TO: All Participants Eligible for Benefits under the Fresno Unified School District’s Health Care Plan
RE: Enroll In Medicare When You Become an Eligible Retiree to Minimize Your Payments
DATE: April 30, 2013
The Joint Health Management Board at the Fresno Unified School District is reminding you of the importance of enrolling in Medicare once you are eligible. The District’s Health Care Plan indicates that you must enroll in Medicare Parts A & B as soon as you become eligible for Medicare as a retiree. Your specific Coordination of Benefits (COB) changes once you become eligible for Medicare as a retiree, which may result in reductions of Plan payments and increases in your payments if you fail to enroll in Medicare. This requirement only applies to retirees in the Fresno Unified School District Employee Health Care Plan. Active employees age 65 or over are not required to enroll in Medicare.
The official healthcare Plan Booklet states in the section “Effect of Plan Benefits for Participants Eligible for Medicare”:
EFFECT OF MEDICARE FOR RETIREES
”A retired Employee and covered Dependents must enroll in Medicare Parts A (Hospital) and Medicare Part B (Medical) upon becoming eligible for Part A (Hospital) coverage under Social Security. If you are a Retired member or an eligible Dependent of a Retired member and are eligible for Medicare, regardless of whether you are enrolled or not, the benefits of this Plan will be paid secondary and Medicare will be the primary. This means that if you are eligible for Medicare, your benefits under this Plan (as secondary payor) will be reduced by what Medicare would have paid.
If you are a Retired member or an eligible Dependent of a Retired member and are not eligible for Medicare, the benefits of this Plan will be paid the same as for active Employees and their Dependents.”
In addition, the official healthcare Plan Booklet states in the “Coordination of Benefits” section:
“In order to be eligible for the Fresno Unified School District’s Employee Health Care Plan’s Medical and Prescription Drug benefits under Plan Options A and B, all Retiree Plan participants age 65 and over and all Retired disabled Plan participants who are eligible for Medicare Parts A & B based on age or disability, regardless of age, must enroll in Parts A and B of Medicare as their primary insurance coverage.
If the Retired Plan participant does not enroll in Medicare when they become eligible for Medicare, regardless of whether they enroll in Medicare or not, the benefits of this Plan will be coordinated as if Medicare is the Primary provider, resulting in a reduction in Plan payment as the secondary payor.”
It’s important that you enroll in Medicare once you become eligible as a retiree. Failure to do so could result in reduced Plan payments thereby increasing your payments for your healthcare services.
What You Need to Do: Visit www.medicare.gov or call (800) MEDICARE (633-4227) for general information about enrolling. To learn more details about enrollment periods, visit www.medicare.gov/publications to view the fact sheet “Understanding Medicare Enrollment Periods.” You can also call (800) MEDICARE (633-4227) to find out if a copy can be mailed to you.
If You Have Questions: For questions concerning Medicare, please visit www.medicare.gov or call (800) MEDICARE (633-4227) to get the most current information.