DeSantis Touts High-Quality, Affordable Health Plans for State Retirees. But is it really good?


Gov. Ron DeSantis announced Tuesday that new health plan options will be available to more than 30,000 Medicare-eligible retirees participating in the State Group Health Insurance Program starting in 2020. The new choices are Medicare Advantage and Prescription Drug (MA-PD) plans, which combine the benefits of Medicare and prescription drug coverage into a single plan and offer other valuable benefits such as vision, hearing, dental, and wellness benefits.

“Florida is finding innovative healthcare options to improve the quality of health care services for state retirees while also saving taxpayers money,” DeSantis said. “These new health plans will provide more flexibility while creating the potential to save more than $80 million for taxpayers.”

In February DeSantis directed the Department of Management Services (DMS), which administers the program, to pursue innovative methods to deliver health care options to its members, including competitively procuring for MA-PD plans and making those plans available on a voluntary basis during this year’s open enrollment for the 2020 plan year.

“These new health plan options will provide access to high-quality care to thousands of retirees while saving them, collectively, as much as $7 million,” said DMS Secretary Jonathan Satter. “This is one way we can provide retirees in the State Group Insurance program with the best possible benefits and services for the premiums they pay.”

The Department initiated a competitive procurement for MA-PD plans in April and, on Aug. 7, awarded three health insurance companies to provide MA-PD plans. UnitedHealthcare will offer a Preferred Provider Organization (PPO) MA-PD plan statewide with access to a national network; Humana will offer a Health Maintenance Organization (HMO) MA-PD plan in 40 Florida counties; and Capital Health Plan will offer an alternate HMO MA-PD option in se ven counties in the Big Bend.

The MA-PD plans will provide the standard hospitalization and medical coverage of Medicare Part A and Part B as well as prescription drug coverage. In addition to lower monthly premiums for retirees, the new plans will also offer the following:

  • Reduced out-of-pocket costs for preventative care, specialist visits, and home health services;
  • Expanded benefits for vision, hearing, and dental services; and
  • Access to telehealth, fitness programs, and caregiver support.

Medicare-eligible retirees will be able to voluntarily enroll in one of the new plans during the Department’s Open Enrollment period which begins Oct. 14, 2019, and concludes Nov. 1, 2019.  The plan coverage will be in effect on Jan. 1, 2020.

Currently, retirees can continue the coverage they had as active employees by paying the entire monthly premium. Once they become Medicare-eligible at age 65, Medicare is the primary payer of medical and prescription drug claims, and the program coordinates benefits with Medicare. This health option will still be available to retirees under the program.

More information will be available in the first week of September. Click here.