Marti S. says:

        NO WE DON”T WANT UNIVERSAL HEALTH CARE!!!! I do NOT want the government telling me what doctors I can or cannot see, and poking their nose into my business anymore than they already do! Plus many countries with universal health care have VERY LONG waiting times to get in to see a doctor. A friend who is a doctor in Canada, (an orthopedic surgeon) is limited by the number of cases he can see (or money he can make) yearly. He generally reaches this by March, so he has a second home in Loveland (dual citizenship) and comes down to CO to practice medicine the rest of the year since he isn’t limited here. It’s ridiculous. My best friend’s son married a Canadian and they live in Canada and it takes forever to get an appointment with a specialist–meaning 6 months or more. Countries that have this KEEP IT THERE–DON’T BRING IT HERE!!!

    • Alan says:

      Same here. The difference between what the PERACare plan through UHC and the UHC PPO Advantage Plan are minimal, except that the plan available to all Medicare recipients (at least in my county) are zero premium. Benefits are comparable. No deductible for medical or prescription drugs.

      Being a new Medicare recipient, the only issue I’ve had is Medicare believing I still had coverage through the state. We finally got that straightened out, and all my previously denied claims were reopened and paid. Five sets of x-rays, a primary care visit, an ER visit, IV drugs, two MRIs, and my total costs were under $250. All of my meds are generic, 100 day refills free by mail. I don’t even have to go to the pharmacy for them. $40/quarter OTC allowance, either mail order (2 day delivery) or a debit card. That’s $320 a year for the two of us, and the items available in the online catalog run the gamut from aspirin and vitamins to heating pads, braces, shower mats, toothpaste, and toothbrushes.

      Why pay more for similar coverage?

  2. Angela McLean says:

    Need to know if United Health Care is accepted better than Anthem Advantage that is named MEDICARE. Many providers do not take Medicare these days! Will ALL providers currently with Anthem accept United Health Care? Do the dental benefits provided by Cigna, notoriously known by dentists to refuse to pay even covered services as listed without an appeal be better? Which specific procedures are covered?

  3. Nancy Carlson says:

    What about about Pre-Medicare PERA Care? It went up again this year, how many years in a row is that now. And deductible is ridiculous.

    • Ramona says:

      That’s what I was going to ask. Why change carriers if the premium is going to go up anyway? Changing is just always asking for trouble. I’ll probably end up losing my doctor for the privilege of paying more for the premium. Screwed again!!

    • Kim lack says:

      Every year it has gone up and it is rediculous.

  4. Frank Bregar says:

    United Healthcare’s “regular” plan does not offer much of a choice for physicians and specialist on the Western Slope. Hopefully because this plan is tied to Medicare we will be able to see our own PCP and medical specialist and not forced to use United Healthcare sparse Western Slope physician list. In 2007 the United Healthcare did cover St. Mary’s Hospital as “in network”, however, the radiologist that practiced at St. Mary’s were not part of the United Healthcare’s “in network”, so their charges were “out of network”. The expense of the radiologist being “out of network” cause me to change to Community Hospital for any radiology services.

  5. Bonnie Leaf says:

    I’m glad to see that pre-Medicare premiums will come down in 2022, however the 2021 pre-Medicare premium for Kaiser HMO is unreasonably high. $1321 per month is not a reasonable expense for a healthy person to pay. Please lower the cost as soon as possible.

    • Kim Lack says:

      Sorry to say but pre-Medicare people don’t get a break. The insurance increase we just received is for the 2022 plans and it is not right. I pay $6000 a year for a couple trips to dr. Anything more then I pay like crazy if I get hurt or sick

  6. Deb Kraemer says:

    This change will cost me in at least two ways. United Health Care does not cover an expensive medicine whereas Anthem did cover the medicine with an affordable co-pay. This will be extremely detrimental to my retirement years as I cannot afford the medication on my own. Secondly, no other M.A. plan carries or covers the same medication. There is no place else to go. You have completely eliminated my one and only coverage, and I would still have a monthly premium if I decide to stay with PeraCare coverage. Gym memberships mean nothing now as I won’t have the medication and treatment that would allow me to utilize any gym equipment.

    • Connie says:

      The Rx coverage is very poor if you’re on expensive life saving daily medication, and they do have a donut hole period, despite what they call it. By not offering a supplemental medigap plan, they’ve really screwed those of us who can only use those types of plans, also their specialists are not as inclusive as they claim to be either. Very disappointed and buyer beware if you have expensive medication.

