• Medicare 

    What you need to know.

     

    General Information

    Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, retirees, the disabled, and children of deceased workers and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).  

    Here are the ABC's and D of Medicare

    Medicare Part A (Hospital Insurance): Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.  There is typically no cost for Part A. 

    Medicare Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. For 2017, the cost of Medicare Part B is $134.00 and is deducted directly from your Social Security check. 

    Medicare Part C Sometime called "MA Plans," are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. You get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare.

    Medicare Part D (prescription drug coverage): Part D adds prescription drug coverage.  These plans are offered by insurance companies and other private companies approved by Medicare.  Unions may also sponsor Retiree Drug Subsidy Plan (RDS) that provide Creditable Coverage".  These plans are an alternative to Medicare Part D for eligible retirees.

    For more information, see Medicare's website, medicare.gov

     

    Active employees and their spouses who are covered by medical insurance through the School District of the City of Niagara Falls must obtain Part A at age 65.

     

    Most employees forgo enrollment in Medicare Parts B & D until they retire.  Check with Social Security for details regarding your ability to delay enrollment in Parts B & D without penalty. Employees who enroll in Part B while still working are usually not subject to late enrollment penalties as long as they have maintained continuous medical coverage through from age 65 on. If you decide to forgo Part B when you are first eligible, confirm your ability to avoid late enrollment penalties with Social Security. Employees and their legal spouses are usually allowed to enroll in Part B at any time while continuously covered by medical insurance through active employment (or, immediately upon termination of employment or retirement).

     

    When you retire and you or your spouse are 65 or older or eligible for Medicare due to a disability, you and your spouse MUST enroll in both Medicare Parts A and B in order to be enrolled in the coverage coverage School District of the City of Niagara Falls medical plan.   At this time, Independent Health is secondary coverage to Medicare, which means that it typically pays after Medicare pays. In order to be fully covered, for Medicare-covered services you will need both Part A and Part B.

    If you are under 65 and retire due to a disability, you and your spouse (if also disabled) MUST enroll in Medicare Part A & B in order to remain covered under the School District of the City of Niagara Falls medical plan. 
     

    If you postpone enrollment in Medicare, you may have to pay a penalty for late enrollment in addition to the monthly premium. Additionally, if you delay enrollment in Part B, you may also have gaps in your coverage, because you will have to wait until the General Enrollment Period to enroll in Part B. The General Enrollment Period is January 1 through March 31 each year, with coverage beginning July 1.

     

    Below documents that provide additional information on Medicare Parts A & B

     

    Your Guide to Who Pays First

    An official U.S. government publication from the Centers for Medicare & Medicaid Services / August 2015

     

    Important Medicare Information

    Answers to frequently asked questions about enrolling in Parts A & B.

    Important Medicare Enrollment Information 

     

    Medicare & You 2016

    The official U.S. government Medicare handbook published by the Centers for Medicare & Medicaid Services / September 2015.

    Medicare & You 2016