Retirees With Federal Employee Health Care - Beware Of Offers To Switch Drug Coverage

[Update 12/6/2023 5pm: I have received some feedback, directly to me from some Blue Cross Blue Shield/Federal Employee Program (BCBS/FEP) insureds, that tends to confirm that BCBS/FEP rolled this out as a sneak endeavor to offload their prescription coverage into a privatized entity, CVSCaremark.  However, when challenged during phone calls from insistent insureds like those from whom I am hearing, CVS phone representatives tend to back off and allow an opt-out even though the deadline of 12 November has passed.  The fact that the opt-out was never put online tells me that CVSCaremark and BCBS/FEP did not want the opt-out via computer because that makes opting out too easy, causing CVSCaremark to be overwhelmed with opt-outs.

If you still want to opt-out, I suggest that you call the information line 888-338-7737 (armed with my article for backup) and insist that the opt-out be granted.  Ask for the agent’s name and ID number up front. Complain about the short notice. Complain that the phone number connects you only with CVS, a private corporation, and not a government office.  Tell them you will contact your congressional representative and your state’s insurance commissioner, if not granted the opt-out.  If you get a refusal call back later and get another agent who may just cede to your demands. Be audacious!]

About a week ago, I received a letter (see copy below, at FILES) ostensibly from my supplemental health insurer, Federal Blue Cross-Blue Shield (BCBS). It informed me that my prescription drug coverage under them would automatically be moved to the Medicare Prescription Drug Program (Part D) unless I opted out. As a former government employee, this federal BCBS coverage has been my supplemental coverage (I am in Traditional Medicare) since I retired. That coverage also included prescription drugs. Overall, I have been very happy with it. This letter indicated that I had until November 12th to opt out. I called the 800 number they provided and, after multiple attempts, I finally got through the Whack-a-Mole prompts on my keypad. I spoke with a very pleasant woman who, after several questions about the origin of the letter, admitted she was neither with BCBS nor Medicare. She was with CVS Caremark, the private, for-profit pharmacy corporation. BCBS shilling for CVS? Not good, I thought.  

Since the agent was “representing” BCBS, the letter was not totally false, but it was manifestly misleading since I was not talking with my supplemental insurance provider, BCBS, but a PRIVATE INSURANCE CORPORATION BEING PAID TO ANSWER QUESTIONS ABOUT A PLAN FROM WHICH IT WOULD PROFIT.  

As the conversation continued, I learned a couple of things, some specific to my case, and some general information I'll share. 

Were I to opt into their Medicare Prescription Drug Program (MPDP) Part D program they were promoting, they said I could leave at any time (really?) and return to the BCBS pharmacy coverage. But beware, this opting-out, after being automatically opted-in, may not work for those with non-federal insurance coverage who choose to carry Part D.   

This agent also told me that the Part D coverage offered in the letter was likely better for those who currently had high co-pays. I observed that the info presented made it very difficult to figure that out, especially for the elderly who can become confused and taken advantage of. The short time frame given to make a decision also worked against the insured. I complained that this letter came out of the blue. She admitted she was hearing the same complaints from other callers. I encouraged her to bring the issue up with her boss(es).  Mmmm….fat chance?

Then I called the real BCBS Federal Employee Program, the one I count on to provide my prescription drug coverage. It was not easy to reach a person I could actually converse with, but I finally got a fellow whose only info was a simple fact sheet on MPDP. I asked him if premiums for the BCBS pharmacy program would decrease across the board, given the windfall BCBS would experience when it unloaded its drug coverage onto Medicare. I knew that, at least for me, that would not be the case since my BCBS premium will increase next year by nearly $500. The agent also said that my call was not the first on this topic, although overall he has had relatively few. This was not surprising, since callers again have to play Whack-a-Mole with the prompts to speak to a human.

If this all seems a bit confusing, it is because it is difficult, even for the most informed, who struggle with the intricacies of medical insurance argle-bargle. I do smell a hidden scam by the private insurers, at least in this case with BCBS. They want to offload their drug programs onto Medicare, where it is most likely that Part D will devolve into a Mini-MedicareAdvantage program. 

Wasting no time, I mailed my opt-out letter (with tracking) and could see it had been delivered to the address specified. The CVS Caremark personnel, probably disguised as employees of BCBS, are now processing my demand in some warehouse in Scranton, PA (sacred birthplace of “Uncle Joe” Biden who is letting the privatization of Medicare continue apace). I should get a confirmation letter from CVS/BCBS/Medicare (pick which, you never know) informing me of the “approval” of my opt-out choice. We shall see.

The sad part is that even if one pays close attention to these Medicare privatization machinations as I thought I did, one can easily be caught unaware. This is abject cruelty visited upon our most vulnerable citizens. You don’t have to look far for examples of crimes against humanity and I do not feel that I am exaggerating the situation by calling it just that.

In the same “crimes against humanity” vein, we have PeaceHealth, the risibly-called "Catholic non-profit” that has monopolized health care in the Pacific Northwest. I barely avoided being moved out of Traditional Medicare when our local medical care behemoth, PeaceHealth, moved all who had primary care providers with them into their own, for-profit Direct Contracting/ACO Reach. My PC was not with PeaceHealth so I escaped… barely. There are more and more traps laid by Medicare to lead participants into privatized programs that make money from denying claims. But you do get those twinkley-toed gym shoes up front to make you think you got a great deal.

In the meantime, my advice to fellow federal retirees with BCBS is do not to sign up for this offer until you check with your current plan administrator!

Act now!  The deadline is November 12th.