Since Jan. 1, 2012, all Medicare-eligible retirees enrolled in the School Employees’ Health Benefits Program (SEHBP) are automatically enrolled in the state-selected Medicare prescription plan, which is currently OptumRx. This program includes the Medicare-eligible retiree to be enrolled automatically in Medicare Part D.

For 2019, most retirees will see a decrease in their Medicare Part D premiums to $33.19 per month. While there is no standard Medicare Part D cost associated with the program, enrollees whose incomes exceeded the legislated threshold amounts—$85,000 in 2019 for a beneficiary filing an individual income tax return or married and filing a separate return, and $170,000 for a beneficiary filing a joint tax return—will pay a monthly, income-related payment. Those surcharges will be generally lower, except for the highest-income participants.

View the chart below for the full list of the premiums:

The Social Security Administration uses the income reported two years ago to determine the Part D beneficiary’s payment. In other words, the income reported on a beneficiary’s 2017 tax return is used to determine whether the beneficiary must pay a monthly, income-related payment in 2019. If a beneficiary’s income decreased significantly in the past two years, they may request that information from more recent years be used to calculate the payment.

Reimbursement information

For those members receiving post-retirement medical benefits paid for by the state of New Jersey, the monthly, income-related payment for them and their dependents is reimbursed at the end of the year in which the payment is paid—after the proper paperwork is filed with the Division of Pensions and Benefits. Notice on how to file for any income-related adjustment reimbursement is sent to retirees, as well as be posted on the Division of Pensions and Benefits website, by early February.

Have questions?

If you have questions about your Medicare Part D monthly income-related payment, call 800-MEDICARE (800-633-4227). Any questions regarding the reimbursement process should be directed to the New Jersey Division of Pensions and Benefits at 609-292-7524. 

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