Community Health Systems and Fresno Unified\u2019s<\/a> health insurance provider, Aetna, disrupted retiree coverage.<\/p>\nThe disruption began Jan. 1, when Aetna\u2019s Medicare Advantage Plan removed Community Health Systems from its network after the two organizations failed to reach a contract agreement. About 6,250 retirees lost coverage, with roughly 1,500 still able to access primary care through Community.<\/p>\n
Community President and CEO Craig A. Wagoner said that the provider has agreed to extend access to clinic visits and prescription refills through Feb. 20 while negotiations continue. Emergency services and ongoing treatments, including cancer care, remain available, though other services require Aetna approval on a case-by-case basis.<\/p>\n
Emily Brandt, a Fresno Unified retiree, said the extension still leaves uncertainty for patients.<\/p>\n
\u201cThat\u2019s a little vague because sometimes we go for a cancer treatment,\u201d she said. \u201cMr. Wagoner did say publicly that it included cancer treatments. \u2026 There are many kinds of cancer treatments. Does that include surgery? We don\u2019t know. So we are all, FTA and FUSD, nervous with the uncertainty.\u201d<\/p>\n
Fresno Unified Trustee Susan Wittrup criticized the concessions as insufficient.<\/p>\n
\u201cThat\u2019s really not widespread enough to be an appropriate or adequate concession,\u201d she said. \u201cOur people need widespread service and communication to return so that they can get the care they need \u2026 I am still really wanting Aetna and Community to step up and quit using our retirees as pawns in their negotiations.\u201d<\/p>\n
Board Approves Additional Coverage Option<\/p>\n
The district\u2019s Joint Health Management Board (JHMB) also approved on Thursday allowing Medicare retirees to enroll in traditional Medicare as their primary coverage, with a PPO plan as secondary. Previously, retirees could choose only between Aetna Medicare Advantage PPO and Kaiser Senior Advantage HMO.<\/p>\n
The new plan is \u2018intended\u2019 to take effect Jan. 1, 2027, with enrollment during the open period from Oct. 1 through Nov. 30. The district said it will provide detailed information, educational resources, and enrollment support to help retirees compare options.<\/p>\n
The board\u2019s approval included representatives from employee unions and district management.<\/p>\n
\u2014<\/p>\n
Connect with\u00a0\u00a0on social media. Got a tip? Send an\u00a0.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"Fresno Unified School District on Thursday announced a new healthcare option for Medicare retirees, more than two weeks…\n","protected":false},"author":2,"featured_media":135077,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[31],"tags":[112,114,113],"class_list":{"0":"post-135076","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-fresno","8":"tag-fresno","9":"tag-fresno-headlines","10":"tag-fresno-news"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/135076","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/comments?post=135076"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/135076\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/135077"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=135076"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=135076"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=135076"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}