GIC Medicare Guideline: View and print the attached for an overview of when to apply for Medicare
Parts A and B.

Q) What is Medicare?
A) Medicare is a Federal health insurance program for retirees age 65 or older and certain disabled people. Medicare Part A covers inpatient hospital care, some skilled nursing facility care and hospice care. Medicare Part B covers physician care, diagnostic x-rays and lab tests and durable medical equipment. Medicare Part D is a federal prescription drug program.

Q) I’m turning age 65; what do I need to do?  Should I enroll in Medicare A and/or B if I am eligible?
A) If you are age 65 or over, call or visit your local Social Security Office for confirmation of Social Security and Medicare benefit eligibility.  If eligible and if you are retired, you must enroll in Medicare Parts A and B to continue coverage with the GIC.  See the Retiree/Survivor Benefit Decision Guide for your health plan options. 

If eligible and if you continue working after age 65, you should enroll in Medicare Part A.  You should NOT enroll in Medicare Part B until you (the insured) retire. 

The spouse of an active employee who is 65 or over should sign up for Medicare Part A when he or she (the spouse) reaches age 65 and enroll in Part B when the insured retires.  Due to federal law, different rules apply for same sex spouses.  See below for details.

Most enrollees should not sign up for Medicare Part D. 

Q) How to I find out whether I am eligible for Medicare A and/or B benefits?
A) When you or your spouse is age 65 or over, visit your local Social Security Administration office to find out if you are eligible for Medicare Part A for free. If you or your spouse is disabled, contact Social Security about Medicare eligibility. If eligible, contact the GIC for your health plan options.

Q) I have been a state employee for my entire career and have never contributed to Social Security. Why do I need to know about Medicare?
A) You may still be eligible for Medicare benefits. When you turn age 65, visit your local Social Security office for eligibility information. If you are not eligible for Medicare, the GIC will require proof from the Social Security Administration that you are not eligible.

Q) What is the cost of Medicare Part B?
A) The premium is set by the Centers for Medicare and Medicaid Services (CMS).  Contact them or your local Social Security office for the current premium cost.

Q) How do I pay for Medicare Part B?
A) In most cases, the federal government will deduct the Medicare Part B premium from your monthly Social Security check. If you or your spouse are not eligible for a Social Security check, but are eligible for Medicare Part A for free, the federal government will bill you for the Medicare Part B premium.

Q) When must I enroll in Medicare Part A and B?
A) When you or your spouse turns 65, and if you (the enrollee) are retired, you must enroll in Medicare Parts A and B.  If you (the enrollee) continue working after age 65, you and/or your spouse must enroll in Medicare Part A.  (Different rules apply to same sex spouses; see below for details.) When you retire, you and/or your spouse must enroll in Medicare Part B and join a Medicare plan sponsored by the GIC.

If you do not enroll in Medicare Part B within the required time, you will be required to pay federal government penalties. Also, you may be ineligible for health coverage through the GIC if you do not enroll in Part B within the required time.

Q) Should I choose only Medicare for health care coverage?
A) “Medicare only” coverage is not recommended as it has coverage limitations. To ensure comprehensive coverage, Medicare retirees should enroll in a Medicare health plan sponsored by the GIC as a supplement to their Medicare coverage.

Q) What are the consequences if I cancel or do not pay Medicare Part B?
A) If you cancel or do not pay Medicare Part B, the GIC is required to terminate your GIC health coverage. This would mean that you would only have Medicare Part A coverage for inpatient hospital care. You would no longer have coverage for:

• Physician office visits
• Prescription drugs
• Outpatient mental health/substance abuse care
• Outpatient surgery
• X-rays and diagnostic tests
• Hearing aids
• And more

Q) If I enroll in a GIC Medicare supplemental plan, what happens to my spouse's coverage?
A) Your spouse will continue to be covered under your existing non-Medicare plan until he or she becomes eligible for Medicare. You and your spouse must join the same health plan.  See the Retiree/Survivor Benefit Decision Guide for under and over age 65 health plan combination options. 

Q) I’m turning age 65 and have a same sex spouse; what do I need to do?  Should I enroll in Medicare A and/or B if I am eligible?
A) If you are age 65 or over, call or visit your local Social Security Office for confirmation of Social Security and Medicare benefit eligibility.  If eligible and if you are retired, you must enroll in Medicare Parts A and B to continue coverage with the GIC.  See the Retiree/Survivor Benefit Decision Guide for your health plan options. 

If eligible and if you continue working after age 65, you should enroll in Medicare Part A.  You should NOT enroll in Medicare Part B until you retire. 

The same sex spouse of an active employee should sign up for Medicare Part A and Part B when he or she (the spouse) reaches age 65.  Keep in mind that the same sex spouse is subject to federal imputed income taxes.  See the imputed income table for more information.

Most enrollees should not sign up for Medicare Part D. 

Q) I am an ACTIVE state employee age 65 or over; which health plan card should I present at a doctor's office or hospital?
A) When visiting a hospital or doctor, present your GIC health plan card (not your Medicare card) to ensure your GIC plan is charged for the visit. If you are still working and are age 65 or over, your GIC health plan is your primary health insurance provider; Medicare (if you have it) is secondary. You may need to expain this to your provider is he/she asks for your Medicare card.

Q) How do I find out about Medicare Plan options?
A) When you retire at age 65 or over or if you are retired and turn age 65, the GIC will contact you about your health plan options. The GIC's Retiree/Survivor Benefit Decision Guide provides an overview of your Medicare health plan choices.

Q) When can I change GIC Medicare Plans?
A) You may change your GIC Medicare Plan during annual enrollment or if you move out of a GIC HMO Medicare Plan's service area.

Q) At age 65 my spouse or I were not eligible for Medicare Part A for free.  I or my spouse have subsequently become eligible for Medicare Part A.  What do we need to do?
A)  You or your spouse must notify the GIC in writing when you become eligible for Medicare Part A.  The GIC will notify you of your coverage options.  Failure to do this may result in loss of GIC coverage.

Q) I am an active employee who is age 65 or over.  Should I enroll in Medicare Part D?
A) No.

Q)  I am a retiree.  Should I enroll in Medicare Part D?
A)  For most GIC Medicare enrollees, the drug coverage you currently have through your GIC health plan is a better value than the Medicare drug plans being offered.  Therefore, you should not enroll in a Medicare drug plan.  (If you are a member of one of the GIC’s Medicare Advantage plans – Fallon Senior Plan, Harvard Pilgrim First Seniority Freedom and Tufts Medicare Preferred – your plan automatically includes Medicare Part D coverage.) 

If you have limited income and assets, the Social Security Administration offers help paying for Medicare prescription drug coverage and this may be the one case where signing up for a Medicare Part D plan may work for you.  Contact the Social Security Administration for details.

Q) How do I avoid paying a penalty for late enrollment in Medicare Part D?
A) If you should later enroll in a Medicare drug plan because of changed circumstances, show the GIC’s Creditable Coverage Notice to the Social Security Administration to avoid paying a penalty.  This notice is in your health plan handbook and is also on the GIC’s website.

Q) I am eligible for Medicare Part D for free.  Do I keep my GIC coverage?
A) If you are low income and are not in a nursing home, you probably need a Medicare supplemental plan to help cover physician care, diagnostic x-rays and lab tests, and durable medical equipment costs.  However, if you are in a nursing home and have Medicaid, you may not need to keep your GIC coverage.  Keep in mind that the GIC’s Medicare Advantage Plans - Fallon Senior Plan, Harvard Pilgrim First Seniority Freedom and Tufts Medicare Preferred – automatically include Medicare Part D coverage.