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Retirees

Posted on: April 28, 2022

Retirees, Are You Nearing Medicare Eligibility?

Medicare-questions

There are a few things you need to know before turning 65. If you are a retiree on the City of Plano’s medical, dental or vision plan, your coverage ends on the last day of the month before you turn 65. At 65, you must transition to Medicare Part A, Part B, Part D (a prescription drug plan) and a supplemental plan. If your spouse is on a City plan, they may remain on the plan until 65; at which time they must also transition to Medicare.

When do I enroll in Medicare?
Don’t wait – enroll 3 months before you turn 65! The Social Security Administration can have long wait times. So start your enrollment early to avoid gaps in coverage and late enrollment penalties.

You have a seven-month initial enrollment period consisting of:Medicare supplemental coverage

  • 3 months before your 65th birthday
  • 1 month of your 65th birthday
  • 3 months after your 65th birthday

You may be automatically enrolled in Medicare Part A and B if you are already collecting Social Security. Otherwise, it is up to YOU to enroll. You can enroll online at www.ssa.gov (click the “Medicare” tile) or you can call 800-772-1213.  If you live in Collin County, you can also call the McKinney Social Security office at 866-931-2731.  Again, you will need to enroll in Part A and Part B:

  • Part “A” (Hospital Insurance) helps pay for in-patient care in a hospital or limited time at a skilled nursing facility following a hospital stay. Part A also pays for some home health care and hospice care. It’s free if you have worked and paid Social Security taxes for at least 40 calendar quarters (10 years.) It may also be free to you if your spouse is eligible.
  • Part “B” (Medical Insurance) helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and some preventative services. Part B has a monthly premium – $170.10 for most people.

Medicare doesn’t cover everything. You will still be responsible for the 20% Medicare doesn’t cover, as well as for prescription drugs.  

Once you have Part A and Part B, you can enroll in the following:

  • Part D (prescription drug coverage) helps pay for any out-patient prescription drugs, helping to lower costs and protect you against future increases. You must enroll in prescription drug coverage when you become eligible; otherwise, you will pay a penalty once you do enroll.  The City of Plano offers a stand-alone prescription drug plan through Aetna and Part D drug plans are also typically included in Advantage Plans – Aetna Premium Plan and Aetna Standard Plan.
  • Medicare Supplemental or Advantage Plans help pay for what Part A and B do not cover. The City offers a Supplemental Plan through AARP/UHC, as well as two Advantage Plans that include prescription drugs through Aetna – Aetna Premium Plan and Aetna Standard Plan.

Find more info about the City’s Medicare Supplemental plans here. Additional details are on our Retirement Center page under “Medicare Supplemental Plans.

Clear as mud? The Medicare maze can be confusing, but here are a few resources that can help:

For questions or to enroll in any of the City’s plans, reach out to HR Analyst Tracy Stack by calling 972-941-7746.  

IMPORTANT:  Remember to enroll in Part A and Part B three months before your 65th birthday!

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