Becoming Medicare Eligible

Becoming Medicare Eligible eLearning

This comprehensive, click-as-you-go eLearning walks you through the Becoming Medicare Eligible process.

What is Medicare?

Medicare is the federal health insurance program for individuals age 65 or older and some disabled individuals under age 65. It is administered by the Centers for Medicare and Medicaid Services (CMS). You become eligible for Medicare on the first day of the month in which you turn age 65. If your birthday is on the 1st of the month, you become Medicare-eligible on the first day of the prior month. If you are disabled, you may get Medicare coverage automatically after you have received Social Security Disability Income (SSDI) benefits for two years. It is important that you verify timing with Medicare for your specific situation, as Social Security disability eligibility dates may vary.

Medicare has different parts that help cover specific services:

- Medicare Part A (hospital insurance)
- Medicare Part B (medical insurance)
- Medicare Part C (Medicare Advantage plans)
- Medicare Part D (outpatient prescription drug coverage)

Frequently Asked Questions

I am on a non-Medicare Plan but will become Medicare-eligible. What should I do?

If you are enrolled in a non-Medicare ASRS retiree medical plan and become eligible for Medicare, you must enroll in one of the two ASRS medical plans specifically for Medicare-eligible retirees, if continued ASRS coverage is desired. Failure to enroll will result in termination of medical coverage with the ASRS.

Generally, The Centers for Medicare and Medicaid Services (CMS) will mail a Medicare card to you three months prior to your eligibility. Please follow the instructions carefully when you receive your Medicare card. The Medicare card will include your name, Medicare number, the type of coverage you have (Part A, Part B or both), and the date your Medicare coverage starts. It's important to note that enrollment in Medicare and enrollment in an ASRS Medicare-eligible medical plan are two separate actions; however you may be able to enroll in both simultaneously. The ASRS retiree medical benefits program does not permit retroactive enrollments. A new ID card(s) and a Quick Start Guide for your new ASRS Medicare-eligible medical plan will be sent by UnitedHealthcare after your ASRS online enrollment has been processed.

I continued working after age 65 but will want a Medicare plan when I retire. What should I do?

If you became Medicare eligible (e.g. turned 65) and still chose your group health insurance based on your own or your spouse's current active employment; you likely delayed enrolling in Part B. If you still choose to delay enrollment in Part B, follow the instructions in the brochure that comes with the ID card and return the card before the effective date of Medicare coverage. However, if you keep your Medicare card, you will be required to pay Part B premiums. When you are ready to sign up for Medicare Part B after this delay, contact Medicare. Note that your employer can provide a form to you for Medicare that will show why there was a delay in taking Part B. Then, if you choose, remember to enroll online in the ASRS Medicare plan you need.

Medicare seems complicated. Who can I contact to learn more about my eligibility and options?

The Arizona Department of Economic Security Division of Aging and Adult Services houses two programs to aid with Medicare - the State Health Insurance Program (SHIP) and the Senior Medicare Patrol (SMP). The SHIP program provides local, in-depth, and objective insurance counseling and assistance to Medicare eligible individuals, their families, and caregivers, SHIP Benefits Assistance Counselors can explain how Medicare works with supplemental policies, retiree coverage, Medicaid, and other insurers. Contact your local SHIP for one-on-one assistance with reviewing health or prescription drug plan options.

Residents of Maricopa County (Region One), call (602) 280-1059, or visit AAAphx.org

Residents of Pima County (Region Two), call (520) 790-7262, or visit PCOA.org

Residents of Pinal County (Region Five), call (520) 836-2758, or visit PGcsc.org

For SHIP or SMP contact information in other counties, visit https://DES.AZ.gov/services/older-adults/medicare-assistance and navigate to Local SHIP and SMP offices

ENROLLMENT IN AN ASRS MEDICARE PLAN IS NOT AUTOMATIC.

ASRS Medicare Plans

How and When Do I Sign Up for Medicare?

Three months before you turn 65, or when you want to start coverage, contact Medicare to enroll in Medicare Parts A and B, so that your coverage will be effective beginning the first day of the month you turn 65 or retirement after age 65.

Note that enrollment in Medicare may have exceptions and nuances specific to each individual's situation. Visit the Medicare website or call 800-633-4227. TTY users should call 877-486-2048, 24 hours/day 7 days/week. If you have delayed your Medicare enrollment, or you are not collecting social security, you will need to notify Medicare when you are ready to start.

How Do I Enroll in an ASRS Medicare Plan?

When you (and/or your covered dependents) become eligible for Medicare, Parts A and B must be elected and retained in order to enroll in the Medicare plans offered by the ASRS. Medicare Part D is included in both of the ASRS Medicare plans offered.

Before your Medicare effective date (1st day of your birth month), submit your ASRS enrollment form online through your secure account (but no more than 90 days ahead of the effective date.)

Your ASRS coverage becomes effective the first day of the month following your qualifying life event and receipt of your completed enrollment application, and all required proof of your qualifying life event. Therefore, there is no retroactive coverage for health insurance. Please remember to begin your enrollment process with the ASRS before you become Medicare eligible.

It is very important to note the premium benefit to which you are entitled will be reduced to the amount applicable to Medicare-eligible retirees. State law governs how much premium benefit is paid for non-Medicare and Medicare-eligible retirees/LTD recipients.

Currently enrolled non-Medicare members on ASRS plans are sent a Plan Guide 90 days prior to Medicare eligibility. If a member does not respond by switching to a Medicare plan, this will result in termination of medical coverage and you will not be able to enroll in an ASRS Medicare medical plan until the next ASRS Open Enrollment period.