ACTION
Federal Retirement Benefits -
Medicare
Medicare is a Federal health insurance program for people who:
• Are 65 or older, or
• Have been entitled to Social Security disability benefits for 24 consecutive
months, or
• Have end stage renal disease (permanent kidney failure).
Medicare has two parts: Part A, hospital insurance which can
help pay for inpatient hospital care, care in a skilled nursing facility, home
health care and hospice care; and Part B, medical insurance which
can help pay for medically necessary doctors' services, outpatient hospital
services, home health services and a number of other medical services and
supplies that are not covered by the hospital insurance part of Medicare.
NYSHIP requires retirees to be enrolled in Medicare Parts A and B when first
eligible. Your covered dependents must also be enrolled when first eligible.
Once Medicare becomes your primary insurance, the Empire Plan or the HMO you are
enrolled in becomes secondary. This means your secondary insurance provides
benefits for services which Medicare does not cover.
Requirements for enrolling in Medicare apply to both Empire Plan and HMO
enrollees and dependents. Requirements for enrolling in Medicare also apply if
you or your dependent has NYSHIP coverage plus coverage under another employer
plan.
If you or your dependent is Medicare primary, the State will reimburse you for
the usual (base) cost of "original" Medicare Part B monthly premiums
unless you are receiving reimbursement from another source. Retirees, vestees,
dependent survivors, enrollees covered under Preferred List provisions and COBRA
enrollees who become Medicare primary at age 65 are reimbursed automatically.
Domestic partners and enrollees who become Medicare primary before age 65
because of disability or end stage renal disease must apply for reimbursement.
For more information about Medicare, see Medicare: When You Must Enroll and
Coordinating with NYSHIP in the General Information Book & Empire Plan
Certificate, June 1, 2002 or online at the
Department
of Civil Service/Employee Benefits Division web site.
Medicaid
Medicaid is a program for New Yorkers who can’t afford to pay for medical
care. You may be covered by Medicaid if:
• You have high medical bills.
• You receive Supplemental Security Income (SSI).
• You meet certain income, resource, age, or disability requirements.
If you enter a nursing home and spend down your assets, you may become eligible
for Medicaid. You can apply for Medicaid in any one of the following ways:
write, phone, or go to your local department of social services.
In New York City, contact the Human Resources Administration by calling (718)
557-1399. Residents of the five boroughs of New York City may call toll free at
1-877-472-8411.
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