Medicare Frequently Asked Questions:
When am I eligible for Medicare?
Individuals are eligible for Medicare coverage beginning on the first day of the month of their 65th birthday. The initial enrollment period for newly eligible individuals begins 3 months before your birthday month, and extends for 3 months afterward. Beyond this period, individuals must experiece a qualifying event or wait for Medicare's annual Open Enrollment period in order to enroll. Some indivudials with a disability may be eligible to enroll in Medicare prior to their 65th birthday. Please contact Medicare directly for additional information.
Do I have to enroll in Medicare?
If you are still actively employed at the time of your 65th birthday and enrolled in AUSD's active group health plan, you may be eligible to defer enrollment in Part B without incurring a penalty. However, the District strongly encourages employees to meet with Medicare to confirm any required documentation and verify their ability to defer enrollment. Once you retire and are 65+, you are no longer eligible to defer Medicare enrollment. At that time you are required to enroll in Medicare Parts A and B. Failure to do so may subject you to a penalty. The District strongly encourages employees who plan to retire to meet with Medicare prior to retirement to ensure they do not experience a gap in coverage or incur any penalties.
What coverage is included in Medicare?
Medicare cosists of 2 required parts - Parts A and B, as well as optional Part D and Medicare Supplements or Senior Advantage Plans. Most individuals are automatically enrolled in Part A (Hospital Coverage) upon their 65th birthday, and there is no cost to enroll in Part A provided the individual has paid into Medicare for 40 quarters. Part B (Medical Insurance) has a monthly premium and individuals must complete an application with Medicare to enroll. Your premium owed is based on your gross salary over the past 2 years. Part D (presciption coverage) is purchased through the insurance carrier of choice (i.e. Blue Shield, Kaiser.) and is not mandatory. However, individuals who do not enroll in a Part D plan when they are initially eligible but enroll in Part D at a later date will incur a penalty. Most Medicare Supplements or Senior Advantage Plans include enrollmet in Part D. Medicare Supplements and Senior Advntage Plans are sold by many of the insurance carriers you are already familiar with, and help fill the gaps in Medicare's coverage. Medicare Supplements and Senior Advantage Plans are not sold directly by Medicare.
How much does Medicare cost?
Cost estimates can be viewed by visiting https://www.medicare.gov/your-medicare-costs/medicare-costs-at-a-glance.
How do I purchase additional medical coverage?
Upon reaching 65, the District will provide you with information regarding enrollment in the District's Medicare Supplement/Senior Advantage Plan(s). There is a premium to enroll in this coverage. This premium is in addition to your cost to enroll in Part B. Only retirees enrolled in Parts A and B are eligible to enroll in the District's 65+ coverage. Retirees may also wish to look into enrolling in supplemental coverage via an insurance broker or directly with an insurance provider.
What is Creditable Coverage?
Creditable Coverage refers to coverage that is as good as or better than Medicare. AUSD's group health plan is considered "creditable" for anyone enrolled in an active employee plan. However, AUSD's retiree group health plan is not considered "creditable." This means that while actively employed, your 65+ spouse may be able to defer Medicare enrollment. Once you retire, even if you qualify for early retiree benefits, your 65+ spouse will be required to enroll in Medicare.
You may be required to provide Medicare with documentation of creditable coverage for the time during which you or your spouse was 65 and older but not enrolled in Medicare. The "Mandatory Notice" linked below can be provided as verification of this. Medicare may also request a Part B form be completed by the District. Part B forms may be dropped off at the Benefits Department for completion.
State Teachers Retirement System (STRS): 800-228-5453 or www.calstrs.com
Public Employee Retirement System (PERS): 888-225-7377 or www.calpers.ca.gov
Medicare: 800-663-4227 or www.medicare.gov
Social Security: 800-772-1213 or www.ssa.gov
State Health Insurance Assistance Programs: 800-633-4227 or www.shiptacenter.org/
Medicare Rights Center: 800-333-4114 or www.medicareinteractive.org/
Keenan Direct: 855-653-3626 or https://www.keenandirect.com/