Retired Employee Medicare FAQ

Frequently Asked Questions about MEDICARE (Retired Employee): 

Frequently Asked Questions about MEDICARE (Retired Employee)

Disclaimer: 

Disclaimer The contents of this webinar and the web links therein are not meant to provide all the information you should consider when thinking about Medicare but is merely some basic information that might be helpful to you in your preparation for Medicare eligibility. This does not take into account individual situations, so some slides may or may not apply to your situation.

What is Medicare?: 

What is Medicare? Medicare is a federally sponsored program consisting of three parts: Part A – This covers charges associated with an in-patient hospitalization. Part B – This covers doctor’s charges, laboratory charges, physical therapy, etc., which are not related to in-patient hospitalization or prescription charges. Part D – This covers the prescription drug plan (Federal Legend drugs).

MEDICARE ELIGIBLE RETIRED EMPLOYEE: 

MEDICARE ELIGIBLE RETIRED EMPLOYEE Eligibility for the University of Missouri medical insurance program is determined by the retiree’s Medicare eligibility. Any and all dependents who are enrolled in the medical plan when the employee retires will be eligible for the same plan as the retiree.

MEDICARE ELIGIBLE RETIRED EMPLOYEE: 

MEDICARE ELIGIBLE RETIRED EMPLOYEE If you or your dependent is eligible for Medicare due to age or disability at the time of retirement, please provide a photocopy of your Medicare card(s) to the Retirement Office at 1000 W. Nifong , Bldg. 7, Ste. 210, Columbia, MO 65211 or fax it to 573-884-5422.

MEDICARE ELIGIBLE RETIRED EMPLOYEE: 

MEDICARE ELIGIBLE RETIRED EMPLOYEE If you will be eligible for Medicare within 90 days of your retirement, please provide us with a copy of your Medicare card(s) as soon as possible. Be sure to enroll in Medicare 90 days prior to becoming age 65 or Medicare eligible, whichever date is earlier.

MEDICARE ELIGIBLE RETIRED EMPLOYEE: 

MEDICARE ELIGIBLE RETIRED EMPLOYEE As a Medicare eligible retiree, please note that you must be enrolled in Medicare Part A and/or Part B, even if you are enrolled in another medical plan. If you choose not to enroll in Medicare, that portion which should have been paid by Medicare Part A and/or Part B will not be paid by the University of Missouri medical plan.

MEDICARE ELIGIBLE RETIRED EMPLOYEE: 

MEDICARE ELIGIBLE RETIRED EMPLOYEE If you or a dependent becomes eligible for Medicare due to disability after retirement, please contact our office immediately at 573-882-9810 or 1-800-488-5288 or via email at retirement@umsystem.edu ).

MEDICARE ELIGIBLE RETIRED EMPLOYEE: 

MEDICARE ELIGIBLE RETIRED EMPLOYEE If a retiree or dependent becomes eligible for Medicare due to age, the Retirement office will request a photocopy of the Medicare card and advise the retiree/dependent of any changes to the plan or premium, if applicable.

Is the University medical plan for retirees who are eligible for Medicare a supplemental plan?: 

Is the University medical plan for retirees who are eligible for Medicare a supplemental plan? No, it is a secondary major medical plan.

What’s the difference between a supplemental plan and a secondary medical plan? : 

What’s the difference between a supplemental plan and a secondary medical plan? A Medicare supplemental plan is also sometimes called a Medigap policy. These are sold by private insurance companies and are available to someone who is eligible for Medicare. It is tied to Medicare’s approval of claims and limitations. You might want to obtain additional information here: https://questions.medicare.gov/app/answers/detail/a_id/2051/~/what-is-a-medigap-policy%3F

What’s the difference between a supplemental plan and a secondary medical plan?: 

What’s the difference between a supplemental plan and a secondary medical plan? The University’s plan is a comprehensive (major medical) plan which would process claims after (or secondary to) Medicare’s claim processing based on the University of Missouri Plan rules.

Why doesn’t the University offer a supplemental plan?: 

Why doesn’t the University offer a supplemental plan? The University offers a major medical plan because many retirees provide insurance coverage to non-Medicare eligible dependents – spouses and children. A Medicare supplemental plan would only provide coverage to Medicare participants but not to anyone who isn’t eligible for Medicare.

Why doesn’t the University offer a supplemental plan?: 

Why doesn’t the University offer a supplemental plan? Additionally, the University medical plan provides coverage for retirees who do not reside in the United States. A Medicare supplemental plan is limited to Medicare’s restrictions. Medicare only provides coverage in the United States and its territories.

What is a Medicare “Carve Out” plan? : 

What is a Medicare “Carve Out” plan? Retirees who retired on or after 9/1/1990 are under a Maintenance of Benefits (MOB) Approach which is a Medicare “Carve Out” approach. After satisfying the annual deductible, the University’s medical program coverage is first calculated as if there is no other insurance. Any amount payable by Medicare is subtracted from this amount. The excess, if any , is paid as the University Program benefit.

