Serious Concerns Remain Regarding Regressive Healthcare for Retired Public School Employees in Texas

Since the Teacher Retirement System of Texas held informational meetings two weeks ago regarding the dramatic healthcare changes that will take effect in January for all retired public school employees, I have received a number of emails and calls from people with countless questions and serious concerns about what is about to hit us.  I have written extensively about the bottom line, especially for those of us who are under the age of 65.  That bottom line about what the Texas Legislature has done to us includes:

·         The deductible for the individual retiree is increasing from $400 to $1500 in-network.

·         There will be no copay for healthcare or prescriptions until that deductible is met, meaning the retired employee will pay 100 percent (see only exception below—fifth bullet ) out of pocket.

·         The deductible for retirees who have a spouse/child on their insurance increasing to $3000, and not a penny will be paid (see only exception below—fifth bullet) until that is reached.  It will not be based on the individual but rather on the family unit.

·         The Maximum Out of Pocket will be $5,650 for the retiree and $11,300 for the family for in-network expenses.  For out-of-network expenses it will be $11,300 and $22,600, respectively.

·         This list of standard, generic drugs will be covered at 100 percent.

·         Some retired teachers under 65 still don’t know there are no longer three tiers of healthcare plans from which we can choose.  Now we have only one option—the high-deductible plan.

            I have also written extensively about how hard the Texas Retired Teachers Association fought for us. Their calls to action—and the overwhelming response from public school retirees across the state—played a significant role in making the changes a bit less devastating.  (Take, for example, that the Texas Legislature originally voted to increase the deductible for an individual retiree from $400 to $3000!)  Because “the sleeping giant” (aka retired educators who have a tendency to remain silent) awakened and bombarded Texas legislators with phone calls, emails, and visits to their offices, changes were made during the special session.  The $35 annual fee it costs to be a TRTA member is definitely money well spent.  And remember, the Texas Legislature meets again in 2019!  There is no time for silence! 

            It was TRTA that provided legislators and members with some startling facts, including…

·         During almost half of the 30-year history of TRS-Care, the State funded only 0.5% and the school districts contributed nothing.

·         TRS has more than 375,000 retirees with an average annuity of $1995 per month, while 105,000 retirees receive $1000 or LESS per month.

·         95% of public school employees do not pay into Social Security and the vast majority of retirees do not receive ANY SS benefits due to the GPO and WEP. TRS is their sole form of retirement security!

           

            There are a few things I learned at the TRS session that at least provide a glimmer of light in this healthcare darkness.  Here is one of them:

·         We will have a service available to us called “Teladoc.”  This service will allow us to speak to a licensed doctor 24/7/365 via telephone, website, or mobile app in fewer than 10 minutes to treat such conditions as bronchitis, pink eye, skin infections, depression, and anxiety.  Their network includes over 3,100 licensed healthcare professionals, including physicians, dermatologists, and mental health therapists who average 20 years of experience.  They are able to provide us with short-term prescriptions.  Rather than paying the cost of a doctor’s visit or an urgent care facility (with no copay, remember), there will be a $40 consult fee if our deductible has not been met--and that fee goes toward the deductible--or an $8 fee if our deductible has been met. 

            More next week on other programs we should all know about as the clock keeps ticking to our new, regressive healthcare plan.

NOTE:  To wake up and get engaged, we should all be members of our local unit of TRTA, too!  Next Monday is the meeting for the McAllen/Mission-area chapter. Although lunch is available for purchase, it is not required.  Annual membership dues are just $10.

To find the unit nearest you, click here

SECOND NOTE:  Have you visited FamilyWize yet?  If you ever have prescriptions, please do!

THIRD NOTE:  If you were unable to attend the TRS sessions on our healthcare changes but want to know what they had to say, visit this page to watch the webinar.

FOURTH NOTE:  If you aren’t familiar with Texans for Public Education, I urge you to go to their website and/or to follow their threads on Facebook.  It’s about non-partisan block voting for candidates with a record of supporting public education. 

STAY AWAKE, FORMERLY SLEEPING GIANT!!

