Retirees Turning Age 65 or Becoming Medicare Eligible
Retirees age 65 or over at the time of retirement have several options of health plans to choose from. Retiree must enroll in Medicare Part A and B effective the first of the month after retirement. The district offers an HMO and PPO** plan that coordinates with Medicare Part A and Part B and becomes a secondary insurer, not a Medicare supplement.
**When retired and enrolled in Medicare, Medicare becomes primary insurance and the District’s insurance plan becomes the secondary insurer. See the following section for District Group Medicare Plan Options.
Retirees also have the option to elect a District group Medicare plan:
- Medicare Advantage Plan – RX included
- Medicare Supplement Plan F– RX NOT included
- Retirees that elect one of these Medicare group plans are NOT eligible to elect any other MCSD group health insurance plans in the future
- Medicare plans renew each calendar year (January – December)
Hospital Insurance (Medicare Part A)
Retirees age 65 or older or on Medicare due to disability at the time of retirement must enroll in Medicare Part A. Most people do not pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits. The retiree should elect Medicare Part A when it is first offered to avoid a late enrollment penalty.
Medical Insurance (Medicare Part B)
Retirees age 65 or older or on Medicare due to disability at the time of retirement must enroll in Medicare Part B upon retirement. Medicare Part B (Medical Insurance) helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. There is a monthly premium for Part B. The retiree must elect Medicare Part B upon retirement to avoid a late enrollment penalty.
Prescription Drug (Medicare Part D)
Most people will pay a monthly premium for Part D. Prescription drug coverage was made available to everyone with Medicare through Part D. Medicare’s Prescription Drug Coverage (Part D) is an insurance plan, so private companies provide the coverage. Since private companies are providing the plan a monthly premium is charged for the coverage.
The prescription drug benefit provided under the District’s medical insurance program has been actuarially determined to be “creditable”. This means that the District’s prescription drug coverage is as good as, or better than, the coverage provided under Medicare Part D. Since the District’s coverage is “creditable”, there will be no premium penalties, should you decide to enroll in Medicare Part D at a later date.
Retirees (or covered dependents) that are covered on the District’s HMO or PPO health plans do not need to enroll in Part D coverage. If Part D is elected, medical and prescription drug coverage with MCSD will end for the retiree and all covered dependents. REMINDER: Once a health insurance benefits is waived or cancelled, retirees waive the right to participate or enroll in the health insurance benefit at any time in the future.
Important Notice about Medicaid and Medicare Part D
Please note that if a retiree becomes eligible for Medicaid (or any other state or federal financial assistance programs), that the Centers for Medicare and Medicaid Services (CMS) may automatically enroll in the Medicare Part D drug subsidy program. Enrollment in Medicare Part D will terminate your health coverage with the Martin County School District. We suggest that retirees contact the Centers for Medicare and Medicaid Services (CMS) directly to prevent automatic enrollment into Medicare Part D drug subsidy program. By contacting CMS, you can request that they never automatically enroll you into the Medicare Part D drug subsidy program.
Should a retiree be automatically enrolled in the Medicare Part D drug subsidy program, please contact the Risk and Employee Benefits Department for assistance immediately. Save all pieces of communication from Medicare, as this information will help assist the retiree.