Insurance coverage

The Downsides of GovGuam’s Retiree Insurance Coverage Choices This Year | Letters to the Editor

I am a retired employee of the GDOE and fall under Class 2A of the Supplementary Retirees Scheme.

Class 2A is a retired employee and spouse who have Medicare A&B. Medicare will be our primary health care provider: Medicare pays 80% of our medical costs and our secondary health care provider will be under the Supplementary Retirees Plan. RSP reimburses 20% of our medical expenses.

I am writing this letter in regards to proposed government health insurance for retirees, specifically under the RSP.

We are happy with our SelectCare plan, and the Straub Clinic, Honolulu, is our off-island medical facility. They process necessary medical referrals efficiently without any delays. This year, the cost of SelectCare has increased by 500%.

Let’s compare the 2 health plans I listed in this letter. If we choose TakeCare, I have no monthly medical costs. Our primary provider is Medicare. My husband has had two heart operations and is being followed by his cardiologist.

Also, over the years of running, he developed skin cancer. His dermatologist sees him every 6 months. If his dermatologist sees a suspicious lesion, he does the biopsy on the spot and sends the tissues to the laboratory for reading. TakeCare is not a Straub provider, which my husband and I have been going to for our specialist medical care for 8 years.

I was curious and checked TakeCare about their health plan. They have severe restrictions on off-island health care providers, including off-island medical diagnostic procedures. It takes three to 10 days or more to get an approval. References and approval must be made on Guam.

Delays in medical diagnosis create stress and anxiety in the sick patient. Our follow-up care takes place in a Medicare-certified facility, and Medicare is our primary healthcare provider, paying 80% of our bill.

The golden rule is early detection, like cancer or any other disease, early detection is the best in preventive medicine.

SelectCare has a Medical Liaison Officer who helps facilitate the necessary medical and diagnostic specialist procedures for referrals and clearance documents for their clients. Their service is outstanding.

Yes, TakeCare is the cheapest at zero deduction. What about the anxiety, stress and volatile emotions felt by the family and the sick patient, whether or not he is approved for specialist medical care off the island, three to 10 days is a very long wait.

I don’t know who negotiated the rates and benefits for government health insurance, especially for retirees who will be using the RSP. They did not take into account the fate of pensioners. We are on a fixed income. The negotiation was private, so we didn’t even know what benefits we were getting until Friday afternoon, September 23.

This hurts retirees, who qualify for Class 2A with Medicare Parts A&B. The difference between the government share for class 2A and class 2B is astronomical. Government share for class 2B is over $2047.64 per month, yet only spouse gets Medicare, with class 2A spouse and retiree have Medicare Parts A&B, government share is 732 $ per month.

I don’t know how these rates were taken into account, but it’s so unbalanced. It’s the world upside down.

If the government can subsidize Class 2B more than $2,000 per month, Class 2A should also be subsidized more.