In the proposed Aetna Medicare Advantage PPO plan, copays will either remain the same as GHI Senior Care or be eliminated altogether. In no instance will copays go up.

As part of the new plan, the Municipal Labor Committee also negotiated new benefits and services that will further reduce out-of-pocket costs related to your health care. The MLC is scheduled to vote on Aetna’s proposed plan next week. 

Lower copays and deductibles

The following services will have lower out-of-pocket costs than GHI Senior Care:

• An annual deductible of $150 with no Part B deductible starting in 2024. The annual deductible for 2023 will be waived for all New York City retirees since most will already have met the deductible by Sept. 1. (In GHI Senior Care, there is a $276 annual deductible – $50 for GHI and $226 for Medicare Part B.)
• No copay for primary care physician office visits
• No copay for radiation therapy, cardiac rehabilitation therapy or pulmonary rehabilitation therapy
• No copay or annual maximum for durable medical equipment and ambulance
• Preferred generic drugs for free
• No copay for routine hearing and vision exams
• An annual out-of-pocket maximum of $1,500 — the most you have to pay for covered services (including deductibles and copays but not prescription drugs). Once you reach that maximum, you will not have any more out-of-pocket costs for the year. GHI Senior Care had no cap.

See the plan comparison chart
 

New benefits and services

• Hearing aid reimbursement of up to $500 a year (in addition to your Welfare Fund and SHIP reimbursements)
• Teladoc visits (24/7 access to doctors by phone or virtually to get medical treatment for non-emergency conditions) with no cost share
• A 24-hour nurse line
• Unlimited telemedicine behavioral health visits with no cost share or deductible
• A free annual visit by a licensed clinician to provide a health assessment
• 28 free meals in up to 14 days delivered after a stay at a hospital or skilled nursing facility
• 24 free one-way rides each year to and from medical appointments
• $120 annual allowance ($30 every three months) on health and wellness products including vitamins and over-the-counter pain relievers
• Routine podiatry (with $15 copay) now covered