Medicare Enrollment

To enroll in PHIP, all Medicare-eligible members and eligible Medicare dependents are required to be enrolled and maintain both Medicare Part A and Part B. Enrollment in a PHIP Medicare plan includes automatic enrollment in a PHIP Medicare Part D Prescription Drug Plan.

PHIP requires a copy of a Medicare card or a Letter of Entitlement (Social Security Letters of Eligibility are not valid) with your PHIP Enrollment Request Form.

In most circumstances, if you do not enroll in PHIP when you are first eligible for Medicare Part A and Part B, you will forfeit any future opportunity to enroll in a PHIP medical plan.

For a comprehensive guide on PHIP and Medicare view the PERS Health Insurance Program (PHIP) Medicare Enrollment Guide

Medicare at age 65

You will become eligible for Medicare at 65, regardless if you are receiving a Social Security benefit at the time. You are entitled to Medicare the first day of the calendar month during which you turn 65. If your birthday falls on the first day of the month, you are entitled to Medicare the first day of the prior month. (Ex. March 1 is birthday so February 1 will be your Medicare effective date)

If you receive Social Security benefits, you will automatically be enrolled in Medicare. You should receive your Medicare information, including your Medicare Parts A and B card, approximately three months prior to your 65th birthday.

If you ARE NOT receiving Social Security benefits, you will need to contact the Social Security Administration or visit your local Social Security office approximately three months prior to your 65th birthday and apply for Medicare Part A and Part B.

Medicare due to disability

If you are receiving Social Security Disability, you will automatically be enrolled in Medicare Part A and Part B on the 25th month after Social Security benefits begin. This would be considered your initial Medicare eligibility to enroll in PHIP Medicare coverage. Aging in to Medicare later will not be considered an enrollment opportunity under PHIP.

If you are Medicare eligible due to end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS) you will have the option to stay on your employer-sponsored retiree coverage during the first 30 months of your Medicare eligibility while Medicare is secondary to your employer plan. Upon Medicare becoming primary your medical plan choices may be limited under PHIP.

Deferred Enrollment in Medicare Part B

You or your spouse can defer enrollment in Medicare Part B if either of the following apply:

• You are currently working for an employer that has 20 or more employees and have active employer-sponsored group coverage through your job.
• You have employer-sponsored group coverage through your spouse who is currently working for an employer that has 20 or more employees.

If your employer has less than 20 employees, you may not be able to defer your Medicare Part A and Part B.

For information regarding enrolling in Medicare Part B at a later date contact:

Centers for Medicare and Medicaid Services (CMS)
(800) 633-4227 (toll-free)
TTY: (877) 486-2048
www.medicare.gov

Social Security Administration (SSA)
(800) 772-1213 (toll-free)
TTY: (800) 325-0778
www.ssa.gov