As required by law, retired members or their dependents who qualify for the School Employees’ Health Benefits Program (SEHBP) state-paid, post-retirement medical benefits, or those more recent retirees who may be contributing a percentage of their premiums and are eligible for Medicare, must enroll in both Parts A and B of Medicare. Medicare Part A is paid for while actively employed and Part B is paid for during retirement, usually through a deduction from the members’ Social Security checks. State law requires the SEHBP to reimburse these eligible retirees and their dependents for the cost of enrolling in Medicare Part B.

Most members and their dependents will qualify for Medicare benefits under one of the following four conditions:

  • Have reached age 65.
  • Have received Social Security disability benefits for 24 months.
  • Have end-stage renal disease.
  • Have ALS (amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease).

Members currently receiving Social Security retirement benefits, will be automatically enrolled in both Medicare Part A and Part B. They do not need to contact anyone. They will receive a package in the mail three months before their 65th birthday with the new Medicare card.

However, members who are 65 but are not receiving Social Security retirement benefits, will need to actively enroll in Medicare. Members should sign up for Medicare online at socialsecurity.gov or by calling Social Security at 800-772-1213 approximately three months prior to turning 65.

To continue post-retirement medical benefits without interruption, when a Medicare-eligible member or dependent receives their Medicare card, they must send a copy of the card to show proof of enrollment in Parts A and B to the Division of Pensions and Benefits. If this is not done before they are eligible for Medicare, their health benefits could be temporarily terminated. However, retirees enrolled in SEHBP should not sign up for alternate supplemental Medicare coverage. Enrollment in another plan would result in the loss of SEHBP coverage.

The Division of Pensions will send a reminder letter to those who are about to qualify by means of turning 65. However, the Division of Pensions will not send a reminder letter to those who qualify by means of receiving Social Security disability benefits for 24 months, end-stage renal disease, or ALS.

Any questions about this process should be directed to the Division of Pensions and Benefits at 609-292-7524.

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