Enrollment in Medicare

As required by law, retired members or their dependents who qualify for state-paid, post-retirement medical benefits and are eligible for Medicare must enroll in both Parts A and B of Medicare. Medicare Part A is paid for while actively employed while Part B is paid for during retirement, usually through a deduction in the benefit recipient’s Social Security check. State law requires the School Employees’ Health Benefits Program (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).

If a member is currently receiving Social Security retirement benefits, he or she will be automatically enrolled in both Medicare Part A and Part B. The member does not need to contact anyone, but will receive a package in the mail three months before his or her 65th birthday with the new Medicare card.

However, if a member is 65, but is not receiving Social Security retirement benefits, he or she will need to actively enroll in Medicare. Members should sign up for Medicare approximately three months prior to turning 65 by visiting www.socialsecurity.gov or by calling Social Security at 800-772-1213.

When a Medicare-eligible member or dependent receives a Medicare card, the member must send a copy of the card to show proof of enrollment in Parts A and B to the Division of Pensions and Benefits in order to continue to receive post-retirement medical benefits without interruption. If this is not sent before the member is eligible for Medicare, his or her health benefits could be temporarily terminated. NOTE: 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, or contracting 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.