Paying Medicare Premiums and Peralta's Reimbursement Process
The Peralta Community College District requires that all retirees and eligible dependents enroll in the federal Medicare program if they are age 65 or older. This is a condition for receiving lifetime benefits.
Medicare consists of several "Parts" each of which covers a different kind of service. For example, Medicare Part A covers hospitalization expenses, Part B covers doctor's office visits and other outpatient services, Medicare Part C is privatized Medicare where Medicare benefits are implemented by a private insurance company, and Part D covers prescription drugs. Important: Peralta retirees should only enroll in Parts A and B. They should decline Part D coverage as the District will enroll you in Part D when you sign up for your lifetime benefits.
The District will reimburse the retiree or the dependent for any premiums incurred as a result of enrolling in Medicare Parts A, B and D.
There are three times when you can sign up for Medicare Parts A and B.
Initial Enrollment Period
You may sign up for Medicare Parts A and B during your initial enrollment period, which begins three months before the month you turn 65 and ends three months after the month you turn 65. (For example, if you turn 65 on July 15, you can sign up anytime between April 1 and October 31.) Your Medicare coverage will begin the 1st day of the month in which you turn 65.
2. General Enrollment Period
If you did not enroll in Medicare Parts A and B during the Initial Enrollment Period, you can sign up during the Medicare General Enrollment Period which is January 1 through March 31 of each year. Your Medicare coverage will start July 1 of the year you sign up. You may be charged penalties for late enrollment in Medicare. Be aware that the District may not insure you for any month in which you were eligible to be enrolled in Medicare and you did not enroll.
3. Special Enrollment Period
This period is available if you are eligible for Medicare and waited to enroll in Medicare because you or your spouse was actively working and had group health plan coverage through an employer. You can sign up for Medicare any time you are still covered by an employer group health plan through your or your spouse's current employment. If you have not signed up while you were covered by your or your spouse's employer you can still sign up without penalty during the eight months following the month that the group health plan coverage ends, or when the employment ends (whichever is first). (For example, if you retired in June, 2011, you can sign up for Medicare until February 2012 without any penalty for late enrollment.) However, you should enroll in Medicare as soon as you cease having coverage from either your or your spouse’s employment. Be aware that the District may not insure you for any month in which you were eligible to be enrolled in Medicare and you did not enroll.
For more information about Medicare enrollment periods, please contact the Social Security Administration at 1-800-772-1213.
How To Enroll
To enroll in Medicare you can contact the Social Security Administration at 1-800-772-1213 or you may apply for Medicare online at https://secure.ssa.gov/iClaim/rib. Although Medicare Part A will be free for you, there may be a penalty for late enrollment (more than three months after your 65th birthday or eight months after you stop working). Everyone must pay a premium for Medicare Part B. Any premiums for Medicare A and B are fully reimbursed by the Peralta District.
Final Steps
After you have enrolled in Medicare, you must choose from the various options that the District offers to retirees.
Traditional Medicare with United American Medicare Supplement Plan and Anthem Prescription Drug Plan
Anthem Medicare Advantage with Prescription Drug (MAPD) (Medicare Part C plan)
Kaiser Permanente Senior Advantage
For detailed information about each of these options, visit peralta.edu/benefits/retirees
Contact the District Benefits Office to discuss your choices and how to enroll in whichever you choose.
Getting Reimbursed for Premiums That You Pay
The Peralta District will reimburse you for any premiums that you have to pay for Medicare Parts A, B and D. To get reimbursed you must submit documentation to the District's agent, Navia Benefits Solutions. Reimbursement is done monthly. It is done by direct deposit to any account that you specify (details below).
Required Documentation
If you are having your Medicare premiums deducted from your CalSTRS pension or Social Security check it suffices to submit to Navia a copy each year of your January check stub showing the amount deducted from your check for Medicare. You may also submit a copy of the Social Security Statement issued each December by the Social Security Administration which announces your annual premium for the following year. (If you have just signed up for Medicare, you should submit a copy of the first check stub that shows the amount of the Medicare deduction.) This must be done on an annual basis because the Medicare premiums usually change every calendar year. You should black out any personal information that may appear on the stub/announcement (e.g., your social security number). The copy of your documentation must be accompanied by a completed copy of a Premium Reimbursement Claim Form that you can download here.
If you are paying your Medicare premiums directly to Medicare you must submit copies of the statements you receive each month or quarter showing the amount you are paying. For example, you will be billed by the Centers for Medicare and Medicaid Services for January at the beginning of December, for February at the beginning of January, for March at the beginning of February, etc. Once you have each monthly statement, you can submit a copy to Navia together with the Medicare Reimbursement Claim Form (available from the District Office and online at Navia’s web site here. You will receive reimbursement at the beginning of the following month. (Note: Be sure to complete the stub on the statement before making a copy, and be sure to black out any personal information, e.g., your social security number or credit card number.)
If you are being billed quarterly (because you are only paying for Medicare Part B) you must submit a copy of the quarterly statement with the Premium Reimbursement Claim Form. You will still be reimbursed once a month for three months even though you have paid for the entire three month period. If the quarter includes a new year, you will need to submit a separate Premium Claim Form for the parts of the quarter in each of the two years. For example, if the quarter spans December-February, you will need to submit a copy of the statement with a Reimbursement Claim Form for December and then a new form for the months of January and February. The District will reimburse you by direct deposit to the bank account of your choice.
Register for Navia Benefits
To register for Navia Benefits, visit www.naviabenefits.com, click “Register” in the upper-right corner of the screen and select “I'm a participant.”
You will be asked to complete a form that asks you to choose security questions, supply answers and choose a user name and password. You will also be asked for additional information. Once you have completed the process of creating an account with Navia, login and choose Forms and Documents in the My Tools menu or click here. You will need the bank's routing number, the account number, and the bank's mailing address.
Note: Your bank may require further verification to activate your bank account. A deposit will be made to the account in the next 1-3 business days after you provide the banking information. Once you confirm the deposited amount on the Navia site, the account will be activated and available for use. For further assistance please contact Navia directly at 866-897-1996.