Medicare
What is Medicare?
Medicare is a government health care system for people 65 or older, people under 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant).
What are the different parts of Medicare?
Medicare Part A - Hospital Insurance
This part of Medicare covers inpatient care in hospitals, skilled nursing facility care, hospice care and home health care. You don't usually pay a monthly premium for Part A if you or your spouse paid Medicare taxes while working (40 quarters are required to obtain Part A for free). If you aren't eligible for premium-free Part A, you may be able to purchase it at $411 a month (2016).
Medicare Part B - Medical Insurance
This part of Medicare covers services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and some preventive services. Most people will pay the standard premium amount, which is $121.80 per month (2016). Social Security will refer to your gross income as reported on your IRS tax return from 2 years ago to determine whether you pay a higher amount.
Medicare Part C - Advantage Plans
A Medicare Advantage is another way to obtain your Medicare coverage. If you join a Medicare Advantage Plan, you still have Medicare, except you assign your Medicare rights to private companies that Medicare approves. Medicare Advantage Plans may offer extra coverage, like vision, hearing, dental, and other health and wellness programs. In addition to other Medicare standard premiums, you might pay a monthly premium for the Medicare Advantage Plan.
Medicare Part D - Prescription Coverage
Medicare offers prescription drug coverage to everyone with Medicare. To get Medicare prescription drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and specific drugs covered.
When do I sign up for Medicare?
Initial Enrollment Period
You can sign up for Part A and/or Part B during the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.
Example: John Doe turns 65 June 5th. He may sign up as early as April, or as late as October. John Doe may face a penalty if he waits to enroll after October.
Special Enrollment Period
Once your Initial Enrollment Period ends, you may have the chance to sign up for Medicare during a Special Enrollment Period (see below). If you didn't sign up for Part A and/or Part B when you were first eligible because you're covered under a group health plan based on current employment (your own, a spouse's), you can sign up for Part A and/or Part B, anytime you're still covered by the group health plan and during the 8-month period that begins the month after the employment ends or the coverage ends, whichever happens first.
Example: John Doe is 67 and retired in June. His employer provided insurance coverage until June 30th. John Doe has 8 months from July 1st to enroll in Medicare, otherwise he may face a late enrollment penalty.
General Enrollment Period
If you don't sign up for Part A and/or Part B (for which you must pay premiums) during your Initial Enrollment Period and you aren't eligible for a Special Enrollment Period (see above), you can sign up between January 1 - March 31 of each year. Your coverage will begin July 1st of that year. You may have to pay a higher Part A and/or Part B premium for late enrollment.
If you don't sign up for Medicare when you're first eligible, you may have to pay a late enrollment penalty!!!
Who do I contact to sign up for Medicare?
You should contact your local Social Security Administration (SSA) office to start the Medicare process. They will be able to provide you with eligibility and premium information on Medicare. If you have specific questions about Medicare coverage, you can visit Medicare.gov or call 1-800-MEDICARE.
Have you enrolled in Medicare?
To help preserve the Kaiser and Blue Shield PPO plans, it is important retirees and their covered spouses enroll in Medicare Part A & B. Your Blue Shield lifetime retiree medical plan is self-funded by the District. Coordination with Medicare Part A and Part B is critical to ensure the financial solvency of the plans.
District Management Retirees - Pursuant to Board Policy 4354.1
Retired members and dependents must enroll in Part B of Medicare (Medical Insurance) when they are eligible.
Retired members and dependents must enroll in Part A of Medicare (Hospital Insurance) when they are eligible.
The district shall require such certification of enrollment in Medicare and eligibility for enroll as it deems appropriate.
Classified Retirees -Pursuant to CSEA Contract, Article XXII -Section 1, Subsection D
Upon eligbility for Medicare, all "lifetime" retirees shall enroll in Medicare Part A and Part B. Any premiums associated with Medciare participation shall be borne by the retiree and not the District
Certificated Retirees- Pursuant to ATA Contract Article XXXIII A:
Unit members retiring on or after July 1, 2015, who have met Article XXIII A Section A1 eligibility requirements, shall enroll and pay for Medicare Part B and, if eligible, enroll in Medicare Part A if eligible for premium free benefits, until death. This Medicare requirement shall apply to eligible dependents as well. Dependents of the retiring unit member who become eligible for Medicare on or after July 1, 2015 shall also enroll and pay for Medicare Part B and, if eligible, enroll in Medicare Part A if eligible for premium free benefits, until death.
Your Medicare Coverage
Find out if your test, item, or service is covered: