Medicare Part B Reimbursement
The City will reimburse retirees and their eligible dependents for Medicare Part B premiums paid, excluding any penalties. You must be receiving a City pension check and be enrolled as the contract holder for City health benefits in order to receive reimbursement for Part B premiums.
For most retirees, the refund is issued automatically by the Health Benefits Program. If you are currently receiving your pension check through Electronic Fund Transfer or direct deposit, your reimbursement will be deposited directly into your bank account. This will be separate from your pension payment. If you dont have EFT or direct deposit, you will receive a check in the mail in June.
A Better Deal For Retirees And Nyc: But The City Made Two Mistakes With Its Medicare Advantage Plus Plan
A potential win-win initiative for retired city employees and local taxpayers is being undermined by two mistakes in its implementation. Indeed, a state Supreme Court justice just issued a temporary restraining order putting the reform on hold because of the confusion created by the haphazard way the city has handled the roll-out of what should be a welcome change to retiree health-care benefits.
The initiative is reform of the health insurance program for city retirees and their dependents who are on Medicare. The current program covers about 250,000 retirees and their dependents and costs taxpayers almost $1 billion annually, $350 million more than it cost 10 years ago, according to figures provided by the city. A new arrangement, known as an Advantage plan, has been created and is scheduled to begin in January 2022. Sponsored by Empire Blue Cross and Emblem Health, the plan was developed by the mayors Office of Labor Relations and the Municipal Labor Committee , a coalition of municipal employee unions that negotiates health benefits for the unionized city workforce.
Kellermann is the former president of the Citizens Budget Commission. Brecher is research director emeritus of the Citizens Budget Commission and professor emeritus at NYU Wagner.
Dc 37 Health & Security Plan Benefits
Important Information for DC 37 Members About to Retire
For medicare-eligible* retirees who are eligible to receive a pension from NYCERS/BERS/TRS/NYSERS/CIRS* Medicare-eligible = age 65 and/or disability
You must be a DC 37 member, Medicare eligible, and be pension eligible under NYCERS/BERS/TRS/NYSERS/CIRS.
City Health Insurance
You may wish to refer to the City of New Yorks Health Benefits Program Summary Program Description booklet.
Complete a Health Benefits Application form.
Apply for Medicare Parts A and B at your nearest Social Security office. If you are retiring before or at the age of 65, ` apply for Medicare Parts A and B in the three months before your 65th birthday. You will not be eligible for Medicare Parts A and B until you reach your 65th birthday.
When you retire and are age 65 or over, you must have Medicare Parts A and B to continue your City health insurance. The premium cost of Medicare Part B will be taken out of your Social Security check. When you retire, you and your eligible dependents will be reimbursed for the cost of Medicare Part B once a year.
City of New York40 Rector Street, 3rd FloorNew York, NY 10006 513-0470
Medicare is the primary health insurance for retirees age 65 or over . City health insurance is the secondary health insurance. If you are retired and receiving Medicare Parts A and B, you may choose a supplement to Medicare or a Medicare + Choice health insurance plan.
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Joint Statement Regarding Health Benefits Program For City Retirees
dateDec 2, 2021
The NYC Medicare Advantage Plus Plan, a Custom Program for City Retirees, will not be implemented on January 1, 2022.
Joint Statement from the Office of Labor Relations, the Alliance and the Municipal Labor Committee Regarding 2022 Health Benefits Program for City Retirees.
In July, Mayor Bill de Blasio and Labor Relations Commissioner Renee Campion announced an agreement with the Municipal Labor Committee to implement the NYC Medicare Advantage Plus Plan, a custom program for City retirees. Two companies that were not selected following the fair and competitive procurement process have filed lawsuits challenging the award of the contract to the Alliance. Those lawsuits were dismissed by the Court on October 21, 2021.
A group of City retirees also filed a lawsuit challenging the Citys decision to implement the NYC Medicare Advantage Plus Plan. In that case, the Judge has requested a revised implementation plan and has extended the date for retirees to decide whether they want to opt-out of the plan. The judge has put the plan on hold until that issue is resolved. This, of course, affects when the plan can be implemented. We recently learned that the judge is not expected to decide these issues any earlier than the second week of December. A new date for implementation will be announced after a decision by the Court.
In that spirit, below please find a few key points about what we know now and how it impacts our retirees:
Nyc Medicare Advantage Plus Plan For Retirees
The City of New York is offering a new group Medicare Advantage plan exclusively to their retirees through an alliance between Empire BlueCross BlueShield and EmblemHealth.
The NYC Medicare Advantage Plus Plan is not being implemented on April 1, 2022. Retirees do not need to opt out of the Medicare Advantage Program in order to remain in Senior Care or their current plan on April 1, 2022.
All retirees will remain on their current health plans until further notice.
As more information becomes available, we will continue to update this page. Read more updates here.
