Health Care Benefits: Medicare
At age
65, you are eligible to enroll for Medicare benefits. To enroll in Medicare,
contact your local Social Security office within one month of reaching
age 65. Once you enroll, Medicare will coordinate its coverage with your
state health plan.
Coverage
Under A State Health Plan
If you are enrolled in any state health plan, that
health plan will be the primary carrier and will pay first. Medicare will
be the secondary carrier and will pay toward any remaining balance.
If you
choose to delay enrollment in Medicare until your group health plan terminates,
there is a seven-month enrollment period available beginning with the
first day of the first month in which you are no longer enrolled in a
group plan. You may enroll any time during that period. There is no premium
penalty for this delay in enrollment.
Employees
age 65 and older with at least 40 quarters of work credits under Social
Security pay no premium for Medicare Part A. Employees do pay the premiums
for Part B.
No
Coverage Under A State Health Care Plan
If you elect not to participate in a state-sponsored health plan, you
will remain eligible for Medicare coverage. Medicare will provide your
primary coverage.
Other
Retirement Health Care Coverage
If you have coverage under a retirement health insurance plan and are
enrolled in a state-sponsored health plan, the state’s health plan
will provide primary coverage.
Health
Care Coverage for PERS Retirees
Employees who meet all of the following conditions must enroll in a health
care plan offered by the state:
- Retired from
a PERS position and is re-employed in a position covered by PERS;
- Receives both
a salary from the state and a retirement allowance; and
- Appointed as
a full-time permanent (appointment code 1), part-time permanent (appointment
code 4), full- or part-time internal interim, full- or part-time (appointment
codes 11 and 13), 11, 12 interim (appointment code 16), or established
term regular (appointment code 17) employee.
Enrollment
must occur within 31 days of the date of hire for employees who meet the
above criteria and are hired on or after February 9, 1994. Coverage will
become effective on the first day of the month following the month in
which the employee enrolls. As an example, retirees who enroll in February
will have March coverage. Retirees who fail to enroll within the 31-day
time frame must wait until the next open enrollment period to choose a
health plan. Employees who fail to enroll in a health plan offered by
the state and who have no other insurance will have their claims reduced
by PERS by those amounts provided or available under the state’s
health plans. A retiree
may waive health care coverage only if that employee has coverage from
another health plan other than through the state or PERS. The state health
care coverage will be primary. PERS health
care coverage will be secondary. |
