Medicare Information

Medicare

Medicare information helps retirees understand their federal health insurance options, enrollment timelines, and how coverage works with district‑provided plans.

​Medicare Part A ​Medicare Part B

​What does it Cover?

​Inpatient care (hospitalization, Skilled nursing, hospice)

General medical services (physician visits, diagnostic and lab, durable medical equipment), preventative care​

​What does it cost?

Most people will qualify for free coverage

​Monthly premium is subject to change each year, based on income

​Do I need to enroll?

​Yes, it is important that you enroll in these benefits as soon as you are eligible. Remember, it’s a good idea to request your Medicare enrollment package three months before your 65h birthday.

​You must actively enroll when you become eligible to avoid a potential cost increase for these benefits. If you’re unsure if this cover-age is right for you, consult a Medicare Representative.​
 

Medicare details and when to apply

The Districts retiree health benefits coordinate with Medicare to give you comprehensive medical coverage.

Individual situations vary and you need to determine what is best for you. Please confirm your enrollment eligibility with Medicare @ (800) 633-4227.

Hospital insurance that helps cover inpatient care in hospitals, skilled nursing facilities, hospice and home health care.

Sign up 3 months before the month of your 65th birthday @ www.Medicare.gov.

Cost: You won’t pay a premium if you paid Medicare taxes while working.

Those not eligible for free part A can elect to enroll in part A at $422 per month (2018).

There is a monthly charge for Part B

​If you don't sign up when you are first eligible, you will be assessed a 10% penalty for each year you did not sign-up.

If an employee is turning 65 and is still actively working and covered by District group health plan, they may decline Medicare part B without a penalty. This is also true for your spouse if they are covered under your current plan. It's important to note that COBRA and retiree coverage does not count towards this exception.

If the retiree passes away before their spouse, their spouse may need to purchase Part B and they would be assessed the 10% penalty when they sign-up. This could be a significant cost. The surviving spouse can continue the RSCCD benefits by paying the full premium.

Once you retire you will have 8 months to enroll in Part B without incurring a penalty. To apply for Part B, go to www.medicare.gov​, select "I have employer or union coverage" and download the application for enrollment in ​Part B.

Prescription drug coverage is included in your retirement benefits offered through the District and your coverage is considered to be comparable to or better than the prescription drug coverage that is offered through Medicare Part D.  Therefore, you do not need to enroll in Medicare Part D.

You may defer this coverage as long as you have District provided drug coverage which is considered "Creditable Coverage" to Medicare. Keep a copy of the documentation that advised the coverage is creditable, as it may be needed when you do sign up later.

 

​Creditable Coverage Disclosure Notice for Medicare- Part D Prescription Coverage

Important Notice from Rancho Santiago Community College District About Your Prescription Drug Coverage and Medicare

Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Rancho Santiago Community College District and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.

  1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
  2. Rancho Santiago Community College District has determined that the prescription drug coverage offered by the Anthem Blue Cross Medical Plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th through December 7th.

However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.

If you decide to join a Medicare drug plan, your current Rancho Santiago Community College District coverage will be cancelled. Anthem Blue Cross offers the following prescription drug copays:

Anthem Blue Cross PPO Plan

Retail (30-day supply) Mail Order (90-day supply)

Generic

$15

$15

Brand Name

$25

$20

Compound Drugs

$15

Not Covered

Anthem Blue Cross HMO Plan

Retail (30-day supply) Mail Order (90-day supply)

Generic

$10

$10

Brand Name

$15

$15

Compound Drugs

$10

Not Covered

Non-participating pharmacy – member pays the above retail participating pharmacies copay plus 50% of the remaining prescription drug covered expense and the costs in excess of the maximum amount allowed.

If you do decide to join a Medicare drug plan and drop your current Rancho Santiago Community College District coverage, be aware that you and your dependents will not be able to get this coverage back.

When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?
You should also know that if you drop or lose your current coverage with Rancho Santiago Community College District and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.

If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following November to join.

Contact the person listed below for further information. NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Rancho Santiago Community College District changes. You also may request a copy of this notice at any time.

More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.

Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).

Date: October 31, 2012
Name of Entity/Sender: Rancho Santiago Community College District
Contact--Position/Office: Diane Loya, Risk Management
Address: 2323 North Broadway, Suite 225,
Santa Ana, CA 92706
Phone Number: 714.480.7567

 

CMS Form 10182-CC Updated October 2012

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