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

Getting a letter that declares, “An exciting new prescription drug benefit for you!” should activate your BS detector.

Getting a letter that declares, “An exciting new prescription drug benefit for you!” should activate your BS detector.

By

[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.

Attached Files

Comments by Readers

Geoff Middaugh

Nov 05, 2023

Thanks Dick.   Very informative for us right now.   I hadn’t figured it out yet, but you have.  

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Dick Conoboy

Nov 05, 2023

 Geoff,

Well, if my internet searches are of any measure, I am the only one to have figured it out at present.  That in itself gives me pause.  Being point man is a dangerous business!

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Dave Stanbrough

Dec 09, 2023

Thanks Dick,

As I read your article I saw it was a replay of my experience so I won’t retrace covered material except for a few additional points on mine. Like you I sent my Opt Out form in with Delivery Confirmation which arrive Scranton, PA Nov 3rd. All good, right? Not! On Dec 5th I get a packet FEP MEDICARE PART D KIT. I spent the next 3 days on the phone and eating Ativan hoping my 5 heart stents would hold out. So finally got a recording which allowed me to verbally say Opt Out and got a reply my record had been updated and I would get a letter in 7-10 days. I didn’t trust that so I continued calling until I got a live voice. The young lady said she was updating my record and a letter would follow in 7-10 days. My heart would not rest. I decided to log into my Medicare account only to find out the dirty bastards had already enrolled me in Part D effective 1/1/2024. I got a Medicare Customer Service Agent on the phone while we both viewed my record. I briefed her on the situation and cited the new Medicare “escape hatch” where I had been enrolled without my consent or knowledge and could she at least FLAG my account with that notation. She said she was already doing it as we spoke. So I rested a bit, starting to think about the letter I was going to write and how many ways I can call somebody a chickenshit. But yesterday the 8th, I logged into Medicare and the Part D enrollment was gone. So in the end I thought more about this required Opt Out or saying No. One analogy comes to mind. Even if the word NO cannot be expressed it’s still a reportable rape! Even after the start date of 1/1/ 2024 there still is a “escape hatch”. I hope more retirees find your article. Best wishes!

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Dick Conoboy

Dec 09, 2023

Dave,

Thanks for your most revealing comment.  This entire Medicare Part D operation seems to have been put together with chewing gum and baling wire.  I will look into all this further as we slide into 2024.

Regards,

Dick

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Dave Stanbrough

Dec 10, 2023

Dick,

Please do continue to investigate. You connected an important dot to CVS/CAREMARK which appears to be setting up a shadow Medicare Advantage Drug Plan under the FEPBLUE logo. Reading the fine print on all their documents states that continued enrollment is dependent on Medicare contract renewal. By any other name this is a contract Advantage plan and they have to follow Medicare rules which includes the “escape hatch”. They simply cannot enroll anybody without consent! Their OPT OUT strategy is flawed and worthless. How do you OPT OUT of something you are not in? 

Dave

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Dick Conoboy

Dec 11, 2023

Dave,

Correcta Mundo!  😊

But someone at CMS is ignoring what you stated so simply. 

Yet another reason to call the line and protest as I urged all to do in the update to my article on the 6th of December.

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Dave Stanbrough

Dec 16, 2023

UPDATE: On Dec 12 I got a letter Welcome to FEP MPDP PART D. I tossed it on the pile that I had been accumulating, then logged into Medicare. Still no Part D had been added. Then on Dec 15 another FEP letter ( dated Dec 7) confirming my OPT OUT. It appears there is a lag time in their screwed up system. So now I am wondering if I will still get a new enrollment card which I will have to sort out. What a screw up!

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