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What to do if you're

Enrolling in Medicare

If you're like most people, when you turn 65 you will become eligible to enroll in Medicare, the federal program to provide older adults and those with disabilities or permanent kidney failure with secure access to medical care. To make sure you have the right coverage and to avoid Medicare premium penalties, it's important to understand the rules and enroll properly.

Active UC employees who are covered by medical insurance through their UC employment are typically not required to enroll in Medicare. If you're employed by UC and not planning to retire in the next year or so, this roadmap is probably not for you. For important considerations for employees and their dependents who turn 65 or otherwise become eligible for Medicare prior to retirement, please see Understanding Medicare.

Please note: You may receive offers to enroll in non-UC Medicare plans, even from insurance carriers like Kaiser that work with UC. These offers are for individual Medicare plans, which may not cover all the benefits offered by your UC group plan, so consider carefully before making any plan changes. You may only be enrolled in one Medicare plan at any one time. If you have any questions, please contact the Retirement Administration Service Center (RASC)

1

Learn the basics.

This roadmap walks you through a few important steps, but there's a lot more to learn about Medicare. Take a look at the resources in the sidebar to make sure you understand Medicare's rules, how Medicare works with your UC retiree health coverage, what costs to expect and what providers you'll be able to see.

2

Figure out when you need to enroll.

If you’re eligible for Medicare and you’re retiring soon or retired, enrolling in Medicare is not optional for most people.

If you are a prospective or current retiree who is eligible for premium-free Part A and you don’t enroll in Part A and B before your 65th birthday (or, if later, your retirement date), you could lose your UC-sponsored medical coverage and be charged penalties by UC and lifelong penalties by Medicare.

If you are required to pay a premium for Part A as a retiree, you are not required to enroll in Medicare Parts A and B. However, UC does require that you send in a denial letter from Social Security to keep your current coverage. 

3

Decide which UC Medicare plan is right for you.

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):

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

4

When it's time, enroll in Medicare. 

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 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 65th 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. 

5

Assign your Medicare benefits to your UC-sponsored retiree medical plan.

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. 

Non-Medicare Plans Retiree Medicare Plans Required Forms
UC Care or CORE UC Medicare PPO with Prescription Drugs Navitus (PDP) Enrollment Form for UC Medicare PPO or UC High Option Supplement to Medicare (UBEN 123)
UC Blue & Gold HMO UC Medicare Choice Enrollment Form for UC Medicare Choice (UBEN 121)
Kaiser Permanente CA Kaiser Permanente Senior Advantage Medicare Advantage Enrollment/Election Form for Kaiser (UBEN 127)
UC Health Savings Plan 31-day PIE to enroll in a new plan and assign your Medicare benefits Retiree Continuation, Enrollment, or Change - Medical, Dental, &/or Legal Plan (UBEN 100)

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.

6

Understand your UC and Medicare premium costs.

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.