Medicare is a federal health insurance program for people age 65 and over, and certain disabled persons.
When Medicare is Available
You are eligible for Medicare on the first day of the month that you turn 65 (unless your birthday is on the first day of the month, then eligibility is the first day of the previous month). This age is not scheduled to rise as the full retirement age for Social Security benefits gradually rises to 67. Medicare is also available if you have been entitled to Social Security disability benefits for two years (waived if you have amyotrophic lateral sclerosis), or if you have end-stage renal disease (kidney failure). A spouse or child with kidney failure also may qualify.
Enrolling in Medicare
When you retire, if you are age 65 or older, you must enroll in Medicare Parts A and B coverage. There is no cost for coverage under Medicare Part A. You pay a premium each month for Part B. If you receive Social Security, Railroad Retirement Board, or Office of Personnel Management benefits, your Part B premium will be automatically deducted from your benefit payment. If you don’t receive these benefit payments, you will receive a bill. You can find the current rates by visiting the Medicare Part B web page.
If you enroll late, or if you drop out and enroll again, you may have to pay higher premiums. You will pay 10% more for each full 12 months that you could have been, but were not, enrolled in Part B. You don't include any months when you weren't enrolled in Part B while covered by an employer-sponsored group insurance plan based on your or your spouse's current employment.
If you continue to work in retirement, and are covered by your employer's group health plan, you may want to wait until you retire to enroll in Medicare Part B because your employer's plan will be primary. Most people should enroll in Medicare Part A (Hospital Insurance) when they are first eligible. If you are eligible for premium-free Part A*, you can enroll in Part A at any time after you are first eligible for Medicare. If you want to delay both Part A and Part B coverage, you don’t need to do anything when you turn 65. To sign up for Part B upon retirement, and without penalty, contact PeopleLink for a Request for Employment Information (CMS-L564) form to be completed on your behalf. Please note if you are covered by the HDHP and contributing to a HSA, you may not be covered by any part of Medicare.
*Most people get Part A for free, but some have to pay a premium for this coverage. To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child. To receive premium-free Part A, the worker must have a specified number of quarters of coverage (QCs) and file an application for Social Security or Railroad Retirement Board (RRB) benefits. The exact number of QCs required is dependent on whether the person is filing for Part A on the basis of age, disability, or End Stage Renal Disease (ESRD). QCs are earned through payment of payroll taxes under the Federal Insurance Contributions Act (FICA) during the person's working years. Most individuals pay the full FICA tax so the QCs they earn can be used to meet the requirements for both monthly Social Security benefits and premium-free Part A.
Medicare Coordination with the NYU Retiree Medical Plan
If you or a dependent is eligible for Medicare benefits, coordination with Medicare benefits will apply – even if you have refused, discontinued, or neglected to apply for Medicare coverage.
Medicare Part C (Medicare Advantage plans)
Medicare Part C, often referred to as a Medicare Advantage plan, is the part of Medicare policy that allows private health insurance companies to provide Medicare benefits. It provides all of your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage with additional benefits, such as prescription drug coverage. Medicare Advantage plans may potentially save you money because out-of-pocket costs in these plans can be lower than Part A and Part B, in some cases. However, when you join a Medicare Advantage plan, you are still in the Medicare program and must continue paying your Part B premiums.
Medicare Part D (Prescription Drug Plans)
Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
NYU has determined that the prescription drug coverage offered by the NYU retiree medical plans is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is considered Creditable Coverage.
Because your existing coverage with New York University is, on average at least as good as standard Medicare prescription drug coverage, you can keep your NYU coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
You can join a Medicare drug plan when you first become eligible for Medicare and each year from November 15th through December 31st. This may mean that you may have to wait to join a Medicare drug plan and that you may pay a higher premium (a penalty) if you join later. You may pay that higher premium (a penalty) as long as you have Medicare prescription drug coverage.
If you lose creditable prescription drug coverage, through no fault of your own, you will be eligible for a sixty (60) day Special Enrollment Period (SEP) because you lost creditable coverage to join a Part D plan. In addition, if you lose or decide to leave NYU-sponsored coverage, you will be eligible to join a Part D plan at that time using an Employer Group Special Enrollment Period.