Informational Updates | csa-queens-site

How To Find UnclaimedFunds

from Thomas DiNapoli, Comptroller

How to find unclaimed funds:

Search using the person's full legal name as well as nicknames and maiden names that might have been used on accounts.

New York State Comptroller's Office: osc.state.ny.us/unclaimed-funds or 1-800-221-9311
National Association of Unclaimed Property Administrators (for out-of-state searches): unclaimed.org/search/
U.S. Treasury (for misplaced Savings Bonds and other Treasury securities): treasurydirect.gov/savings-bonds/treasury-hunt/
FreeERISA.com (provides data on 401ks, 403bs and other retirement and benefit plans; users must create an account) freeerisa.com/about/Default.aspx
IRS (Determined treasure hunters can create an ID.me account here; it can help in finding 1099 forms and retirement accounts): bit.ly/3QAnH0F

Directory of Useful Telephone Numbers & Websites

Attached is a list of useful telephone numbers and websites for Federal Agencies and other organizations. Click on the white button for the list

How You Can Help Your Family After Your Death or Incapacitation

A Checklist for a Surviving CSA Spouse or Domestic Partner

2023 IRMAA Application

The 2023 Medicare Part B IRMAA Reimbursement Form has been released by the City Office of Labor Relations. It is available by clicking on the yellow button below.

CSA Legal Service Plan

CSA has negotiated a free legal service plan for all CSA Retirees. Click on the red button below for detailed information.

Zoom Hosting Resource Sheet

On December 21, 2020 the CSA Queens Retiree Chapter held a virtual a Zoom Hosting Workshop presented by Susan Rippe Hoffman. Click on the white button for the Resource Sheet from that workshop.

Updates from Norm Sherman

Informational Update Vol 15 #8 August 23, 2024

1. COVID-19

Although the COVID-19 pandemic is long over, there has been a tremendous increase in the virus this summer, ruining vacation plans and causing fever and coughing among the virus-infected individuals. Although the Centers for Disease Control and Prevention (CDC) no longer tracks individual infection numbers, experts believe the number of infected cases could be the largest summer amount yet.

As of now, the variants have not proven to cause serious illness, and vaccines remain effective. However, this could easily change as new variants keep emerging.

COVID-19 Vaccine

The CDC recommends that everyone 6 months or older receive the 2024-25 updated COVID-19 vaccine to protect them this fall and winter against the virus, even if they never had a COVID-19 vaccination previously.

As I write this article, I just received a news flash that the US Food and Drug Administration approved the updated vaccine from Moderna & Pfizer. The vaccine shots should now become available in the coming days and will target a strain called KP.2

The good news is that the COVID-19 vaccine cost is free. The Department of Health and Human Services (HHS) has said the coronavirus “must be provided to vaccine recipients with no out-of-pocket costs.” If you go to your local pharmacy for the shot, you will probably be asked to show your current ID and health insurance card.

Who Pays for the COVID-19 Vaccine

Medicare will pay for the COVID-19 vaccine for Medicare beneficiaries under Part B; HHS will pay for all others not on Medicare. However, those health insurance plans not compliant with the Affordable Care Act (ACA) will have to request reimbursement from the HHS provider relief fund. Under no circumstances can they bill patients directly.

2. Physical Therapy

I often get questions from Medicare-eligible retirees about physical therapy coverage. Does the CSA Retiree Welfare Fund cover physical therapy? What about Medicare? Well, the answers are simple: yes, and yes. However, there is a caveat: if you are on Medicare, you must first exhaust its coverage before you can file for the Fund’s coverage.

Medicare Coverage

In 2024, Medicare continued to cover physical therapy under Part A (hospital insurance) and Part B (medical insurance). For Part A, the therapy takes place either in a hospital or a Skilled Nursing Facility. Part B covers outpatient services that take place at various locations or, under certain conditions, at home.

In the past, Medicare limited the number of therapy visits. That is not the case now as there is no longer a hard cap on therapy services. However, there is a soft cap or threshold amount that cannot be exceeded unless the healthcare provider indicates on a claim form that the therapy is medically necessary and documents why this is so. The cap this year is $2,330.

Also, the physical therapy regulations require a licensed physical therapist to reassess the patient every 30 days. The reassessment measures the improvement from the previous 30 days.

CSA Retiree Welfare Fund’s Coverage

After an annual $100 deductible, you will get back 80% of the therapy cost up to $2,000. When you file your first claim, you will need a statement from Medicare (or your primary carrier if it covers physical therapy) that you have exhausted their coverage.

3. Question of the Month

Q. I recently was in the emergency room and received an invoice for $50. Is that reimbursable?

A. I’m sorry you had to go to the emergency room. I hope you had a speedy recovery

The Fund would process the $50 deductible under the Supplemental Medical Benefits program. However, under this program, there is a $100 annual deductible. If $50 is the only out-of-pocket expenditure during the calendar year, then the answer is no.

