Retired Teachers Chapter News

Rate decrease for some non-Medicare GHI retiree subscribers

Sep 21, 2006 3:08 PM

A decrease of approximately $5 in their monthly premium goes into effect on Oct. 1 for retirees who are in the Non-Medicare GHI plan. The decrease results from the introduction of Step Therapy and Prior Authorization of certain drug classifications in the plan design. This will help manage and stabilize premium and co-pay costs.

Retirees will see the adjusted amount in their October pension checks. The new monthly rates are $105.46 for individuals and $197.84 for family coverage.

Step Therapy and Prior Authorization are already in the drug plan of UFT in-service members. Step Therapy encourages the use of safe and effective first-line medications, first-line drugs that are well established and known to be safe and effective.

Members who are currently using a specific prescription drug will continue to receive that drug. Step Therapy applies only to members trying a prescription drug therapy for the first time.

Prior Authorization requires a prior approval by the plan to assure that certain drugs are being administered according to FDA guidelines. In all cases, the member’s physician can consult directly with the plan administrators to expedite the needed prescriptions.

Since there are many generic versions of diabetic prescription drugs now available, that part of the drug plan has also been adjusted. Generic diabetic co-payments will remain at $5 and brand-name diabetic medications co-payments will be $15.

The rates for retirees who are enrolled in the GHI Senior Care/Medicare Part D plan remain unchanged through the end of the calendar year.

The New York City Health Benefits program will be mailing information to participating retirees in the coming weeks.