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What’s Happening To Retiree Healthcare
On Wednesday, July 14, 2021, the Municipal Labor Committee voted to approve a contract with the NYC Office of Labor Relations to move city retirees, including CUNY retirees, from traditional Medicare with supplemental city insurance to a privatized Medicare Advantage plan. The PSC was one of five unions to vote against the move to Medicare Advantage and the PSC retirees chapter pushed back against the plan both before and after the July vote.
NYC set 1/1/22 as the target date for moving retirees to an Anthem/Empire Medicare Advantage Plus plan. Municipal retirees were to choose one of two options:
- Move by default into a premium-free Medicare Advantage plan or
- Opt out in order to stay in traditional Medicare with supplemental City insurance .
But in December 2021, a judicial injunction pushed implementation to 4/1/22. Then on March 3, 2022, a NYS supreme court judge ruled that NYC could not charge the $191.57 premium. The City immediately appealed and decided not to implement its original plan on 4/1/22.
Then in breaking news on 7/18/22, Anthem/Empire withdrew its MA+ plan, meaning everything is on hold — in effect status quo ante. .—————————————–
Questions About Your Irmaa Or Medicare Part B Reimbursements
Medicare Part B 2021 Reimbursement
Medicare-eligible retirees and their Medicare-eligible dependents will be reimbursed annually for the standard Medicare Part B amount of $148.50 per month , excluding any penalties and late enrollment fees, and subject to be pro-rated.
Medicare Part B reimbursements were issued in April 2022. Please check your bank account/statement .
If you already submitted your Medicare Part A & B card to the Health Benefits Program, this payment is automatic and you will receive it annually.
Medicare Part B 2020 Reimbursement
Medicare Part B 2020 reimbursements were issued in April 2021. Please check your bank account/statement for your payment.
If you already submitted your Medicare Part A & B card to the Health Benefits Program, this payment is automatic and you will receive it annually.
Medicare Part B 2019 Differential Reimbursement
Please note that if you were Medicare-eligible prior to 2016, you must complete the Medicare Part B Differential Form for 2019 in order to receive the Medicare Part B differential payment. The payment was based on the amount that you paid in 2019.
If you were enrolled in Medicare Part B effective after 2016, then you are already receiving the full payment and do not need to complete the Medicare Part B Differential Form.
Medicare Part B 2019 differential reimbursements were issued in March 2021. Please check your bank account/statement for your payment.
IRMAA 2021 Reimbursement
IRMAA 2020 Reimbursement
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Judge Orders City To Delay Retiree Medicare Health Care Plan Switch Until April 1
Mayor Bill de Blasio shakes hands with District Council 37 Executive Director Henry Garrido after announcing a contract agreement in 2019 for municipal workers.
Ed Reed/Mayoral Photography Office
This story was published in partnership with New York Focus, an independent, investigative news site covering New York state and city politics. Sign up for their newsletter here.
A New York state judge Tuesday ordered that a proposed cost-cutting change in city government retirees health insurance be delayed until at least April 1, 2022. Retired city workers will have until June 30, 2022 to opt out of the plan. The ruling also listed several steps the city must take to provide more public information about the plan before the judge will allow it to move forward.
The ruling represents a setback for the de Blasio administration, which had originally sought to implement the change shifting retired city workers from Medicare plans to cheaper, privately-managed Medicare Advantage plans, on January 1, 2022. Retirees were to be automatically enrolled in the new plan unless they opted out by October 31, 2021.
Despite the delay, a spokesperson for the New York City Law Department, Nick Paolucci, said that the plan was a victory for the city.
City Coverage For Medicare
In order to maintain maximum health benefits, it is essential that you join Medicare Part A and Part B at your local Social Security Office as soon as you are eligible. If you do not join Medicare, you will lose whatever benefits Medicare would have provided. Read More
The Citys Health Benefits Program supplements Medicare but does not duplicate benefits available under Medicare. Medicare-eligible members must be enrolled in Medicare Parts A and B in order to be covered by a Medicare HMO plan. To enroll in Medicare and assure continuity of benefits upon becoming age 65, contact your Social Security Office during the three-month period before your 65th birthday. In order not to lose benefits, you must enroll in Medicare during this period even if you will not be receiving a Social Security check.
If you are over 65 or eligible for Medicare due to disability and did not join Medicare, contact your Social Security Office to find out when you may join. If you do not join Medicare Part B when you first become eligible, there is a 10% premium penalty for each year you were eligible but did not enroll. In addition, under certain circumstances there may be up to a 15-month delay before your Medicare Part B coverage can begin upon re-enrollment.
If you or your spouse are ineligible for Medicare Part A although over age 65 , contact us at:
NYC Health Benefits Program22 Cortlandt Street, 12th FloorNew York, NY 10007
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Tier 6 Member Vesting Update
On April 9, 2022, Governor Hochul signed Chapter 56 of the Laws of 2022 relating to the New York State budget for the 2022-2023 state fiscal year. Part TT of the 2022-2023 Budget Bill amended the Retirement and Social Security Law to lower the minimum number of years required for Tier 6 members to vest for service retirement from 10 years to 5 years of credited service.
