When you sign up for Medicare, you join more than 60 million Americans in the massive public health insurance program. But registering involves more than just checking a box on a form; there are multiple parts to Medicare, and rules and premiums vary.
UFT retirees don’t have to navigate the transition alone. UFT Welfare Fund staff can assist you. They are knowledgeable about the complex insurance program and also about how it works in concert with city health benefits.
“What’s most important is should you have any questions, reach out to us,” UFT Welfare Fund Director Geof Sorkin said. “Let us assist you, let us guide you, let us help you make sense of all of these changes.”
Once you’re in, Medicare pays 80% of the allowable amount for Part A (hospital, skilled nursing, rehabilitation and hospice care) and Part B (physicians’ visits, laboratory tests and some prescription drugs). For Part D (prescription drug coverage), retirees pay a portion of the cost, based on the drug price and the provider’s drug formulary.
When to apply: It’s important to meet deadlines for applying to avoid penalties. Depending on your status, the timing varies. Remember that the application process takes three months.
If you are turning 65 and have already retired, apply for parts A and B effective the first day of your birthday month. If your birthday is the first of the month, the effective date must be the first of the previous month.
If you are still working at age 65, apply for Part A three months before you turn 65 and defer applying for Part B until three months before your retirement.
If you plan to retire within three months of turning 65, apply for parts A and B at the same time, making your retirement date the effective date of coverage.
The cost: Part A is free to recipients who have contributed to Medicare through payroll deductions for at least 10 years. There is a deductible for each time you are admitted to a hospital.
Part B has a monthly premium, a deductible and coinsurance. New York City reimburses the Part B premium for its retirees and Medicare-eligible dependents. The city sends the standard Medicare B reimbursement each April. Some retired UFT members with higher incomes may also be eligible for the annual Income-Related Monthly Adjustment Amount (IRMAA) reimbursement because they pay more than the standard Medicare Part B premium.
After paying 80% of the allowable amount for parts A and B, Medicare sends claims to your Medigap plan (Medicare Supplement Health Insurance). Your city retiree health plan pays 20% of the allowable amount.
The optional rider benefit to the city health plan becomes retirees’ Part D plan, so no action is needed. After intense lobbying by unions and other advocates, Congress passed the Inflation Reduction Act, which took effect in 2023. The new law has reduced Medicare recipients’ costs and increased protections.
How to apply: UFT members who already receive Social Security benefits at age 65 will automatically be enrolled in parts A and B. If not, visit medicare.gov or call Social Security at 800-772-1213 to begin the Medicare enrollment process.
If you are Medicare-eligible when you retire, Social Security needs proof of group health coverage to process your Part B application. You must obtain a receipt when you file retirement papers and include it with the NYC Health Benefits application you file with the city Department of Education. You request a CMS-L564 form from the DOE, which you file with Social Security. When you receive a proof of enrollment letter, file it with the DOE.
For more information, download a helpful UFT booklet. You can reach the UFT Welfare Fund at 212‑539‑0500.
For information about city retiree plans, go to NYC.gov.