health-special-provisions-for-medicare-eligible-employees

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Medicare-Eligible Employees
Coordination of Benefits (COB)

Health Benefits Videos

Attend a Health Benefits Seminar

Forms and Downloads

Responsibilities & Health Benefits Assistance

Choosing a Health Plan

Enrollment

PICA

Changes in Status

Flexible Spending Accounts Programs

Effective Dates of Coverage

Health Plan Premiums

Transfer to Another City Agency

Change Union/Welfare Fund

Termination and Reinstatement

Leave of Absence Coverage

COBRA

Special Continuation of Coverage

Disability Benefits

Medicare-Eligible Employees

Coordination of Benefits (COB)


NYC Health Benefits Program

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Coverage for Employees 65+

Federal law requires the City of New York to offer employees over 65 the same coverage under the same conditions as offered to employees under 65.

So if you're over 65, still working for the City and enrolled in the NYC Health Benefits Program, do not use your Medicare card when you visit your doctor's office. Instead, be sure to use the member ID card provided to you by your current HBP health plan.

Special Provisions

The same stipulation applies also to dependents over 65 and those covered by Medicare through the Special Provisions of the Social Security Act for the Disabled.*Read More

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Federal law requires the City of New York to offer employees over 65 the same coverage under the same conditions as offered to employees under 65. The same stipulation applies also to dependents over 65 and those covered by Medicare through the Special Provisions of the Social Security Act for the Disabled.* In such cases, enrollment in the City health plans is automatic (unless waived) and Medicare becomes secondary coverage.

If you are a Medicare-eligible active employee and want Medicare to be your primary coverage, you must complete the waiver section of the Health Benefits Application. By doing so, you will not be eligible for the City’s group health plan. For an application, contact your agency health benefits or payroll office or NYCAPS Central at (212) 487-0500 (Department of Education employees should contact HR Connect at (718) 935-4000).

Employees and their dependents covered by Medicare have identical benefits to those provided to employees and their dependents under age 65.

Because of the cost of these benefits, the City does not reimburse employees or dependents for their Medicare Part B premiums if the City health plan is primary. Medicare Part B premium reimbursement will be available at retirement when Medicare becomes the primary plan.

*The rules differ for persons eligible for Medicare due to end-stage renal disease. Consult your Medicare Handbook or local Social Security Office for further information.

Medicare and Retiring Employees

Important informaton for Medicare and Retiring Employees.Read More

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At retirement, employees who have chosen Medicare as their primary plan or whose dependents have not been covered on their plan because their spouse/domestic partner elected Medicare as the primary plan may re-enroll in the City health benefits program. This is done by completing a Health Benefits Application and submitting it to their agency health benefits, payroll or personnel office. Also at retirement, Medicare-eligible employees for whom the City Health Benefits Program had provided primary coverage are permitted to change health plans effective on the same date as their retiree health coverage.

Medicare Medical Insurance (Part B) is voluntary with a monthly premium that is subject to change. If you and/or your dependents choose City health coverage as primary, Medicare will be supplementary to any City health plan. There are no penalties for late enrollment in Medicare Part B if employees choose the Health Benefits Program as primary coverage and cancel or delay enrollment in Medicare Part B coverage until retirement or termination of employment (when Medicare enrollment is permitted for a limited period of time). Medicare Hospital Insurance (Part A) should be maintained. For most persons, Part A coverage is free.

When to Apply for Medicare

Active
(Regardless of Age)

Retired
(Under Age 65)

Retiring
(Age 65 & Over)

When to apply for Medicare Part A (Hospital)

3 months before the employee turns age 65 (not mandatory)

3 months before the retiree turns age 65
At time of retirement; Coordinated with date of retirement (1)

When to apply for Medicare Part B (Medical)

Employees are covered by City Health Benefits while employed. Employees do not have to apply for Medicare Part B until retirement from City service and they are over age 65. Covered dependents, under age 65, also continue to receive non-Medicare coverage under City Health Benefits.

3 months before the retiree turns age 65

At time of retirement; Coordinated with date of retirement (1)

Retirees over age 65, and their covered dependents over age 65, must bring proof of Medicare Part A and B when applying for NYC Retiree Health Benefits coverage.
The City reimburses the monthly Medicare Part B premiums.
(1) Call Social Security at 1-800-772-1213; Bring letter from City of New York verifying retirement date. Medicare becomes effective the 1st of a month.