Medicare for Retirees

Working and turning age 65

  • If you are currently working for a state agency or higher education institution that participates in the Texas Employees Group Benefits Program (GBP), your state health insurance remains primary to Medicare.
  • If you are eligible for free Medicare Part A, you should enroll. This will provide secondary hospitalization coverage to your state health insurance.
  • As an active employee, you can delay your enrollment in Medicare Part B about 90 days before your retirement date.
  • The above applies if you are actively working and a dependent on your state health insurance becomes Medicare eligible.

Once you are retired and Medicare eligible, Medicare becomes primary to your retiree state health insurance coverage.

Retired and turning age 65

  • You should sign up for Medicare Parts A and B. Now that Medicare is primary, we assume that it will pay your medical expenses first.
  • Without Medicare, you will pay most or all of your out-of-pocket medical expenses.
  • Call ERS as soon as you receive your Medicare information (located on your Medicare ID cards).
  • Once ERS confirms your Medicare Parts A and B enrollment, you will be enrolled in the HealthSelectâ„  Medicare Advantage Plan, administered by Humana. The plan combines Medicare Parts A and B with your state health insurance and provides additional group benefits you may not receive with Medicare alone. It covers most or all of your medical expenses. You will also be enrolled in HealthSelect Medicare RX (Part D prescription drug coverage), administered by UnitedHealthcare®.

Over 65 and about to retire

  • You should sign up for Medicare Parts A (if not already enrolled) and B about 90 days before your retirement date.
  • Now that Medicare is primary, we assume that it will pay your medical expenses first. Without Medicare, you would pay most or all of your out-of-pocket medical expenses.
  • Call ERS once you receive your Medicare information (located on your Medicare ID card).
  • Once ERS confirms your Medicare Parts A and B enrollment, you will be enrolled in the HealthSelect Medicare Advantage Plan, administered by Humana. The plan combines Medicare Parts A and B with your state health insurance and provides additional group benefits you may not receive with Medicare alone. It covers most or all of your medical expenses. You will also be enrolled in HealthSelect Medicare RX (Part D prescription drug coverage), administered by UnitedHealthcare.

Under 65 with disability

  • If you have received SSA disability benefits for at least 24 months or you have End-Stage Renal Disease (ESRD), you may be eligible for Medicare sooner.
  • You should sign up for Medicare Parts A and B when you are first eligible. Now that Medicare is primary, we assume that it will pay your medical expenses first. Without Medicare, you will pay most or all of your out-of-pocket medical expenses.
  • Call ERS as soon as you receive your Medicare information (located on your Medicare ID cards).
  • Once ERS confirms your Medicare Parts A and B enrollment, you will be enrolled in the HealthSelect Medicare Advantage Plan, administered by Humana. The plan combines Medicare Parts A and B with your state health insurance and provides additional group benefits you may not receive with Medicare alone. It covers most or all of your medical expenses. You will also be enrolled in HealthSelect Medicare RX (Part D prescription drug coverage), administered by UnitedHealthcare.

To enroll in Medicare Parts A and B, visit www.ssa.gov or call the Social Security Administration toll-free at (800) 772-1213, or TTY users call (877) 325-0778.

Do I need to enroll in Medicare Part A and Part B?

Yes. You need to enroll in both if you’re Medicare-eligible and no longer work for a state agency or higher education institution that participates in the GBP.

Part A covers hospitalization and is free for most people.

Part B covers medical costs other than hospitalization such as doctors' visits or lab work. It has a monthly premium. You are responsible for your Medicare premiums. If you do not enroll in Part B, you’ll pay most or all of your health care out-of-pocket costs for Part B services. The SSA may add a lifetime penalty to your monthly premium if you are retired and do not enroll in Part B when first eligible.

Do I need to enroll in Medicare Part D?

No. ERS provides Part D prescription drug coverage for Medicare-eligible retirees, dependent, and survivors through the HealthSelect Medicare Rx Plan, currently administered by UnitedHealthcare®. This plan is as good as or better than most private Medicare Part D plans. You must be enrolled in Medicare Parts A and/or B in order to be eligible for Medicare Part D.

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