Frequently Asked Questions On Medicare
Do both my dependent and I need to apply for Medicare
upon reaching age 65?
You and your dependent(s) must enroll in those parts
of Medicare for which you and your dependent(s) are eligible in order
to receive a LACERS' medical plan premium subsidy and to continue your
Retired medical plan coverage.
Everyone over age 65 who is a citizen or legal resident
is eligible for Medicare Part B. You may be eligible for Part A due to
your spouse's or your earnings history with Social Security. Your local
Social Security Office will help you determine your eligibility and accrued
credits for Medicare Part A. Find your local Social Security Office by
calling (800) 772-1213/TTY (800) 325-0778 or visit their website at
www.ssa.gov.
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When do I need to apply for Medicare?
It is necessary to file two months (or up to 90 days)
prior to reaching age 65, to avoid a lapse in your medical plan coverage
or LACERS subsidy. If you are still employed at age 65 or older,
special rules apply on when you can apply for Medicare. See question
below.
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What happens if I work past age 65? Do I get penalized?
If you are retiring after age 65 and/or your dependent(s)
are over age 65, the Social Security Administration, which administers
Medicare enrollment, requires a special form to be filled out by
LACERS for each person who is age 65 and over. Each Social Security Office
has its own form, usually titled "Special Enrollment Period." By having
this form filled out, you will still need to enroll in Medicare Part
B but
you will not be penalized for not enrolling at age 65.
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Why is it so important for me to apply for Part
B? Don't you pay my Medical premiums anyway?
Enrollment in Medicare Part B is required in order
for you to continue to receive a LACERS medical plan premium subsidy.
The Medicare Part B requirement lowers the overall medical insurance
premiums that LACERS negotiates with the medical plan providers.
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Do I get reimbursed for the amount I pay for Medicare
Part B?
Only if you, the City Retiree,are enrolled in both
Parts A and B of Medicare, does LACERS reimburse you for the basic Part
B premium. There is no Medicare Part B reimbursement for City Retirees
only enrolled in Part B. Also, there is no Part B reimbursement for dependents
or Surviving Spouses/Domestic Partners.
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What is Medicare Part B tiered premiums?
As part of the Medicare Modernization Act (MMA) of 2003, starting in 2007 and for the future, Members whose modified adjusted gross income (not just LACERS Retirement Allowance) exceeds $80,000 per year ($160,000 for couples) will pay an income-related monthly adjustment amount (IRMAA) in addition to the standard premium and any late enrollment penalties. Please read the 2007 Medicare Guide for more detail.
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How will Social Security know how much income I have?
The MMA authorized the Internal Revenue Service (IRS) to disclose information to the Social Security Association regarding a person's modified adjusted gross income. Contact Social Security at (800) 772-1213 for more details.
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When will Social Security notify me of what my monthly 2007 Part B premium will be?
The basic premium (25%) is set at $93.50 for 2007. According to Social Security, they will notify you in late November or early December each with the amount your Part B premium will be for the following year.
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I am a City Retiree with Medicare Parts A and B. Will LACERS reimburse me for the additional cost of Part B?
No. The Los Angeles Administrative Code, which governs LACERS benefits, states that the Part B reimbursement for a City retiree with Medicare Parts A and B is the basic Part B premium. The basic premium is defined as 25% of the actuarial cost of the Medicare Part B program, which amounts to the monthly premium of $93.50 in 2007, not including any IRMAAs or enrollment penalties.
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How do I know if I'm eligible for Medicare Part
A?
You may be eligible for Part A due to your spouse's
or your earnings history with Social Security. Call or visit your local
Social Security Office to help you determine your eligibility and accrued
credits. Find your local Social Security Office by calling (800) 772-1213/TTY
(800) 325-0778 or visit their website at www.ssa.gov.
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What happens if I don't apply for Part B?
It only becomes a problem when you are eligible for
Part B and decide not to enroll in Part B. In this instance, you would
be in danger of losing your LACERS medical plan premium subsidy and medical
coverage. You could also be subjected to paying a lifetime penalty to
Social Security.
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How do I find out what Medicare benefits I'm eligible
for?
Your local Social Security Office will help you determine
your eligibility and accrued credits. Find your local Social Security
Office by calling (800) 772-1213.
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How will LACERS know when I have Medicare Parts
A or B?
It is your responsibility to notify LACERS when you
and/or your dependent(s) have Medicare, either Part B only or Parts A
and B. If you and/or your dependent(s) have Medicare, you must supply
a copy of the Medicare card to LACERS. LACERS periodically conducts a
Medicare status audit of Members and dependents enrolled in a LACERS
sponsored medical plan. Those Members and dependents who are eligible
for Medicare but who do not have Medicare according to LACERS records
will be required to enroll in Medicare or lose the medical plan premium
subsidy and their medical coverage.
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What is Medicare Part D?
As of January 1, 2006, the Medicare Part D Prescription Drug Benefit (which is part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003) provides elderly and disabled people on Medicare access to prescription drug coverage.
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Do I need to enroll in Medicare Part D?
No, you do not need to enroll in Part D separately from your LACERS plan. Medicare Part D is already integrated into your LACERS medical plan. Please read the 2007 Medicare Guide for details.
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What if I am currently enrolled in a second Medicare Plan?
If you are covered by a second Medicare plan that offers the Part D prescription drug benefit or uses the Part D subsidy credit, you must decide whether to keep your LACERS plan or your other health insurance plan. We recommend that you verify any rules affecting your coverage through your second plan with that plan sponsor - we are unable to obtain this information for you. Remember, if you enroll in Medicare Part D through your second plan or your second plan uses the Part D subsidy credit, your LACERS medical plan will be terminated.
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