One of the very few benefits that NYSUT offered that was considered a good deal was the Catastrophe Major Medical Plan. This plan is an affordable supplemental health insurance policy that pays benefits for nursing home care, rehabilitation, at home care, and other medical expenses not covered by the basic health care, including Medicare. The plan was closed in 2011 and many UFT members missed out on a plan that, had they knew about it , would have joined. The good news is that NYSUT has decided to reopen the CMM plan. You can read the information Here
The actual application for the NYSUT CMM is now available on the NYSUT member benefits page but you can download the 3-page application with instructions Here.
The deductible ranges from zero for preventive benefits to $5,000 per family and $2,500 for an individual. The annual premium is age dependent and ranges from a low of $82.90 for members under 40 years of age and to a high of $654.77 .for members over 95 years old. At 65 years of age the premium will be $453.93 or $18.91 per paycheck. Remember, the time limit for filling out the application is only for 45 days, starting on May 1, 2017 and closing as of June 15, 2017. There is no guarantee that this offer will be available in the future.
The bottom line, while this is not a replacement for the prohibitively expensive long term care plans that many insurance companies are pitching. It certainly is a much needed supplemental health insurance plan that's missing in our health benefits universe and is the fifth leg to our retirement.
7 comments:
Thank you so much
Thanks Chaz for the info.
Chaz,
Is the 45 day window for this year, and there will be another window the following year, or is this the only window for the next several years?
The 45 day window is for this year only. Cannot say if there will be another chance to join next year or years after that.
anything for retired members? They said retired members cannot join.
How can I find out if another open enrollment happens? I am retired with a sick spouse and never told about this benefit. I am a BERS member
Hi, this plan seems like a scam. It seems to not cover anything other than if you pay more than $2,500 in in network co-pays or $5,000 of out of network co-pays.
So for example if you are in need of expensive medical care that is not covered by your primary UFT medical insurance (GHI), than this CMM plan will not cover any of it. They informed me that they only cover whatever is covered or allowed by the primary plan. So for example if the treatment cost $250 and the plan only covers $50 of it and of that you have a $25 copay, you would have to spend $25,000 on 100 of these treatments in a calendar year and spend $2,500 on copays before the plan would start to pay you out on future treatments. Post reaching this maximum you would spend $250 per treatment and get $25 back from your primary insurance (GHI) and get the other $25 reimbursed by the CMM plan.
It seems highly unlikely to ever get paid out on these plans as recurring treatments with $25 or even $50 copay would have to occur at least once a week for almost a whole year before anything gets paid out. I struggle to see any scenarios where this plan makes financial sense.
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