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On March 30, 2023, the City of New York contracted with Aetna to provide a Medicare Advantage plan to the city’s roughly 250,000 retirees and their dependents. Aetna will replace the city’s fully subsidized Senior Care Medicare supplement plan provided by EmblemHealth. The five-year contract with Aetna features premium-free coverage, lower deductibles, and a cap on out-of-pocket spending. The contract also reduces the number covered services requiring prior authorization and includes new benefits and programs, such as non-emergency medical transportation, fitness programs, and wellness incentives.

The city estimates that switching retirees from . . .

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Medicare

The Medicare program is a health insurance program funded by the federal government for older adults, aged 65 and above, as well as younger individuals who have disabilities or end-stage renal disease. There are both strategic opportunities and challenges for health and human service provider organizations serving Medicare beneficiaries, who often have complex health and social support needs. As a result, Medicare plans are looking for innovative services and initiatives that demonstrate a return-on-investment in spending and consumer outcomes.

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Medicare mental health specialists with high uptake of telemedicine mental health services between 2018 and 2023 had a 0.88 percentage point higher share of services provided to fee-for-service (FFS) beneficiaries in rural areas, compared to mental health specialists in the lowest telemedicine uptake quartile, according to a recent study. Much of the increase in rural service use was due to existing patients moving farther away from their specialists, rather than new rural beneficiaries seeking out… Read

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