    • Ramona says:

      They do this because they really want you to drop PERAcare and go full Medicare. Then they don’t have to pay their part of the premium.

    • Mark says:

      Maybe you should get your insurance directly through Anthem versus PERA. This way you can hopefully get coverage for the medications that you need. There is nothing requiring you to get your coverage through PERA.

  7. John says:

    I’ve heard of certain United Health Care plans with a Medicare premium reimbursement. Does the new UHC program offer the same?

    • PERA On The Issues says:

      Hi John, the PERACare plans do not include Medicare Part B premium reimbursement; you will still have to pay that premium to Medicare.

  8. JOELLEN DAVIS says:

    I agree with M. Kopelove. I am currently enrolled in United Healthcare Advantage Program with a ZERO premium. I was previously enrolled in Pre-Medicare, PeraCare and had no problems, but because of the cost involved, I enrolled in UHC when I turned 65.
    What would be the cost involved to enroll in Pera’s UHC Program?

  9. Kathy Atkins says:

    PERACare has always been too expensive for me. I had only Medicare when I became eligible. I changed to Medicare Advantage through Kaiser this year in Maryland and for the first time since I retired I can afford insulin. I really love the $50 OTC benefit I get to use every quarter.

    • Larry Williams says:

      Interesting. We live in Maryland and loved our Kaiser in Colorado which is not available through PERA in Maryland. But the new United with lower premium and very similar benfits looked good to us. Would like to hear some specifics from you if you are wilking to share.

  10. Larry Williams says:

    Interesting. We live in Maryland and loved our Kaiser in Colorado which is not available through PERA in Maryland. But the new United with lower premium and very similar benfits looked good to us. Would like to hear some specifics from you if you are willing to share.

    • Kathy says:

      I had Kaiser when I lived in Colorado as well and loved it. I pay $25 for Medicare Advantage. I also pay $25 for dental, vision, and other things but my main concern was dental. Out of pocket hasn’t been too bad but decreases as I go. I really, really liked every doctor I have seen for various things.

    • Kathy says:

      I do not go through Pera for coverage – it was cheaper without PeraCare.

  11. Brad says:

    This is all smoke and mirrors. DON’T BE FOOLED by this, my premiums are going up another 10% from $460.00/month to the NEW BEST DEAL United Healthcare at $500.00/month. In 5 Years my premiums have gone from $170.00/month to the New Best Deal at $500.00/month. We need a better negotiator as my pay has only increased $40.00/month over the same time period.

    • Kim Lack says:

      Mine is about same. I retired in 2015 and I don’t think with the new increase that my net income has gone up. Every year with the health insurance price increase my net income is always less. After 30 years of service we should receive the same premiums that we had the year we retired.

      • Mark says:

        What would make you think that you are entitled to have insurance premiums the same as when you retired? The cost of everything generally increases every year. If the cost of your insurance premium would stay the same as when you retired, who do you expect to pay for the difference between this amount and the real cost of the insurance?

    • Mark says:

      Since it appears that you are and have not been happy with insurance from PERA, maybe you should look elsewhere for your insurance coverage.

  12. Glenn says:

    The cost of pre medicare insurance thru PERA is outrageous and I think that is the way PERA wants it. I would like to know how much money PERA saves by people getting their insurance else where. Then PERA keeps the 230 dollar a month subsidy for health insurance. I asked about this during an online, telephone meeting but never received an answer.

    • Connie says:

      I agree and I think that subsidy should be sent to the retiree so you can purchase whatever insurance you need which so far for me has never been a peracare plan.

  13. NICHOLAS BARBUSHACK says:

    If Ihave anthem doctor’s and they don’t take United, can I stay with Anthem if I choose and would it be the same premium-presently paid?

    • PERA On The Issues says:

      Hi Nicholas, if you don’t want to switch to UnitedHealthcare, you’re welcome to go with a different plan, but it wouldn’t be the same plan you’re currently on as PERACare won’t be offering that Anthem plan in 2022.

  14. Dawn says:

    What is the comparison between the medical discounts/caps on preferred provider services between Anthem and UHC? Anthem discounts actually kept costs down in terms of out of pocket expenses. PreMedicare premiums are getting outrageous especially when paired with ridiculous deductible and co-pays; basically a catastrophic insurance plan. Very disappointed, we have enough retirees that we should not be paying this high a premium

  15. Pam Masterson says:

    Our hospital/clinic has chosen not to accept any Medicare Advantage programs because of the problems they had with Anthem Medicare Advantage. We live 50 miles from the closest hospital besides the one in our town. What happens in the case of a stroke, heart attack, etc. where time is of the essence? Can’t PERA offer the choice of a supplement like we had before Medicare Advantage?