Chris Ardis retired in May of 2013 following a 29-year teaching career. She now helps companies with business communications and social media and works as a sales coordinator for Tony Roma's and Macaroni Grill. Chris can be reached at cardis1022@aol.com. (Photo by Sarina Manahan)

Texas Legislators—How Could You?

As I walked out of the Hynes Event Center in Mercedes Monday, October 23, I felt sick.  Literally.  I also felt angry….and sad…and worried.  How could Texas legislators do this to public school employees who spent years teaching our state’s children, caring for their physical and emotional needs, feeding them, keeping the facilities clean, answering the phone and greeting parents and community members, and doing everything else school district employees do?

            I had just left a Texas Teacher Retirement System session about the changes to our healthcare plans, compliments of the 85^th Texas Legislature.  For those of us who are under 65, our plan is called a “High Deductible Health Plan.”  Healthcare.gov describes an HDHP like this:  “A plan with a higher deductible than a traditional insurance plan. The monthly premium is usually lower, but you pay more health care costs yourself before the insurance company starts to pay its share (your deductible).”  Perfect description.

            I already knew the 85^th Texas Legislature raised our deductible from $400 to $1500.  I also knew I would no longer have a co-pay.  What does that mean?  It means that now when I go to the doctor or pharmacy (That’s right!  I no longer have a pharmacy co-pay, either.), instead of paying approximately $25, I will pay the full bill until I reach my $1500 deductible.  No problem.  As a wealthy retiree, $1500 is chump change.  Oh, wait!  I am a retired teacher.  Fifteen hundred dollars is a lot of money.

            Once I reach my $1500 deductible, Aetna will pay 80 percent of my medical bills and prescription drugs, if I use an in-network doctor.  When I have paid $5650 out of pocket to in-network facilities, physicians, and pharmacies, Aetna will pay 100 percent of my in-network medical costs.

            The more the presenter talked, the sicker I felt.  I couldn’t imagine how retired public school employees whose spouse is covered under their TRS healthcare must have been feeling.  For them, grim couldn’t even begin to describe their situation.  The deductible for public school retirees with two or more family members on their healthcare plan is $3000.  You would think that means $1500 for the retiree and $1500 for the spouse, but that’s not the case.  Thanks to our Texas legislators, those retirees must pay 100 percent of their medical and prescription costs until they have spent $3000 out of pocket.  So even if the retiree has already paid $1500 for medical and pharmaceutical bills, he/she has to keep paying until $3000 has been spent.  However, when it comes to the family’s maximum-out-of-pocket, that is figured on an individual basis rather than by family.  Go figure.

            Texas Legislators, how well do you know the statistics?  According to the Texas Retired Teachers Association, TRS has more than 375,000 retirees whose average monthly pension is $2035.  But what’s even worse…much worse…is that 30 percent of TRS retirees, roughly 105,000, receive $1000 or less per month.  How in the world do they expect these dedicated public school retirees to afford the healthcare they have subjected us to? 

            But why should they worry?  After all, remember--they kept all other state employees, whose healthcare is covered by the Employees Retirement System of Texas rather than by TRS, at a $0 deductible.  And don’t forget—that includes retired legislators who have served at least eight years.  So I served the children of this state for 29 years, and I have a $1500 deductible with no co-pay, and they can serve eight years and pay a $0 deductible?

            Texas Legislators, how could you?

(Note:  Last week, Eloise Montemayor, community relations/public sector associate with United Way of South Texas shared information with me about FamilyWize, a United Way partner that reduces the cost of prescription medicine through agreements with pharmacies nationwide.  FamilyWize is for individuals with and without insurance, there is no cost to use FamilyWize, and there are no income qualifications.  Go to familywize.org and print out a card or download the app.  For any prescription medication you need to purchase, visit their site and find the local pharmacy that will give you the best deal.  When you go to pick up your prescription, show them your card.  At this point, every penny counts.)

Chris Ardis retired in May of 2013 following a 29-year teaching career. She now helps companies with business communications and social media and works as a sales coordinator for Tony Roma's and Macaroni Grill. Chris can be reached at cardis1022@aol.com. (Photo by Sarina Manahan)