Health Care Benefits

Health Care Benefits

By

Leonard Zwelling

In response to a great deal of confusion and misinformation, the Faculty Senate sponsored a town hall on July 22 to educate the faculty on its health care benefits package. The main speaker was Laura Chambers from the UT System who designed the health insurance program currently in place. This program covers far more than the MD Anderson faculty. It covers the faculty, staff, and trainees at all UT components and those of Texas A and M. Over 200,000 people are in the risk pool and over 33,000 retirees.

I am going to try to outline the coverage as I understood the presentation. I urge each faculty member to fully familiarize himself with the details of the plan that applies to him and his family. Here’s my take.

1. These are great plans, far better than anything that one could acquire on the open insurance market.
2. There are two main parts. Which of the two plans you are in is determined by whether or not you are still employed and whether or not you are over 65. UT SELECT is for those still working or retirees under 65. It works like a PPO. UT CARE is for retirees. It is actually the better of the two plans as there are almost no co-pays in UT CARE. It is a true Medicare Advantage plan, but with many extras and no downside.
3. Everyone gets Medicare Part A when they turn 65. This is for hospital care.
4. You must apply for Part B which covers out-patient care. You do that about three months before turning 65 if you are retired or three months before retiring if you are already 65. If you are still working and on UT SELECT, you need not get (and pay for) Part B.
5. Part C is the Medicare Advantage part of UT CARE. It is what has gotten the bad rap as many such plans are not inclusive of all physicians. But UT CARE covers a majority of doctors in the US—all who take Medicare and bill Blue Cross.
6. Part D is the drug benefit. That is provided by Express Scripts and is optional, but advisable if you take any chronic meds.
7. Coverage for dependent care must be paid for at about 50% of the total premium.
8. ALL UT employees are in these programs. Yes, even President Pisters.
9. It is not administered by MD Anderson but by UT System.

On a personal note, as many of you know, I am 76 and retired (and thus on UT CARE), and my wife, Dr. Kleinerman, is not retired so she’s on UT SELECT. My coverage is better than hers as I rarely pay co-pays and she almost always does.

Thus, anyone who tells you that the MD Anderson health care benefits are not fabulous is just plain wrong.

If you have questions, I refer you to the Physicians Referral Service or Human Resources, but it is in your best interest to learn about these plans in detail. Yes, it does affect you and yes, it does matter.

I say this because fewer than 300 people attended the town hall meaning the vast majority of faculty may still be in the dark about their benefits, or worse, listening to people who know less than they do.

Get the facts from PRS and make your choices accordingly. Just know that the leaders at UT System have worked hard to develop this unique plan and all faculty members benefit from the efforts of Ms. Chambers and her team.