If you’re 65, chances are you’re eligible for Medicare.The federal
program began in the 1960s to provide those over age 65 with
secure access to medical care. If you’re still working, your employer medical plan remains your primary coverage, but you may need to make some decisions
about Medicare for yourself or a family member who is turning 65.
How and When to Enroll in Medicare
You’ll most likely become eligible for Medicare when you turn 65, but it could happen earlier as a result of becoming disabled or being diagnosed with permanent kidney failure or ALS (amyotrophic lateral sclerosis). If you are an employee, your employer will usually send you a letter about Medicare a few months before you reach age 65. As long as you are an employee, you will remain in your current employer medical plan regardless of whether you enroll in Medicare. If you’re retired, your employer should send you a Medicare information packet that includes forms and instructions three months before your 65th birthday. In general, Medicare will require enrollment by age 65. It’s generally to your advantage to follow the guidelines below. These guidelines also apply to any covered family members who become eligible for Medicare. Once you retire Medicare becomes your primary medical insurer.
A B C’S OF MEDICARE AND DON’T FORGET D
Medicare’s terminology can be confusing at first, but once you understand a few essentials, it becomes pretty straightforward. Medicare has four parts: A, B, C and D.
covers hospital inpatient care, skilled nursing and hospice care, and home health services. It’s “premium free,” as long as you, your spouse or your ex-spouse have worked full time for 10 years and paid Social Security taxes. If you qualify through your spouse or ex-spouse, you need to have been married at least 10 years.*
covers outpatient medical services like doctor visits, including some preventive care as well as ambulance services, mental health care, and equipment like wheelchairs and walkers. You must pay a monthly premium to maintain Medicare Part B coverage; under Medicare regulations, this monthly premium is higher for those with higher incomes. Part B premiums are paid to the Social Security Administration (SSA). If you’re receiving Social
Security income, the premiums will be deducted from your monthly Social Security benefit. If not, Social Security will bill you directly. If you’re eligible for one of UC’s Medicare-coordinated medical plans, it’s possible that you’ll get a portion of your Part B premium refunded to you. That’s because the amount UC contributes toward your retiree medical benefits is sometimes higher than the total cost of the premium. If this is the case, the university will refund part of the amount that you pay for your Medicare Part B premiums. (The reimbursement is added to your UCRP monthly pension benefit payment.) To be eligible for any reimbursement, you must have assigned your Medicare to the UC medical plan at the appropriate time by filling out a form and maintaining continuous enrollment by paying both your Part B and UC medical plan premiums on time. Be aware, though, that the Part B reimbursement will decrease in future years. UC is gradually reducing the percentage that it contributes to retiree health premiums. For 2017, UC’s contribution covers, on average, 71 percent of the total premium.
is different—it doesn’t refer to a separate subsection of care like Parts A, B and D. Instead, it’s another term for Medicare Advantage plans—a type of Medicare-approved plan run by private companies. UC’s HMO plans offer Medicare Advantage options. Under these arrangements, you’re required to assign your Medicare Parts A and B benefits to your plan (enrollment into D is automatic), and to maintain that assignment. In return, the plan provides all of your benefits. To learn more about how this works, see “How UC Medical Plans Work with Medicare,” on page 11.
also called the Medicare prescription drug benefit. This is a mandatory program unless you’re enrolled in part C, which usually carries a drug benefit. What is covered in part D drug plans cover all commercially available vaccine drugs when medically necessary to prevent illness. Many Medicare drug plans place drugs into different “tiers” drugs in different tiers each tier have a different cost. Lower tier drugs will normally cost you less than a higher tier drugs. Drug tier changes have to be approved by Medicare.
SOCIAL SECURITY AND MEDICARE
People tend to link Social Security and Medicare, but there are many instances when they are not connected. For example, the age at which individuals are eligible for their full Social Security benefit may be later than age 65, but the Medicare eligibility age remains at 65. When you turn age 65, you must sign up for Medicare, if you’re eligible.
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