FAQs About Aetna Medicare Advantage PPO Plan

Click here to view a comprehensive FAQ, organized by category, to answer members' questions about the Aetna Medicare Advantage PPO plan for Medicare-eligible New York City retirees/dependents.

Visit Aetna's website to learn more about the Aetna Medicare Advantage PPO and view plan documents: https://www.aetnamedicare.com/cony/en/index.html

If you have questions about the Aetna Medicare Advantage PPO plan that are not addressed in the FAQ, contact Aetna Member Services at (855) 648-0389, 8 a.m. - 9 p.m. ET, Monday - Friday.

NYC Health Benefits Program - FAQs about NYC Medicare Advantage Plus PPO Plan

The NYC Medicare Advantage Plus Plan was not implemented on April 1, 2022. All retirees will remain in their current plans until further notice. For additional information, you can call the special Alliance call center at 1-833-325-1190, Monday to Friday, 8 a.m. to 9 p.m. Click on the below link to review:

Frequently Asked Questions about the NYC Medicare Advantage Plus PPO Plan (June 16, 2022)

Medicare Lawsuit Decision And Order On Motion

An INJUNCTION/RESTRAINING ORDER was filed alleging the respondents (City of NY and Office of Labor Relations) unlawfully amended the Medicare plan of current retirees. The Court has previously held on October 21, 2021 that the selection of the Alliance to administer the proposed Medicare Advantage Plus Plan was not arbitrary and capricious, however the implementation of the plan was irrational. As such, the Court ordered the parties to conference and negotiate a favorable implementation process and for the respondents to present to the Court a plan consistent with the October 21 order. On 12/14/21, the NY Supreme Court Honorable Judge Frank ruled on the Medicare Advantage lawsuit allowing the MA plan to go forward effective April 1, 2022, subject to the Alliance’s interim reporting on implementation plan progress. To read the Court’s 12/14/21 decision click here .

Since that time, the parties have made multiple submissions and appearances before the Court; and on 3/3/22, the Honorable Judge Frank issued a Decision and Order on Motion ordering that “the preliminary injunction previously put into place by this Court is lifted, except that:

1. Enrollment in the Medicare Advantage Plan may not occur until at least April 1, 2022, and that retirees shall have the option of opting out of the Medicare Advantage Plan for not less than three months following the effective date of the Medicare Advantage Plan;

2. The respondent is permanently enjoined from passing along any costs of the New York City retirees’ current plan to the retiree or to any of their dependents, except where such plan rises above the H.I.P.-H.M.O. threshold, as provided by New York City Administrative Code Section 12-126; and

3. The respondent shall ensure that all retirees and dependents of such retirees pay the deductible for only one plan for the calendar year 2022. Click here to read the entire Court Decision

New information and updates regarding the NYC Medicare Advantage Plus Plan

As per the NYC Office of Labor Relations Health Benefits Programs, the NYC Medicare Advantage Plus Plan is not being implemented on April 1, 2022.

Retirees do not need to opt out of the Medicare Advantage Plus Program in order to remain in Senior Care or their current plan on April 1.

All retirees will remain in their current plans until further notice.

We will post updates for retirees as we have more information.

For additional information, you can call the special Alliance call center at 1-833-325-1190, Monday to Friday, 8 a.m. to 9 p.m.

For additional information and resources on NYC Health Benefits Programs click here


Medicare Advantage Lawsuit Decision

An INJUNCTION/RESTRAINING ORDER was filed alleging the respondents (City of NY and Office of Labor Relations) unlawfully amended the Medicare plan of current retirees. The Court has previously held on October 21, 2021 that the selection of the Alliance to administer the proposed Medicare Advantage Plus Plan was not arbitrary and capricious, however the implementation of the plan was irrational. As such, the Court ordered the parties to conference and negotiate a favorable implementation process and for the respondents to present to the Court a plan consistent with the October 21 order. On 12/14/21, the NY Supreme Court Honorable Judge Frank ruled on the Medicare Advantage lawsuit allowing the MA plan to go forward effective April 1, 2022, subject to the Alliance’s interim reporting on implementation plan progress. The Judge accepted our argument that retirees are to be held harmless for possible multiple deductibles occasioned by being in one plan for the first part of the year and then in the MA plan for the balance. To read the Court’s decision click here

Any questions please free to contact the union office . We hope to have another information session sometime after the holidays.


Office of Labor Relations Issues Notice of Medicare Advantage Plan for Retirees

Starting in January 1, 2022, the City of New York and the Municipal Labor Committee have agreed to implement a Medicare Advantage program for all City retirees and their eligible dependents age 65 and over. The new program will be called the NYC Medicare Advantage Plus Plan and be provided by an Alliance between Empire Blue Cross Blue Shield and EmblemHealth. The NYC Medicare Advantage Plus Plan will provide comprehensive premium-free health coverage to retirees. The NYC Medicare Advantage Plus Plan will allow retirees and their eligible dependents to keep their current doctors and hospitals. All retirees and their eligible dependents will automatically be enrolled in the NYC Medicare Advantage Plus Plan. Retirees who do not wish to be enrolled in the new Plan, effective January 1, 2022, will have the ability to opt-out and remain in their current retiree health plan. To remain in their current health plan, retirees will have to pay an additional plan premium, the specifics for which will be determined in August, and available on the Health Benefits Program website at https://www1.nyc.gov/site/olr/health/summaryofplans/health-ratechart.page.

Click here to read the entire notice.

Customized Group Medicare Advantage Plan for NYC Retirees

Please review the MLC presentation on Customized Group Medicare Advantage Plan for NYC Retirees. Retirees had many questions concerning this issue and the presentation may clarify and provide additional details on how the medicare advantage plan will work. UPOA is in the process of scheduling a Zoom meeting for Retirees in August 2021 (meeting details will be emailed as soon as it is scheduled) to review the presentation and provide any additional information.