Informational Update Vol 15 #7 July 28, 2024

1. Basics of Medicare

When I first went on Medicare, I admit my knowledge of it was quite limited. I knew very little about the various parts of Medicare. What I did know was that Medicare, passed into law in 1965, was a universal health insurance plan that would give me peace of mind in the event I needed to see doctors. Since that time, I learned a great deal about it and have used that knowledge to advise and inform our Medicare-eligible members.

This year we can expect a lot of members to become Medicare-eligible. My experience has shown that many in this group, as well as long-time Medicare-eligible members, were like me initially: unfamiliar with how Medicare works. Consequently, I decided to write about Medicare, giving just the basics at this time.

Medicare is a federal health insurance program in the United States, primarily designed for individuals aged 65 and older, but also available to certain younger people with disabilities and those with End-Stage Renal Disease.

Medicare is divided into four parts: A, B, C, and D.

Part A (Hospital Insurance) – for most people, the premium is $0

· Inpatient Hospital Care. If a doctor has you admitted to a hospital, Part A covers you completely for the first 60 days, partially for the days 31 - 90, and not at all beyond 90. The good news is that the CSA Welfare Fund covers you completely (except for a $300 deductible, which the CSA Welfare Fund partially covers) for 360 days.

· Skilled Nursing Facility (SNF) Care. After a 3 or more day stay in a hospital, you may be sent to a SNF for additional services, which include rehab, administering medicine or changing bandages. Part A covers days 1-20 in full & partially from days 21–100. You pay full after that. Again, there is good news: BlueCross BlueShield covers days 21–100 in full. Unfortunately, you pay in full beyond 100 days.

· Hospice Care. Part A will cover hospice care if a provider certifies the need for such services.

· Home Healthcare. Part A may cover home healthcare if you need skilled care and are home bound. Skilled care generally requires a licensed or medical person to carry out the services.

Part B (Medical Insurance) – covers doctors' services, outpatient care, medical supplies, and preventive services. Part B requires a monthly premium, which can vary based on income. Once again, we have good news: the city reimburses the premium in full.

Part C (Medicare Advantage) – is an alternative to Original Medicare (Parts A & B) that is offered by private insurance companies. These companies must be approved by Medicare. Advantage plans can have different rules, costs, and coverage restrictions compared to Original Medicare.

Part D – helps to cover the cost of prescription drugs and vaccines. Part D plans are offered by private insurance companies approved by Medicare and have separate premiums. For Medicare-eligible members the premium is covered by the High Option Rider, which costs $120 per month per person, $240 per family. This amount is deducted from the pension check. Some Medicare-eligible members also pay an additional amount (IRMAA) depending on their income. Unfortunately, the Part D premium is not reimbursable.

Navigating Medicare can be very daunting due to the various parts and coverage options. Fortunately, there are lots of resources you can consult for further information.

2. Question of the Month

Q. I want to apply for 2023 IRMAA but misplaced my 2022 benefit verification SSA letter. How can I get a copy?

A. There are three ways: 1) visit your local Social Security office and request the SSA letter 2) call SSA and ask them to mail you the letter, OR 3) download a copy from the SSA website, www.SSA.gov. This will require your having an online SSA account. If you don’t have an account, you can open one on the SSA website by just following the prompts.

Informational Update Vol 15 #6 June 20, 2024

1. Empire BlueCross BlueShield Name Change

On January 1st, 2024, Empire BlueCross BlueShield (Senior Care hospital) was renamed to Anthem Blue Cross and Blue Shield. It is only a name change; your hospital benefits remain the same.

This past week, you should have received your new Anthem Blue Cross and Blue Shield I.D. card for hospital care. You should immediately use this card for hospital care. Continue to use your Emblem Health I.D. card for all medical care (Part B) you receive outside of a hospital.

Make sure that your personal information on this card is correct. If there is an error, or you have any questions, contact the Anthem Customer Service number on the back of the card. The Service is open from Monday through Friday, 8 a.m. to 6 p.m.

To get more details on your hospital benefits, open an account on Anthem.com/NYC. You will be able to search for providers, check costs for care, and update your profile information, including your communication preference and email address.

2. Surviving Spouses/ Registered Partners

I continue receiving calls from members’ surviving spouses/registered partners asking whether they are still entitled to the CSA Welfare Fund benefits. As a result of these calls and as a refresher, I am re-printing the article I wrote on this topic two years ago.

While the passing of a member is a very difficult time for the surviving spouse/registered partner, the good news is that the CSA Retiree Welfare Fund continues to provide him/her with supplemental medical coverage WITHOUT COST for 5 years from the date of the member’s passing. The only condition is that the surviving spouse/registered partner must have a basic city health plan or the equivalent through another health plan to receive the Fund coverage. Also, the Fund’s retiree benefits stop before the 5 years should the survivor remarry.

