When you turn age 65—whether you’re still working or not—you 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.
If you’re still working when you turn age 65 (or become Medicare-eligible), you can wait to enroll in Medicare and stay covered in your UC medical plan for non-Medicare members. However, most employees enroll in Medicare Part A (which covers hospitalization) since there is typically no cost.
There are specific rules for the timing of when you must enroll in Medicare Part B, which has a monthly premium. Generally, you can delay enrolling in Part B if you are still working and have coverage through your employer. However, the rules are complex and there are penalties associated with not following them carefully (lifetime higher premiums for Part B.) You can find more information on medicare.gov. You might also want to discuss your personal situation with Medicare directly at (800)-MEDICARE.
UC Coverage Coordinates With Medicare
With the exception of the Health Savings Plan (HSP), each UC non-Medicare medical plan has a corresponding Medicare option offered to eligible employees and retirees after they enroll in Medicare. However, the Medicare version of the non-Medicare plans often have different benefits, doctors, service areas and behavioral health providers.
Once you enroll in Medicare, you’ll need to choose a UC Medicare option. You cannot continue to be enrolled in the Health Savings Plan (HSP). You have the opportunity to can change your UC Medicare plan each year during the Open Enrollment period.
If some family members are eligible for and enrolled in Medicare and others are not, you’re considered a split-Medicare family.
Tip: During the Open Enrollment period before you enroll in Medicare, take a look at the Medicare version of your current plan so that you can easily transfer to that plan’s corresponding Medicare plan when you turn 65.
When You Must Enroll in Medicare
- If you are retired when you turn age 65, you must enroll in Medicare. If you are eligible for premium-free Part A and you don’t enroll in Part A and B before your 65th birthday, you could lose your UC-sponsored medical coverage and be charged penalties by RASC and lifelong penalties by Medicare. Ninety (90) days before you turn 65, RASC will send you the Medicare forms you'll need to fill out, along with the date UC needs you to enroll in Medicare and return the forms.
- If you’re receiving Social Security benefits. You’ll be automatically enrolled in Medicare Parts A and B, unless you contact Social Security to opt out.
Medicare Part A (hospital care) is usually offered at no cost. There is a monthly premium for Part B (doctor and lab services) and Part D (prescription drugs) based on your income. Medicare premiums are in addition to any premium you pay UC for your UC medical coverage.
What Happens to Your UC Coverage When You Enroll in Medicare
Once you enroll in Medicare, you can still stay enrolled in UC medical benefits. However, you’ll need to enroll in a UC option for Medicare members. This means you can no longer be enrolled in the UC Health Savings Plan, receive Health Savings Account (HSA) contributions from UC, or make your own HSA contributions. However, you can use any balance in your HSA to pay for Medicare premiums and eligible health care expenses. This rule also applies to any Medicare-eligible enrolled family members.
Medicare (not the UC medical plan) becomes your primary insurance, meaning Medicare will pay for Medicare-covered expenses first. Your UC plan then covers many of the remaining costs. This could be either a percentage of the eligible expenses left over after Medicare pays its share, or expenses that Medicare doesn’t cover, such as for behavioral health.
To get the highest level of benefits, make sure your doctors and other providers accept Medicare and are in-network providers through your UC medical plan.
Learn more about the UC Medicare-coordinated medical plans.