If you retired from a full-time position at CUNY and have retiree health insurance coverage from the City of New York, you may be eligible to receive reimbursement for the monthly premium you pay for Medicare Part B. It could save you more than $1,200 a year – or twice that amount if your spouse or domestic partner also meets eligibility requirements.
Medicare Part B is the part of Medicare that covers doctors’ visits, outpatient care and other services not covered by Medicare Part A, which covers hospitalization. In most cases, the Medicare B premium is deducted from your Social Security check.
For 2016 filings, the standard monthly Part B premium amount is $121.80, however most retirees will continue to pay the same standard Part B premium amount paid in 2015, which was $104.90. If your modified adjusted gross income, as reported on your IRS tax return from two years ago, is above a certain amount, you will have to pay more. The threshold is $85,000 if filing an individual tax return, or $170,000 on a joint return.
Medicare beneficiaries with incomes above these thresholds must pay progressively higher Part B premiums above the standard monthly amount. This additional premium, above the standard monthly rate, is known as the Income Related Monthly Adjustment Amount (IRMAA). If you are subject to these additional IRMAA payments, the amount can change each year depending on your income.
GETTING SIGNED UP
Reimbursement of your Part B premium is processed by the New York City Health Benefits Program and you won’t receive reimbursement unless you have submitted notice of your eligibility. You do not need to submit an annual request to receive reimbursement for the standard monthly premium; once you are signed up you will continue to receive this basic reimbursement each year. Retirees in the Teachers’ Retirement System (TRS) with NYC health coverage must write to the NYC Office of Labor Relations (see “Claim your reimbursement”), while retirees in TIAA (CUNY’s Optional Retirement Program (ORP)) must send a form to CUNY University Benefits Office.
If you pay more than the standard monthly premium because of IRMAA, you can also be reimbursed for the additional amount. However, you must apply annually for the IRMAA reimbursement by completing a separate application and submitting it to the NYC Office of Labor Relations (see “Claim your Reimbursement”).
Reimbursement of your Medicare Part B premiums is a benefit that was won through union action. Municipal unions first won reimbursement at the bargaining table in 1966, but a succession of mayors pled poverty and paid only a portion of the premium. In 2001, the city paid just 70 percent, which was then $384. The return to 100 percent reimbursement was won through “old-fashioned politicking” by the New York City labor movement, says Irwin Yellowitz, a labor historian and former chair of the PSC Retirees Chapter.
By 2000, “it had been an issue that was out there for a very long time,” Yellowitz said. The reimbursement meant more and more to people, especially lower-paid city workers, as premiums rose steadily. “The argument that the city couldn’t afford it didn’t wash anymore,” he said.
New York City unions, including the PSC, the UFT and AFSCME District Council 37, helped mobilize retirees and other members to send postcards, meet with City Council members and testify before the council on the issue. In 2001, the City Council passed a measure reinstating the full reimbursement and overrode then-mayor Rudy Giuliani’s veto of the bill. But Giuliani sued to block implementation and the measure remained tied up in court. In 2002, union efforts finally bore fruit: with Giuliani out of office, the city agreed to drop its suit.
CLAIM YOUR REIMBURSEMENT
The initial eligibility determination process for requesting reimbursement of the monthly standard premium for Medicare Part B is different for members of the NYC Teachers’ Retirement System and for members of TIAA. In both cases, you must provide a copy of your and/or your eligible dependents’ Medicare card(s), which must be signed and must indicate the effective dates of your enrollment in both Parts A and B. (Be sure to send a copy, not the original.)
If you are receiving your pension check from TRS you must contact the NYC Health Benefits Program in writing, advising them of your Medicare Part B eligibility. Your letter must include copies of any relevant Medicare cards and birth dates for yourself and spouse or domestic partner; your retirement date, pension number and pension system; the name of your health plan; and the name of your union welfare fund (the PSC/CUNY Welfare Fund). You must send your letter to:
NYC Office of Labor Relations
Health Benefits Program
40 Rector Street, 3rd Floor
New York, NY 10006
Attn: Medicare Unit
Participants in NYCERS (the NYC Employees’ Retirement System) or BERS (Board of Education Retirement System) should also send their letters and copies of Medicare cards to this address.
If you are receiving your pension check from TIAA, you must complete an application that is available on the CUNY website and submit it to CUNY’s University Benefits Office. The application is online at tinyurl.com/Medicare-Part-B-application. Send the completed form, plus copies of your retiree health insurance card and your Medicare card (and Medicare card of your spouse or domestic partner), to the address below. Your Medicare card(s) must be signed and must indicate the effective dates of enrollment in both Parts A and B. Send these documents to:
University Benefits Office
555 W. 57th Street, 11th Floor
New York, NY 10019
TIAA members should make sure to follow this procedure; it is the only way to ensure that you will receive your Part B reimbursement.
If you are Medicare eligible, upon retirement, you should apply for Medicare Parts A and B, then you should sign up for reimbursement immediately upon receipt of your or your dependent’s Medicare card (which must indicate enrollment in Part B). For reimbursement of this monthly standard premium, you will only need to sign up once. But be sure to notify the agency to which you originally applied (either the NYC Office of Labor Relations or CUNY University Benefits Office) of any address or status changes to avoid delays in receiving your reimbursement check.
Please note that if you will receive NYC health coverage in retirement, you may apply to receive reimbursement for Medicare Part B payments for your spouse or domestic partner even if you yourself are not yet Medicare Part B eligible.
REIMBURSEMENT FOR IRMAA
Reimbursement for the standard premium payments are generally sent out in June of the year after those Part B payments were made. Reimbursements for IRMAA payments are processed later, usually the following June. For example, reimbursement for standard Part B premium payments made in 2016 would be sent out in June 2017, while IRMAA reimbursements for 2016 would be sent out in June 2018. Effective June 2016, if you are currently receiving your pension check from TRS through Electronic Fund Transfer (EFT) or direct deposit, your reimbursement will be deposited directly into your bank account. If you don’t have EFT or direct deposit, you will receive a check in the mail in June. If you are receiving a pension check from TIAA, you will continue to receive a check. At this time EFT or direct deposit for Part B premium reimbursement is not available to retirees who are members of TIAA.
Currently, the NYC Health Benefits Program is working on IRMAA reimbursements for calendar years 2015, 2014 and 2013. You must fill out the appropriate form to apply for reimbursement of IRMAA payments depending on the year you are claiming (available online at tinyurl.com/IRMAA-reimbursement). The reimbursement form for 2016 payments should be available there by June 2017. Remember that to receive reimbursement for IRMAA payments, you must apply annually and submit the appropriate supporting documents.
Retirees who have a major life-changing event and whose income has decreased can request a reduction in their IRMAA payments by completing a Medicare IRMAA Life-Changing Event form or scheduling an interview with their local Social Security office. (People who are newly retired are often overcharged for these premiums, when Social Security looks back at the prior year’s income.)