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THE BALTIMORE FIRE OFFICERS |
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1030 S. Linwood Avenue |
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CITY OF BALTIMORE DHR-EMPLOYEE BENEFITS DIVISION IMPORTANT MEDICARE INFORMATION
As a Baltimore City retiree, you and your covered dependents must enroll in BOTH MEDICARE PART A (HOSPITAL INSURANCE) & PART B (MEDICAL INSURANCE) as soon as you or your dependent is eligible. Who is eligible for Medicare? • People age 65 or older • Some people with disabilities under age 65 determined by Social Security Administration (SSA) • People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant) When and How Do I Enroll in Medicare Parts A & B? If you are not already getting Social Security retirement benefit checks, you should call or visit your local Social Security office or call Social Security at 1-800-772-1213 to enroll in Medicare Parts A & B during your Initial Enrollment Period. Your Initial Enrollment Period begins three months before the month you turn 65 and ends three months after you turn 65. If you wait until the month you turn 65, your Medicare Part B start date will be delayed. If you are already getting Social Security retirement checks due to a disability, you will be automatically enrolled in Medicare Parts A and B and a Medicare card will be mailed to you on the 25th of the month after the disability benefits began. When you receive your Medicare card, the Social Security Administration will give you the option of turning down the enrollment in Part B. BALTIMORE CITY REQUIRES THAT YOU ENROLL IN BOTH MEDICARE PARTS A & B. Note: If you and/or your spouse do not enroll in Medicare Part B when you are first eligible, you will not be able to enroll until Social Security Administration’s General Enrollment Period. This period runs January 1 through March 31 each year and will become effective July 1. The premium for Part B Medicare may increase by 10% for each 12-month period that you could have had Part B, but did not enroll. If the premium for Part B increases, you will have to pay this extra amount as long as you have Part B. If you have any questions regarding how to enroll in Medicare Parts A & B, contact your local Social Security office at 1-800-772-1213. What will happen to my Baltimore City health plan coverage when I become eligible for Medicare? The month you and/or your spouse turn 65, Medicare Parts A & B will become your primary coverage (all eligible claims are paid by Medicare first). Your Baltimore City health plan coverage will become a supplemental plan to Medicare, which will be your secondary coverage. Your Baltimore City supplemental health plan will cover only that portion of your health claims not covered by Medicare up to the maximum Medicare Allowed Amount. If I do not enroll in both Medicare Parts A & B when I am eligible, how will my claims be affected? If you do not enroll in both Medicare Parts A & B when you are eligible, your Baltimore City health plan coverage will be converted to the supplemental health plan coverage for the individual who is Medicare eligible. THE INDIVIDUAL WHO IS ELIGIBLE FOR MEDICARE WILL THEN BE RESPONSIBLE FOR THE PORTION OF CLAIMS THAT BOTH MEDICARE PARTS A & B WOULD COVER AS PRIMARY. Your Baltimore City supplemental health plan will cover only that portion of your health claims not covered by Medicare up to the maximum Medicare Allowed Amount. What do I do after I enroll in both Medicare Parts A & B and receive my Medicare card? Once you have enrolled and received your Medicare card from Social Security Administration, you must contact our office to request an Employee Benefits Enrollment Form to give us your Medicare claim number and effective dates of both Medicare Parts A & B. Submit your completed enrollment form along with a copy of your Medicare card to DHR-Employee Benefits Division, 201 E. Baltimore Street, Suite 500, Baltimore, MD 21202 eight weeks prior to your 65th birthday. If you have any questions regarding your Baltimore City health plan coverage, please contact our office at 410-396-5831. Baltimore City retirees should select option 2 and then choose option 1 to speak to a customer service representative. If you have any questions regarding Medicare benefits, please call 1-800-633-4227.
Important Notice from the City of Baltimore about Your Prescription Drug Coverage and Medicare Part D NOTICE OF CREDITABLE COVERAGE Please read this notice carefully and keep it where you can find it. This notice applies to all City of Baltimore employees, retirees and dependents that are entitled to Medicare and are enrolled in the current prescription drug coverage through The City of Baltimore. It also explains the options you have under Medicare Part D prescription drug coverage and can help you decide whether or not you want to enroll. At the end of this notice is information about where you can get help to make decisions about your prescription drug coverage. Important Points to remember Medicare prescription drug coverage (Medicare Part D) became available in 2006 to everyone with Medicare through Medicare Part D prescription drug plans and Medicare Advantage Plans that offer prescription drug coverage. All Medicare prescription drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. The City of Baltimore has determined that the prescription drug coverage offered by the City of Baltimore’s Express Scripts plan is creditable coverage. Creditable coverage means that, on average for all plan participants, our plan through Express Scripts is expected to pay out as much as the standard Medicare Part D prescription drug coverage will pay. Because your existing prescription plan is creditable coverage and is on average at least as good as the standard Medicare Part D prescription drug coverage, you can keep your Express Scripts coverage and not pay extra if you later decide to enroll in Medicare Part D prescription drug coverage. When Can You Join A Medicare Drug Plan? Individuals can enroll in a Medicare Part D prescription drug plan when they first become eligible for Medicare and each year from November 15th through December 31st. Beneficiaries leaving employer/union coverage or if you lose your Express Scripts coverage through no fault of your own, you may be eligible for a Special Enrollment Period to sign up for a Medicare Part D prescription drug plan. You should compare your current coverage, including which drugs are covered, with the coverage and cost of the plans offering Medicare Part D prescription drug coverage in your area. What Happens to Your Current Coverage If You Decide to Join a Medicare Drug Plan? If you join a Medicare Part D drug plan, your City of Baltimore prescription drug benefits will be affected. Should you do decide to enroll in a Medicare Part D prescription drug plan your coverage and your dependent’s coverage with Express Scripts will terminate. Be aware that you and your dependents may will not be able to re-enroll in the City of Baltimore’s Prescription drug plan until the next open enrollment period. When Will You Pay a Higher Premium (Penalty) To Join a Medicare Drug Plan? You should also know that if you drop or lose your coverage with the City of Baltimore and don’t enroll in Medicare Part D prescription drug coverage after your current coverage ends, you may pay more (a penalty) to enroll in Medicare prescription drug coverage later. If you go 63 continuous days or longer without prescription drug coverage that’s at least as good as Medicare’s prescription drug coverage, your monthly Medicare Part D premium will go up at least 1% per month for every month that you did not have that coverage. For example, if you go 19 months without coverage, your premium will always be at least 19% higher than what many other people pay. You’ll have to pay this higher premium as long as you have Medicare Part D prescription drug coverage. For More Information about this Notice or Your Current Prescription Drug Coverage Contact our office for further information at 410-396-5830. NOTE: You will receive this notice annually and at other times in the future such as before the next period you can enroll in Medicare Part D prescription drug coverage, and if this coverage through Express Scripts changes. You also may request a copy at anytime. For More Information about Your Options under Medicare Part D Prescription Drug Coverage • • Call your State Health Insurance Assistance Program (see your copy of the Medicare & You handbook for their telephone number) for personalized help, • Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. More detailed information about Medicare plans that offer prescription drug coverage is in the "Medicare & You" handbook. You’ll get a copy of the handbook in the mail every year from Medicare. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA) online at www.socialsecurity.gov, or you can call them at 1-800-772-1213 (TTY 1-800-325-0778). Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show that you are not required to pay a higher premium (penalty) amount.
REV. 01/02/09 |
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