The Fund coverage includes but is not limited to, dental, optical, hearing aids, drugs, physical therapy, and home health aides. The whole list of benefits can be downloaded from the CSA Welfare Fund website.

Surviving spouses/registered partners are also entitled to the CSA Retiree Chapter supplemental benefits. However, to enjoy these extra benefits, the surviving spouse/registered partner must join the Chapter. While being a member of the Chapter has a monthly charge, it is money well spent since the Chapter benefits will greatly enhance the Welfare Fund benefits.

After 5 years from the member’s passing, the Welfare Fund supplemental benefits automatically ends unless the surviving spouse/registered partner extends the benefits by paying a monthly COBRA premium. This extension will be necessary if the surviving spouse/registered partner belongs to the CSA Retiree Chapter and wants to continue to get their supplementary medical benefits.

3. Question of the Month

Q. How do I know if I am entitled to 2023 IRMMA reimbursement?

A. Do one of two things:

Look at the 2022 November SSA verification letter. It will show what your standard premium is and, if applicable, your IRMAA surcharge. If there is a surcharge, you are entitled to an IRMAA reimbursement.
Look at your 2023 1099 SSA letter. In 2023 the standard amount was 164.90 per month or $1,978.80 a year. If the amount listed on the letter is greater than the yearly amount, then you paid an IRMAA surcharge and are entitled to an IRMAA reimbursement.

Informational Update Vol 15 #5 June 3,2004

1. Medicare Vision Coverage

There is some confusion regarding Medicare Vision Coverage. To clarify, Medicare covers most medical eye-related issues, such as diagnosing tests for eye problems and treatment of eye diseases. Unfortunately, Medicare does not cover routine eye exams or eyeglasses.

Under Medicare Part B, Medicare will cover some preventative and diagnostic eye exams such as:

Yearly Diabetic-Related Exam for patients with diabetes or ocular disease symptoms (covered whether conducted by an ophthalmologist or optometrist).
Yearly Glaucoma Screening Tests for people with high risk for glaucoma. You are at high risk if you have diabetes, a family history of glaucoma, are an African American 50 or older, or Hispanic American 65 or older. The screening must be done or supervised by a doctor certified to perform it in your state.
Macular Degeneration – covers certain diagnostic tests and treatment of the disease, including injections. Those receiving treatment must have age-related macular degeneration (AMD).

Medicare Part B will also cover surgery to correct ongoing vision problems, such as cataract surgery. However, Medicare will cover this surgery only if you have traditional or laser surgery.

The CSA Retiree Welfare Fund also reimburses laser vision correction $500 once in a lifetime and multi-focus lens (after cataract surgery) $500 per eye once in a lifetime.

After cataract surgery. Part B will cover one set of contact lenses or standard eyeglass frames. If you wish to upgrade the frames, you will have to pay for it. The eyeglass provider must also be a Medicare-approved supplier to qualify.

2. Express Scripts Pharmacy

Express Scripts is a prominent online pharmacy and pharmacy benefits manager (PBM) that began in St. Louis, Missouri in 1986. Initially a small PBM that provided services to local businesses, Express Scripts expanded its services to include mail order pharmacy and specialty pharmacy services.

Express Scripts administers and manages prescription drug plans for numerous organizations including those covering retired NYC retired employees. This relationship is important because it impacts on the retirees’ability to access necessary medications at affordable prices.

Most Medicare-eligible CSA retirees have Part D coverage through Express Scripts. They can have prescriptions filled at an Express Scripts network pharmacy, like CVS or Publix, or filled online from Express Scripts. While Express Scripts aims to keep their drug prices low, you should shop the network pharmacies for the best possible prices.

For those Medicare-eligible members who use Express Scripts, I strongly urge you to open an Express Scripts account to avail yourself of its many benefits.

Here are some of them:

1. You can print out your prescription ID card.

2. You can access your list of medications.

3. You can compare your local pharmacy’s prices with Express Scripts’ prices. Interestingly, in comparing my medications, my local pharmacy always charged less than Express Scripts

4. You can access your Medicare, Part D Explanation of Benefits (EOB). This monthly document can go paperless or mailed to your home.

5. You can see the process Express Scripts follows if your medication requires Prior Authorization from your doctor.

3. Question of the Month

Q. I am a retired member and bought glasses from a GVC participating provider. I recently received $65 from the CSA Retiree Chapter but never received $150 (glasses cost $326) from the CSA Retiree Welfare Fund. Why?

A. To begin, the CSA Welfare Fund no longer reimburses you directly for your glasses, A participating GVC does. However, GVC will either reimburse you up to $150 or, as most likely happened in your case, took $150 off the price of your glasses instead.

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