Medicare information

Office of Statewide Benefits provides information on Medicare Parts A, B enrollment

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9:57 a.m., Dec. 6, 2012--The Delaware Office of Statewide Benefits recently announced that it is contacting employees and retirees who participate in the group health plan and are age 45 or over through a mailing that describes when participants are required to enroll in Medicare Parts A and B upon eligibility based on employment status, age or disability.

Enrollment in Medicare Part A has no monthly premium and helps to cover inpatient care in a hospital or skilled nursing facility; enrollment in Medicare Part B has a monthly premium and helps cover doctors’ services, some medical services and supplies not covered by hospital insurance.

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The situations listed below represent common examples of when enrollment in Medicare is required.

Active employee or active employee’s spouse enrolled in the group health plan turns 65.

  • Enrollment in Medicare Part A is required;
  • Enrollment in Medicare Part B is not required until the active employee retires or no longer has active employer health coverage.

Retiree or retiree’s spouse is enrolled in the group health plan, not covered by another active employer’s health plan, turns 65 or becomes disabled.

  • Enrollment in Medicare Part A is required;
  • Enrollment in Medicare Part B is required;
  • Eligible to enroll in the State of Delaware Group Health Plan Medicare Supplement (Special Medicfill) plan with or without prescription coverage.

Retiree or retiree’s spouse is enrolled in the group health plan and covered under another active employer’s health plan (under retiree or spouse) turns 65 or becomes disabled.

  • Enrollment in Medicare Part A is required;
  • Enrollment in Medicare Part B can be deferred until no longer covered under active employer’s health plan;
  • Eligible to remain enrolled in the group health plan non-Medicare plan until no longer covered under active employer’s health plan. Active employer’s health plan will provide primary coverage.

Special enrollment rules apply to those diagnosed with end-stage renal disease (kidney disease) or Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease. Information on enrollment requirements associated with these conditions can be accessed at www.medicare.gov.

Failure to enroll and maintain enrollment in Medicare Parts A and B upon eligibility may result in the subscriber being held financially responsible for the cost of all claims incurred, including prescription costs. Retirees and spouses enrolled in Medicare Parts A and B must provide a copy of their Medicare Identification Card to be enrolled in the state of Delaware Special Medicfill plan.

Additional information on the requirement to enroll in Medicare is available on the Office of Statewide Benefits website in PDF format.

The state of Delaware Eligibility and Enrollment Rules can be reviewed at this site in PDF format.

Free information on Medicare is available from ELDERinfo by calling 1-800-336-9500. Information can also be obtained on the ELDERinfo website or on the Medicare website.

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