Members Retirees Employers
  • Change font size: 
  • A
  • A
  • A
MEDICARE BASICS

Medicare is health insurance for people who meet the following requirements:                                

•  65 or older

•  Under 65 with certain disabilities

•  Any age with end-stage renal disease requiring dialysis
   or a kidney transplant

ENROLLING IN MEDICARE

Medicare’s seven-month Initial Enrollment Period begins three months before the month you turn 65 and ends three months after your birth month. You want to sign up for Medicare when you first become eligible to ensure your Medicare coverage will not be delayed, and will start the month you turn 65.

If you enroll in Medicare during your birth month or the three months after your birth month, your coverage will be delayed.

If you do not sign up during the Initial Enrollment Period, Medicare charges a lifetime penalty for each 12-month period you could have had Part B coverage.

If you are covered by your employer's health plan or your spouse's employer plan, the penalty does not apply. Once that coverage ends, contact Social Security within eight months to sign up for Medicare.

For more information:


Medicare Parts A, B, C, and D

Medicare Part A (hospital insurance) helps cover:

  • Inpatient care in hospitals
  • Skilled nursing facility care (not custodial or long-term care)
  • Hospice care
  • Home health care

Part A is premium-free for most people, based upon either their own work history or their
spouse’s work history in Social Security.

Medicare Part B (medical insurance) helps cover:

  • Services from doctors and other health care providers
  • Outpatient care
  • Home health care
  • Durable medical equipment
  • Some preventive services

Everyone is eligible for Part B, and pays a monthly Part B premium. In 2017, the premium for new enrollees is $134.00 per month.

For more information, watch the video "Why It's Important to Pay Your Part B Premium."

Medicare Part C (Medicare Advantage Plans):

  • Includes Part A and Part B benefits
  • Offered by Medicare-approved private insurance companies that have contracts with Medicare
  • Usually includes prescription drug coverage (Part D)
  • Can include extra benefits, such as fitness memberships

Medicare Part D (prescription drug coverage):

  • Helps cover prescription drug costs
  • Run by private insurance companies

Purchased separately unless you enroll in a Medicare Advantage plan that includes Part D

For more information, watch the video "All About Medicare Part D."


Medicare Coverage Choices

When you become eligible for Medicare, you have a choice to make on how to receive your coverage:

Original Medicare or a Medicare Advantage Plan

For more information, watch the video "Your Medicare Coverage Choices."

Resources and Links

Medicare

Social Security

SERS Medicare Plans


Medicare and SERS' Health Care Coverage

Medicare enrollment status is important in determining your SERS health care coverage options.

When you are enrolled in a SERS health plan, you are expected to contact the Social Security Administration and enroll in Medicare, if eligible, three months before reaching age 65.

If you can enroll in Medicare Part A without paying a premium, you should enroll. SERS’ health care coverage provides substitute coverage for individuals who are not eligible for premium-free Part A.

You will need to enroll in Medicare Part B and pay the required premium to Medicare.

If you fail to enroll, your share of health care costs will be higher under your SERS health care coverage.

Once SERS has confirmed your Medicare enrollment, you will be placed in a SERS Medicare Advantage plan that includes prescription drug coverage.

You should not enroll in another Medicare Advantage plan or Medicare Part D prescription plan if you want to keep your SERS health care coverage. Under federal rules, if you enroll in another such plan, SERS will have to cancel your SERS health care coverage.


Medicare Part B Reimbursement

SERS retirees who are eligible for Medicare Part B and enrolled in SERS’ health care coverage are eligible to receive a Medicare Part B reimbursement.

SERS currently reimburses eligible benefit recipients $45.50 per month to help pay Medicare Part B premiums. If your Medicare Part B coverage is cancelled, or your Part B premium is paid by any other source, such as your state, union, employer, Medicaid or other entity, you are not eligible for the reimbursement.

Reimbursement starts after SERS receives proof of Medicare Part B enrollment. The reimbursement is not retroactive. It is listed on retiree summaries as “Med B reimbursement.” The Medicare Part B reimbursement will end if SERS’ health care coverage is cancelled or Medicare Part B enrollment ends. Spouses and dependents are not eligible for this reimbursement.