  16. Melody says:

    The one thing to remember is that health insurance is a massive business. They are in business to make as much money as possible in every way the can.
    I am Pre-Medicare and the PERA plan looks horrible to me. On the western slope the only offer is United Health Care. I have asked PERA to send more information but it looks like everything is a 20% copay.
    For those of you worried about prescription costs try GoodRx and others like that. Under my current plan GoodRx beats the cost every single time. I was even asked by my insurance company where I get my prescriptions. I told them GoodRx has a cheaper price than my insurance plan in every single example. GoodRx won’t go towards your deductible as part of the insurance company plan is to make money off of each prescription we buy. We pay the premium and we pay money to them for the prescription.
    I do not know if this plan is under the United Health Care CEO David Wickman. Wickman made $17.87 million in 2020.

  17. Kim Lack says:

    PERA, why did premedicare go up?

    • PERA On The Issues says:

      Hi Kim, unfortunately rising health care costs are a problem across the country. Premiums are primarily driven by the cost of services and prescription drugs, and PERA’s pre-Medicare plans cover retirees aged 50-64, which is a group that generally uses more services than other sections of the population. PERA understands the impact the premium increases have on our retirees, and we participate in several health care organizations that are working to improve the affordability of the health care marketplace both locally and nationally, and participate in and adopt new programs where possible.

  18. Wendell logan says:

    Is the new united Healthcare plan through PERA the one sold by AAAP.

    • PERA On The Issues says:

      Hi Wendell, no, this is a custom Group Medicare Advantage (PPO) plan designed exclusively for Colorado PERA retirees.

  19. Fred Boettcher says:

    Today’s Denver Gazette, page C 1. Top article on high inflation hurting consumers. Bottom article on social security going up 5.9%. Nice to know that PERA supported to freeze our increase at 0 or 1.25% or whatever. Pathetic!

  20. Judith Lavezzi says:

    Everytime a new provider comes around that has a New Lower Cost as its banner, I know that what it really means is lower service and lower coverage. Even the Advantage program that I had was downgraded over the last few years, as more and more medicines became unavailable, and the co-pay, when they were approved was outrageous. I would like to know that the prescriptions aren’t equivalent when the doctor orders one thing, and the 22 year old telephone person tells me that is not what is covered. The cost of medicine is totally out of sight. Do I still have my choice of doctors? Or did United Health Care choose that for me too, as the price for my “lower cost”

  21. Chill says:

    I am sure our PERA COLA will be increasing since Social Security COLA is actually trying to keep up with REAL inflation. Right?
    And still no WEP fixes yet. Oh well baby steps I guess. Which is ok if you are a baby.

  22. Fran Aguirre says:

    PERA has been losing millions per year on their investments in coal, oil and gas. Check out their investment portfolio. When they are losing this money, are they trying to make it look like they are reducing costs for pre-retirees and retirees? Have they reduced the salary of the top CEO’s????

  23. Ed Brown says:

    The new UHC medicare plan offered by PERA is the best plan I’ve been offered since I retired in 2008. I moved out of the state when I retired, so Anthem was my only option. Their medicare option #1 is $145 a month, but there are virtually no copays for doctor visits, lab tests, x-rays etc. The plan from UHC is basically the same except it costs $37 a month. A savings of $108 a month! Most medicare plans with 0 premiums usually have substantial copays for everything. This is an excellent plan! Thank you PERA. Good job!

  24. Rosalind Hanckel says:

    I am trying to get clarification of the benefits of United Healthcare and the numbers I call are answered by people who don’t really have any idea about benefits in Colorado. They are from out of state and ask me to spell my name 2 or 3 times, speak poor English and are looking up the benefits as we are speaking. Then they are unsure of what the benefits really are. Is there anyone we can speak with at Colorado PERA who really understands the plans? I am very frustrated. I called United Healthcare and Colorado PERA with the same results.

  25. Bill says:

    Why do the PERACARE open enrollment dates (October 11 -November 17, 2021) differ from the general Medicare open enrollment dates (October 15 – December 7, 2021)?

    • PERA On The Issues says:

      Hi Bill, we end our open enrollment period a little earlier so that we can process all enrollment changes and get that information to carriers to ensure that everyone’s coverage is set up and ID cards received before Jan. 1.

  26. B. Jensen says:

    United health care medicare supplement will force me out of an IV drug that was completely covered to a self-inject version that will run $5000+ per month. How is this an improvement over Anthem’s coverage?

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