April 11, 2016

Teachers in the state of Illinois contribute to the Teachers Retirement Insurance Program (TRIP). In February of 2013, the TRIP Medicare Supplement option was replaced with a choice of three different Medicare Advantage plans. Since then, agents have expressed confusion about how the plan works, and what advice to give to retired teachers.

Most people in Illinois are aware of the state’s financial position and (lack of a) budget. The poor financial standing of Illinois is the primary reason why TRIP has switched to the Medicare Advantage options.

Looking for answers

In 2015, I ran for the School Board of Mt. Zion Community Unit School District 3. With my background in senior age health insurance I have fielded my share of questions from teachers looking for answers on what they should or shouldn’t do regarding their health insurance. In my search for answers about this, I have learned that besides the coverage changes, some of the literature is misleading. I now believe I can help clear up some confusion regarding the program, so that Illinois teachers can make an informed decision.

Teachers Retirement

Recently, I had the pleasure of talking to the Director of the Illinois Department of Central Management Services (CMS), who oversees TRIP. She agreed that the mailings are confusing and misleading to retired teachers. I reached out to her to discuss the letter they mailed to every retired teacher, which implied that they could have either a Medicare Supplement or a Medicare Advantage program.

There is no TRIP Med Supp

This was confusing to me, and it is very important for agents to understand, that the State of Illinois does not offer a Medicare Supplement policy. The reason the TRIP letter states that “...TRIP coverage will be changed to the Medicare supplement coverage...” according to what the Director told me, is so they will have a backup plan for the remainder of the year until Open Enrollment for Medicare Advantage is available in the fall of the year.

For Example: A teacher is currently insured through the state with CIGNA. In May they turn 65. If the retired teacher has both parts A & B of Medicare, they will stay with CIGNA until Jan 1, 2017. The CIGNA plan in this scenario will remain in effect through the end of the year. At that time they will convert to the Medicare Advantage program offered by TRIP if they enrolled in the fall of 2016.

“If [the Med Supp] was offered, no teacher would buy the Medicare Advantage program.”

However, there are exceptions to that depending on the age of their spouse and their status with Medicare parts A&B. The most confusing part of the letter says "Medicare Supplement" and we automatically think it is one of the 10 Standardized plans. It is not though, it simply lets Medicare become primary and the health plan they have will be secondary (or supplemental) to Medicare until year end, and it will have deductibles and coinsurance.

Let’s help teachers

My goal is to help retired teachers understand how the plans work before they get sick and need coverage, and to understand which plan is the best buy. I asked the Director why the State of Illinois doesn’t just give a teacher the option to keep a traditional Standardized Medicare Supplement, and charge appropriately? Her response shocked me, but she was truthful. She said, “We have discussed that, and if it was offered no teacher would buy the Medicare Advantage program, and the State of Illinois can not afford to offer the Medicare Supplement plan”. I laughed out loud and thanked her for her help, and she told me to call her anytime I have a question.

For most people insurance is confusing, so I hope you will find this helpful. Retired teachers understand that the monthly premium for TRIP of $88.45 is a “good” price, but it may not be so good when it comes to paying their claims. Have a look at the outline of coverage for the teachers on the TRIP program, and see what you think.

I like the fact that for roughly the same amount of money a retired teacher can purchase a Medicare Supplement Plan G with a traditional standardized plan that is guaranteed renewable for life. I also like that a teacher will not have to face changes in their coverage every year.

My hope is that we can help the great teachers of Illinois to understand what they are buying, and understand their benefit package before they have to deal with claims. Our teachers have served us well, and need to be given honest advice, and I believe we owe it to them to help all we can.


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