Medicare
Federal Health Insurance Program
Medicare Enrollment Options
Active Employees
Active employees, age 65 or older, must be offered the same health insurance as employees less than age 65. Employees enrolled in the District group plan are not required to apply for either Medicare Part "A" or "B" until they terminate employment or retire. The same applies for their spouses who are age 65 or older and covered under the District's group plan.
Retirees
Please see Continuation Options section.
Medicare Basics
What is Medicare?
Medicare is the federal health insurance program for:
People who are 65 or older
Certain younger people with disabilities
People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
Medicare Part A
Hospital Visits
In general, Part A covers:
Active employees who have enough quarters (10 years paid into Social Security) to qualify for no-cost Medicare Part A can enroll prior to reaching age 65 to prevent any gap in coverage.
Enrolling in Medicare Part A will not disrupt coverage under an OUSD-sponsored medical plan.
The OUSD-sponsored medical plan will continue to be the primary plan for active employees and their dependents.
Medicare Part B
Doctor Office Visits
In general, Part B covers:
Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.
You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.
Mental health
Active employees who choose to enroll in Medicare Part B are electing to make Medicare Part B primary; therefore, the OUSD-sponsored medical plan will be secondary.
For more information about Medicare enrollment and coverage, please contact the Social Security Administration Office at (800) 772-1213 or visit www.ssa.gov.
