Enrolling in Medicare

UC’s Medicare plans may have different benefits, service areas and providers than corresponding non-Medicare plans. To make sure you’re transferred into the right plan for you, it’s important to review your options during the Open Enrollment before you enroll in Medicare. Your health care facilitator can be a great resource.

When you become a Medicare-eligible retiree and Medicare has approved your enrollment, you’ll make the switch from your UC non-Medicare medical plan to a UC-sponsored Medicare plan (see step 5 for details about what you need to do):

• CORE and UC Care members are transferred into UC Medicare PPO.
• Kaiser HMO members are transferred into Kaiser Senior Advantage.
• UC Blue & Gold HMO members are transferred into UC Medicare Choice PPO. 
• UC Health Savings Plan members have 31 days to enroll in a UC Medicare plan of their choice. 

If you live outside of California, find out if you are eligible for the Medicare Coordinator Program.

For most benefits, you must enroll your new family member within 31 days of the date they join your family or meet all the eligibility requirements. If you don’t enroll your family member during the PIE, you can enroll him or her during Open Enrollment. You may also enroll your family member in your medical plan only at any time with a 90-day waiting period.

If you’re retiring from UC, enrolling in Medicare will be part of the retirement process. You and your Medicare-eligible family members will need to work with your local HR/Benefits Office to complete the Request for Employment CMS L564 form PDF and submit it to Social Security to enroll in Medicare Part B prior to your retirement.

If you’re retired, ninety (90) days before you turn 65, the UC Retirement Administration Service Center will send you a Medicare Instruction Letter which will include the steps you’ll need to take to enroll in Medicare, along with the date UC needs you to enroll in Medicare and return the UC forms.

These are important deadlines, with significant costs if you miss them. If you are a retiree who does not enroll in Part A and B when you reach your 65^th birthday you could incur lifelong penalties by Medicare plus additional penalties from UC. If, after three to four months you still have not enrolled, you could lose your UC-sponsored medical coverage completely. In most cases, this also applies if you don’t coordinate your Part D prescription coverage with your UC retiree medical plan.

It usually takes about three weeks from when you apply before you receive your Medicare card in the mail. If you are running out of time to get your Medicare card before UC’s deadlines, you may be able to download a Benefit Verification Letter from the Social Security website, My Social Security, within about three business days of applying. Your Benefit Verification Letter includes the information you need (including your Medicare Health Insurance claim number (HICN) and coverage effective dates) to complete your required paperwork.

To keep your UC-sponsored retiree coverage and avoid any penalties, you’ll need to maintain your Medicare enrollment by paying your Medicare Part B premiums without interruption and on time. Depending on your income you may need to pay an additional premium for Part D as well. 

Whether you’re enrolled in a UC-sponsored retiree medical plan with a Medicare version or partner plan or enrolling in a Medicare plan during a Period of Initial Eligibility (PIE), you’ll need to fill out the appropriate form to assign your Medicare benefits to your Medicare plan. As a retiree this occurs when you turn 65; as a UC employee who is 65 or older, this occurs when you retire. 

Remember, if you are enrolled in UC Health Savings Plan, you have a 31-day PIE to enroll in a new plan and complete the required UC form (see above) to assign your Medicare benefits when you turn 65.

In most cases, once you complete the required form and Medicare approves your enrollment, you will transfer to your medical plan’s Medicare plan. There may be differences between your current non-Medicare plan and your new Medicare plan: your doctor, specialists, behavioral health provider, prescription drug formulary and how you pay for these drugs may change.

When you’re enrolled in a UC Medicare plan, you’ll be responsible for premiums from UC and from Medicare.

The retiree medical plan costs on UCnet apply to retirees eligible for 100 percent of the UC/employer contribution toward the premium for each plan. If you are subject to graduated eligibility and, therefore, not eligible for the maximum UC/employer contribution, your costs may be higher than those listed. The UC Davis Health Care Facilitator page includes a premium estimator to help you understand what your share of your retiree medical premium might be. Please sign in to your UCRAYS account to see your actual costs. 

Medicare Part A is usually premium-free, but there is a monthly premium for Part B coverage, paid to the Social Security Administration. This premium is usually deducted from your Social Security benefit, or you are billed quarterly. See the Medicare Fact Sheet and/or the Social Security website for standard rates.

If your income has gone down, you may use form SSA-44 from the Social Security Administration (available at https://www.ssa.gov/forms/ssa-44.pdf) to request a reduction in your income-related monthly adjustment amount.

Most of the UC-sponsored medical plans coordinate Medicare Part D (prescription drug) coverage with the plan’s coverage. Most people are not charged a premium for Part D. However, as with Part B, you may pay a Part D premium based on your income. Check with Social Security to see if you are required to pay a Part D premium. These Medicare premiums are in addition to any premium you pay to UC for your UC insurance.