Retirees Turning Age 65 or Becoming Medicare Eligible

Retirees turning age 65 or becoming Medicare eligible have several options of medical plans to choose from. Retiree must enroll in Medicare Part A and B effective the first of their birthday month in which they turn 65 or first become Medicare eligible. The district offers an HMO and PPO** plan that coordinates with Medicare Part A and Part B and becomes a secondary insurer, not a Medicare supplement.

**When retired and enrolled in Medicare, Medicare becomes primary insurance and the District’s insurance plan becomes the secondary insurer.

Retirees also have the following options to elect a District group Medicare plan:

Medicare Advantage Plan – RX included
Medicare Supplement Plan G– RX NOT included
Retirees that elect one of these Medicare group plans are NOT eligible to elect any other MCSD group medical insurance plans in the future
Medicare plans renew each calendar year (January – December)

Hospital Insurance (Medicare Part A)

Retirees turning age 65, or on Medicare due to disability, must enroll in Medicare Part A. Most people do not pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits. The retiree should elect Medicare Part A when it is first offered to avoid a late enrollment penalty.

Medical Insurance (Medicare Part B)

Retirees turning age 65, or on Medicare due to disability, must enroll in Medicare Part B. Medicare Part B (Medical Insurance) helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. There is a monthly premium for Part B. The retiree should elect Medicare Part B when it is first offered or upon retirement to avoid a late enrollment penalty.

MEDICARE Special Note: When planning for retirement, remember this process (enrolling in Medicare) can take 7-12 weeks and in order to enroll in a Medicare plan, at the time of retirement, you MUST be enrolled and have proof of enrollment (have your Medicare ID card showing enrollment in Medicare Part A and Part B).

Prescription Drug (Medicare Part D)

Prescription drug coverage was made available to everyone with Medicare through Part D. Medicare’s Prescription Drug Coverage (Part D) is an insurance plan, sold by private companies. Since private companies are providing the plan a monthly premium is charged for the coverage. Most people will pay a monthly premium for Part D.

The prescription drug benefit provided under the District’s medical insurance program has been actuarially determined to be “creditable”. This means that the District’s prescription drug coverage is as good as, or better than, the coverage provided under Medicare Part D. Since the District’s coverage is “creditable”, there will be no premium penalties should you decide to enroll in Medicare Part D at a later date.

Retirees, (or covered dependents) that are covered on the District’s HMO or PPO medical plans, do not need to enroll in Part D coverage. If Part D is elected, medical and prescription drug coverage with MCSD will end for the retiree and all covered dependents. REMINDER: Once a health insurance benefit is waived or cancelled, retirees waive the right to participate or enroll in the health insurance benefit at any time in the future.

Important Notice about Medicaid and Medicare Part D

Please note that if a retiree becomes eligible for Medicaid (or any other state or federal financial assistance program), the Centers for Medicare/Medicaid Services (CMS) may automatically enroll the retiree in the Medicare Part D drug subsidy program. Enrollment in Medicare Part D will terminate your medical coverage with the Martin County School District. We suggest that retirees contact the Centers for Medicare/Medicaid Services (CMS) directly to prevent automatic enrollment into Medicare Part D drug subsidy program. By contacting CMS, you can request that they never automatically enroll you into the Medicare Part D drug subsidy program.

Should a retiree be automatically enrolled in the Medicare Part D drug subsidy program, please contact the Risk and Benefits Department for assistance immediately. Save all pieces of communication from Medicare, as this information will help assist the retiree.

MARTIN COUNTY SCHOOL DISTRICT

Retirees Turning Age 65 or Becoming Medicare Eligible