Changes in BJ retirees coverage

I received the 2011 Aetna Medicare 85 PPO Plan for Beacon Journal retirees in the mail. Some of the changes are mandated by the health care reform law recently passed. The main change is that there will tremendous differences in costs if you do not use doctors and facilities that are in the Aetna PPO network under Beacon Journal retiree coverage.

What I saw, if I interpreted things correctly:

$10 co-pay for Tier 1 Generic. Apparently the $5 co-pays are a thing of the past before you hit the dreaded donut hole. The cost to you doubled over 2010.

$40 co-pay for Tier 2 Preferred Brand.
$80 co-pay for Tier 3 Non-Preferred Brand.
That sounds the same as in 2010.

Once you hit the dreaded donut hole:

$5 co-pay for Tier 1 Generic, same as in 2010.
100% co-pay for Tier 2 and Tier 3. Same as 2011 for Tier 3. Not sure whether Tier 2 is an increase over 2010. And the prescripition charge is only for ONE month, not the 90 days as in 2010, if you use a retail pharmacy. It's $10 for 90 days if you use Aetna Rx Home Delivery.

Other items I noticed:

100% coverage for routine physicals, gynecological exams and related lab fees, digital rectal exam and PSA prostate tests, colorectal cancer screening, eye and hearing exams and diabetic supplies after you meet the $250 annual deductible as long as you use network doctors and facilities. Otherwise, you'll pay 25% after you hit the deductible.

There are other changes, so read your Aetna Medicare letter and sheets carefully. If you have questions, call the Beacon Journal Human Resources office for answers. And email John Olesky at Jo4wvu@sbcglobal.net

with the answers you get so he can share the information on the BJ Alums blog.

You can go to AetnaMedicare.com and click on

Find Out

along the right side. And then click on

Find Doctors

And then type in your zip code and put in the distance (I put 40 miles), go to

Provider Type

And make a choice (I typed in Primary Care Physicians) and then go to

Plan

and select

Aetna Medicare Plan PPO

and click on

Start Search

I did that but did not find my primary care physician on the list. I called my primary care physician's office and they said that they were covered.

Since there's a major dollar difference between paying $0 and 25% for in-network and out-of-network, it's worth your time.

Good luck!