How do I enroll?

If you are retired and turning 65, call the Social Security Administration to sign up for Medicare Parts A and B.

If you are retired and will turn 65 soon, it’s up to YOU to enroll in Medicare. Sign up during your initial enrollment period. This is the seven-month period that includes the 90 days before and after your 65th birthday month. 

What is the cost?

Your Medicare coverage includes:

• Part A (hospital insurance)—there is no cost for Part A.
• Part B (medical insurance)—you pay a monthly premium for Part B. 

Detailed information about Medicare costs is available in the Medicare & You handbook from the Medicare website.

Will my doctor accept Medicare?

 Some doctors and providers “accept assignment” on Medicare claims. They agree to accept the Medicare approved amount as payment in full for Part B services and supplies. Contact Medicare to find health care providers or doctors who accept Medicare patients.

If a doctor or provider does not accept Medicare assignment, he or she is not allowed to charge more than 15% above the Medicare-approved amount. Before you turn 65 or become eligible for Medicare, ask your doctor or provider if they accept Medicare assignment.

What about Medicare Prescription Drug Coverage (also called Part D)?

Your state health coverage is comparable to Medicare Prescription Drug Coverage. The Notice of Creditable Coverage explains that if you participate in an ERS health plan:

• You do not need to sign up for Medicare Prescription Drug Coverage, and
• Should you sign up for Medicare’s prescription drug benefit later, you won’t pay a penalty as long as you have the Notice of Creditable Coverage.

What if I am certified disabled by SSA?

As a disabled retiree under 65 residing in Texas, you and your covered dependents will have in-area benefits. When you turn 65, your coverage will be moved to out-of-area. Medicare will be the primary payer. HealthSelect will coordinate to pay secondary benefits.

As a disabled retiree under 65, you may choose out-of-area benefits. When you meet your annual deductibles, Medicare generally pays 80 percent of eligible charges. Your state health plan coordinates to pay secondary to Medicare. To elect out-of-area benefits, contact ERS.

Where can I get more information?