I am eligible for Medicare and retiring from the University but I am going to work for another company. They are offering me medical insurance. How will the insurance coordinate?: 

I am eligible for Medicare and retiring from the University but I am going to work for another company. They are offering me medical insurance. How will the insurance coordinate? The coordination of medical insurance claims based on the scenario above will be as follows: Primary: active employment insurance Secondary: Medicare Tertiary: University of Missouri medical plan

I retired from another company before coming to work at the University of Missouri. Now I qualify for their retirement insurance, the University of Missouri’s retirement insurance and Medicare. What is the order of payment for claims? : 

I retired from another company before coming to work at the University of Missouri. Now I qualify for their retirement insurance, the University of Missouri’s retirement insurance and Medicare. What is the order of payment for claims? The coordination of medical insurance claims will be as follows: Primary: Medicare Secondary: determined by where individual was employed longest Tertiary: shortest term of employment could qualify for third payer

Because I retired from the military before working at the University, I’m eligible for Tricare. How will the coordination of claims work? : 

Because I retired from the military before working at the University, I’m eligible for Tricare . How will the coordination of claims work? In that case, the coordination of medical insurance claims will be as follows: Primary: Medicare Secondary: Medicare Supplemental Plan or Tricare Tertiary: University of Missouri retirement medical plan PLEASE NOTE: If you are eligible for an employer group insurance plan or Tricare , you may be eligible to “suspend” your University of Missouri medical coverage. If you are interested in this option, please contact the Retirement Programs office at 573-882-9810 or 1-800-488-5288 to get further details.

I am a retiree but I’m not 65 yet. I have a disability and am now eligible for Medicare. Do I have to sign up?: 

I am a retiree but I’m not 65 yet. I have a disability and am now eligible for Medicare. Do I have to sign up? Yes, if you are eligible for Medicare due to age or disability, the University’s retirement medical plan will be your secondary insurance coverage. If you don’t sign up for Medicare, that portion which Medicare should have paid on your behalf will be your responsibility. It is your responsibility to enroll in Medicare at the time you become eligible. If you become eligible for Medicare due to disability, it is your responsibility to notify our office immediately. Failure to do so can result in non-payment of claims.

Do I have to meet the annual Medicare deductible and also meet the University medical plan deductible? : 

Do I have to meet the annual Medicare deductible and also meet the University medical plan deductible? The University medical plan credits your account for any Medicare deductible you have satisfied.

What happens if I travel or live overseas? What if I am going on a cruise / Peace Corps / volunteer trip? : 

What happens if I travel or live overseas? What if I am going on a cruise / Peace Corps / volunteer trip? Because the University’s medical plan is major medical coverage, you are covered anywhere in the world. If you are outside of the US, Medicare does not provide any benefits; therefore, the University’s medical plan will be your primary insurance.

What happens if I travel or live overseas? What if I am going on a cruise / Peace Corps / volunteer trip? : 

What happens if I travel or live overseas? What if I am going on a cruise / Peace Corps / volunteer trip? You will be responsible for payment at the time of service and should submit a claim with the necessary receipts of payment and documents which describe the services you received. Currency conversion information should also be provided. Receipts do not have to be in English; however, if translations are required by your insurance administrator, please allow additional time for processing.

What is Medicare “Crossover”? Is there anything I need to do to take advantage of it?: 

What is Medicare “Crossover”? Is there anything I need to do to take advantage of it? This is a free service provided by Coventry which allows Medicare to electronically transfer claim information directly to Coventry. This speeds up the claim processes and also eliminates the need for the provider or patient to file claims with Coventry (unless the claims were incurred out of the country).

I’m a retiree but I’m not taking my Social Security yet – why do I need to sign up for Medicare?: 

I’m a retiree but I’m not taking my Social Security yet – why do I need to sign up for Medicare? Commencement of Medicare is not synonymous with commencement of Social Security. Medicare eligibility is the first day of the month of your 65 th birthday unless you qualify earlier due to disability. Social Security commencement has a different schedule of age requirements.

I’m a retiree enrolled in the myOptions plan and I am also enrolled in Medicare. Can I participate in the Health Savings Account? : 

I’m a retiree enrolled in the myOptions plan and I am also enrolled in Medicare. Can I participate in the Health Savings Account? If you are participating in Medicare, you are not eligible for a Health Savings Account; however, the myOptions plan may still be an excellent choice for you.

My spouse and I are enrolled in the myOptions plan but my spouse isn’t eligible for Medicare yet. Can my spouse participate in the Health Savings Account?: 

My spouse and I are enrolled in the myOptions plan but my spouse isn’t eligible for Medicare yet. Can my spouse participate in the Health Savings Account? If a participant is not eligible for Medicare, your spouse can take advantage of a Health Savings Account. Because this account belongs to the participant, your spouse can use that money to pay for out of pocket health care expenses each year – like a deductible – or save the money for future health expenses, including health premiums.

My spouse and I are enrolled in the myOptions plan but my spouse isn’t eligible for Medicare yet. Can my spouse participate in the Health Savings Account?: 

My spouse and I are enrolled in the myOptions plan but my spouse isn’t eligible for Medicare yet. Can my spouse participate in the Health Savings Account? As long as the participant uses the money for health care expenses, they don’t pay taxes on it. Participants may be eligible to take advantage of the health savings account by applying a tax credit on their annual income tax return.

QUESTIONS?: 

QUESTIONS? This concludes this presentation on Medicare topics for Retired employees. We hope this presentation was helpful. If you have further questions regarding Medicare as a retired employee, please contact our office at 1-800-488-5288 or 573-882-9810 or email: retirement@umsystem.edu