If You are Eligible for Medicare Benefits
If you are covered under the MILA National Health Plan because of active employment and you or your covered dependents are entitled to Medicare coverage based on age or disability or due to end-stage renal (kidney) disease (ESRD), the Medicare-eligible person does not have to enroll in Medicare to receive full MILA National Health Plan benefits.
However, if the Medicare eligible person does enroll in Medicare, the MILA National Health Plan will be the primary coverage and Medicare will be secondary for the Member or the Member’s spouse or child: (a) for as long as MILA coverage is a result of active employment if Medicare entitlement results from the person’s disability or attainment of age 65 or (b) for 30 months if Medicare entitlement results from the person’s ESRD that began during active employment.
Medicare coverage is not automatic for those who are eligible to enroll for it. You must enroll through the Social Security Administration (SSA) in order to be covered for Parts A and B. Medicare Part A does not require a premium payment for those who are “fully insured” as defined by the SSA, but Part B coverage does require a premium payment. The Part B premium is set by the government and is expected to increase annually based upon the Consumer Price Index.
Medicare has two other Parts – Part C and Part D – and you should not enroll for either coverage while you are covered under MILA by virtue of active employment. A Medicare Part C Plan is now called a Medicare Advantage Plan. Medicare Advantage Plans are provided through private insurance carriers and have been designed to replace coverage under Part A & B for retired persons.
Medicare Part D is also provided through private insurance carriers or other companies and supplies prescription drug coverage in return for a premium payment. Because MILA coverage includes prescription drug coverage which is at least as complete and comprehensive as Part D coverage, you probably would not receive an additional benefit for enrolling for this coverage and paying the additional Part D premium.
Medicare rules for payment can be complex. If you have any questions about how these Medicare rules affect you, contact Medicare or MILA.
MEDICARE
If You Are Eligible for Medicare: Generally, if you are a pensioner and are not covered under the MILA National Health Plan by virtue of current employment, Medicare provides your primary coverage, and the MILA National Health Plan provides secondary coverage. However, if your coverage results from active employment in the industry, the MILA National Health Plan is your primary coverage.