IMPORTANT: Eligibility for Retiree City Health Benefits is NOT changed by the above Part TT of the Budget Bill. Pursuant to the Section 12-126 of the NYC Administrative Code and New York City Health Benefits Summary Program Description, below summarizes enrollment eligibility for City Health Benefits as a retiree:
2) Email – Or
What Happens With Our Drug Coverage
For almost all retirees, your drug coverage stays as it is. If you get your drug coverage through your union or are reimbursed, either partially or fully, for the drug plan it will continue as is. If you currently have the Senior Care drug rider, the premium decreases from $150/month/person to $125/month/person beginning in 2022. Whether you decide to go into the MAP or stay with Traditional Medicare with Senior Care, the drug plan will either stay with you or move automatically with you to the MAP. The only time there is a change in drug coverage is if youcurrently have an individual Part D plan . In that case, ifyou enroll in the MAP, you will lose that individual drug plan. You must take the optionalprescription rider or go back to your union sponsored Part D coverage if you had left it for anindividual policy.
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What You Need To Know To Make A Decision
TO GET YOUR QUESTIONS ANSWERED TAKE THESE STEPS IN ORDER
- Barbara Caress’ Presentation at 10/04/21 chapter meeting: Choosing Traditional Medicare or Medicare Advantage.
FAQS FROM QUESTIONS ASKED AT CHAPTER AND INFORMATION MEETINGS
- Questions for NYC Office of Labor Relations/Employee Benefits Program from 8/30 Retiree Meeting in the CHAT
In response to a Temporary Restraining order, the New York City Office of Labor Relations changed the opt out and enrollment dates to the end of March. Leon E. Frank, the judge who issued a Temporary Restraining Order, determinedt that the original enrollment guides were inaccurate or incomplete in several areas and Instructed the City to notify all municipal retirees of errors in the original MA+ material, telling them how to obtain a corrected enrollment guide.
Below are links to the original guides:
VENDOR RELEASES PRE-AUTHORIZATION LIST
NY RETIREE HEALTH RATE CHARTS EFFECTIVE JANUARY 1, 2022
If you opt out of the Alliance Medicare Advantage plan in order to continue with your current NYC health care plan, you will have to pay a monthly premium . Click here to see the rates on the NYC Office of Labor Relations website. Note that you will NOT be paying for prescription drug coverage since that is already covered by the PSC CUNY Welfare Fund.
NYC OFFICE OF LABOR RELATIONS ON RETIREE HEALTHCARE BENEFITS
MEDICARE PART B AND IRMAA REIMBURSEMENTS
CORRECT MAILING ADDRESS
How To Contact Olr
Employee Benefit Program client service walk-in centers remain closed to visitors. Retiree Health Benefits, the Deferred Compensation Plan, Flexible Spending Accounts Program and the Managment Benefits Fund can be reached via email. Please see below for additional information.
The Retiree Health Benefits Program client service walk-in center remains closed to visitors.
Please submit your documents as follows:
1) Forms and documents can be submitted electronically using the following link:
For detailed instructions on how to submit your form/document securely through LeapFile and to view a short video, click here.
Please do not submit your form/document more than once. This will only delay processing.
You will immediately receive notification stating “Success! Your file has been received” upon completion of your document upload. You will not receive a separate email confirmation.
2) Forms and documents can also be mailed to:
NYC Office of Labor RelationsHealth Benefits Program22 Cortlandt Street, 12th FloorNew York, NY 10007
3) Forms and documents can also be faxed to: 306-7373
4) Inquiries and questions can be emailed to
5) For questions regarding the PICA prescription drug benefit program please call 1-800-467-2006.
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Advocating For Members’ Healthcare:
Together, with thousands of other municipal retirees, we pushed back. Our chapter was one of the first to shine sunlight on OLR/MLC negotiations that sought to re-engineer our health benefits by moving municipal retirees from traditional Medicare to privatized Medicare Advantage. Here is a shout out to the municipal retiree organizations and their allies who pushed back against the City’s plan and brought us to this moment — the Cross Union Retiree Organizing Committee , the Council of Municipal Retiree Organizations , the DC-37 Retirees, Physicians for a National Health Plan and of course the NYC Organization of Public Service Retirees which brought the lawsuit and now has 15,000 members on its Facebook page. Below is a partial list of PSC events and city-wide moments in the pushback.
RETIREE CHAPTER NEWSLETTERS BEGINNING IN APRIL 2021 and every month since have provided reporting and analysis on the proposed move to MA+ — and the pushback by retirees.. The April 2021 issue first sounded the alarm about what is happening.
TWO CHAPTER MEETINGS ON THIS ISSUE: The chapter devoted two meetings to the MLC proposal to move retiree healthcare to Medical Advantage and our response. Both meetings were recorded. Click below to see the Videos:
At the beginning of the meeting, a statement of urgent concern, unanimously endorsed by the Retiree Chapter Executive Committee, was read. It is available here.