Medicare Information

Important Notice: Medicare Enrollment for Retirees and Spouses

If you are retiring and plan to continue receiving health insurance through North Syracuse Central School District, it’s critical to understand how Medicare enrollment works for both you and your spouse.

Who Needs to Enroll in Medicare?

Both you and your covered spouse must enroll in Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) if:

1. You or your spouse are 65 or older when you retire, OR

2. You or your spouse are under 65 and disabled, and eligible for Medicare due to receiving Social Security Disability Insurance (SSDI) for 24+ months.

Why You and Your Spouse Must Enroll in Medicare

• Medicare Becomes Primary Insurance: After retirement, Medicare becomes the primary insurance for both you and your spouse.

• Coordination of Benefits: Our retiree insurance will serve as secondary coverage, paying for costs not covered by Medicare.

• Avoid Coverage Gaps: Without enrollment in both Part A and Part B, neither you nor your spouse will have complete coverage for medical services like hospital stays, doctor visits, and outpatient care.

When and How to Enroll

1. Initial Enrollment Period (IEP):

   • If either you or your spouse are approaching age 65 at the time of retirement, make sure to enroll during your 7-month Initial Enrollment Period, which starts 3 months before and ends 3 months after the 65th birthday month.

2. Special Enrollment Period (SEP):

   • If you or your spouse worked past age 65 and were covered under our group health plan, you can sign up for Medicare during an 8-month Special Enrollment Period after stopping work or when employer-sponsored coverage ends.

3. Under 65 and Disabled:

   • If either you or your spouse qualifies for Medicare due to disability, enrollment is often automatic after receiving SSDI for 24 months, but verify eligibility and enrollment to ensure there’s no lapse in coverage.

4. Enroll Through Social Security:

   • Visit www.ssa.gov, call 1-800-772-1213, or visit a local Social Security office to complete your enrollment.

Why Timely Enrollment is Essential

• Late Enrollment Penalties: Failure to enroll in Medicare Part B for you or your spouse may result in lifetime penalties of 10% for each 12-month period of delayed enrollment.

• Claims Denied: If you or your spouse are not enrolled in Part B, our retiree insurance cannot pay secondary benefits, and many claims could be denied.

How Retiree Insurance Coordinates with Medicare

• For retirees and their spouses enrolled in Medicare: Medicare pays first, and our retiree insurance acts as secondary coverage.

• Without Medicare Part A and Part B, your retiree insurance will not cover expenses Medicare would have handled, leaving significant gaps in coverage.

Action Required

• Both you and your spouse must enroll in Medicare Part A and Part B if eligible when you retire.

• Notify [Your Benefits Office] once enrollment is complete for both individuals.

• For questions about the Medicare process or our retiree benefits, please contact [Your Organization’s Benefits Contact Information].

Ensuring both you and your spouse are properly enrolled in Medicare is crucial for maintaining seamless and comprehensive health care coverage. We’re here to help every step of the way—please reach out if you need assistance or further clarification.

Medicare Website: www.medicare.gov

or call 1-800-633-4227