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March 25, 2019
NYS Civil Service Law 167-a. Reimbursement for Medicare

Laws of New York State - Consolidated Laws - Civil Service

Section 167-a. Reimbursement for medicare:

167-a. Reimbursement  for  medicare  premium charges. Upon exclusion
  from the coverage of the health insurance plan of supplementary  medical
  insurance  benefits  for  which  an  active  or  retired  employee  or a
  dependent covered by the health insurance plan is or would  be  eligible
  under  the  federal old-age, survivors and disability insurance program,
  an amount equal to the premium charge  for  such  supplementary  medical
  insurance   benefits  for  such  active  or  retired  employee  and  his
  dependents, if any, shall be paid monthly or at other intervals to  such
  active  or  retired  employee  from  the  health  insurance  fund. Where
  appropriate, such amount may be deducted from contributions  payable  by
  the  employee or retired employee; or where appropriate in the case of a
  retired employee receiving a retirement allowance, such  amount  may  be
  included   with   payments   of  his  retirement  allowance.    Employer
  contributions  to  the  health  insurance  fund  shall  be  adjusted  as
  necessary to provide for such payments.



Medicare Premiums: Rules For Higher-Income Beneficiaries for 2019
Feb 07, 2019

Medicare Premiums:
Rules For Higher-Income Beneficiaries
If you are in 1 of these 6 groups here's what you'll pay:

Individuals with $85,000 or less
Married couples with $170,000 or less
$135.50 Your plan premium
Individuals above $85,000 up to $107,000
Married couples above $170,000 up to $214,000
$189.60 Your plan premium + $12.40
Individuals above $107,000 up to $133,500
Married couples above $214,000 up to $267,000
$270.90 Your plan premium + $31.90
Individuals above $133,500 up to $160,000
Married couples above $267,000 up to $320,000
$352.20 Your plan premium + $51.40
Individuals above $160,000 up to $500,00
Married couples above $320,000 up to $750,000
$433.40 Your plan premium + $70.90
Individuals $500,00 & above
Married couples $750,000 & above
$460.50 Your plan premium + $77.40
 
Individuals of $85,000 or less $135.50 Your plan premium

Individuals above $85,000 & less than $415,000

$433.40 Your plan premium + $70.90
Individuals $415,00 & above $460.50 Your plan premium + $77.40

You Must enroll in Medicare when eligible!!
Jul 09, 2018


Medicare: This info is taken directly from the NYS Civil Service website:

Medicare is the federal health insurance program for people age 65 and older, disabled and receiving Social Security Disability Insurance (SSDI) for 24 months, with end-stage renal disease or with amyotrophic lateral sclerosis (ALS). It is administered by the Centers for Medicare & Medicaid Services (CMS).

As soon as you, as a NYSHIP retiree, vestee, dependent survivor or Preferred List enrollee, become eligible for Medicare coverage that pays primary to The Empire Plan, your Empire Plan coverage becomes secondary to Medicare Parts A and B. The Empire Plan coordinates benefits with Medicare and will not pay for any hospital and medical expenses that Medicare would cover.

The same rule applies to each dependent (spouse/domestic partner, if your agency offers domestic partner coverage, or child) covered under your Empire Plan policy. As soon as your dependent is eligible for primary Medicare coverage, The Empire Plan will not pay for any expenses for the dependent that Medicare would have covered.

Therefore, you and each of your covered dependents must have Medicare Parts A and B in effect by the first day of the month in which each of you reaches age 65 (or, if the birthday falls on the first of the month, in effect on the first day of the preceding month) or before reaching age 65 if Medicare-primary eligible because of disability, end-stage renal disease or amyotrophic lateral sclerosis (ALS).

Note:The requirement to enroll in Medicare Part A and Part B applies if you live in one of the 50 United States or Puerto Rico, Guam, the U.S. Virgin Islands, Northern Marianas or American Samoa.

Since The Empire Plan becomes secondary to Medicare Parts A and B as soon as you are eligible for primary Medicare coverage, if you fail to enroll in Medicare or are still in a waiting period for Medicare to go into effect, you will be responsible for hospital and medical expenses that Medicare would have covered if you had enrolled on a timely basis.

The responsibility is yours: To avoid a reduction in your benefits, you must make sure that you and each of your dependents are covered under Medicare Parts A and B when first eligible, even if you also have coverage through another employer's group plan.

Eligibility for Medicare

You and your dependents are eligible for primary Medicare when you:

  • are age 65 or older, or

  • regardless of age, have been receiving Social Security Disability Insurance (SSDI) benefits for 24 months, or

  • regardless of age, have end-stage renal disease (permanent kidney failure requiring dialysis or kidney transplant) and have completed Medicare's waiting period of up to 3 months and 30-month coordination period, or

  • have amyotrophic lateral sclerosis (ALS) and are receiving Social Security Disability Insurance (SSDI) benefits

You and your dependents each must enroll in Medicare Parts A and B as soon as each of you becomes eligible for any of these reasons. (Unlike NYSHIP, Medicare does not offer family coverage.) When you are eligible, Medicare becomes primary to NYSHIP for you; NYSHIP remains primary for your dependents until they are eligible for Medicare.




Page Last Updated: Feb 07, 2019 (13:50:00)
 
 
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