Social Security and Medicare
Members of PEERS are presumed to be participating members of the federal Social Security and Medicare programs. With few exceptions, PEERS members with sufficient Social Security-covered employment should be eligible to receive full benefits from Social Security and Medicare, as well as PEERS benefits.
In limited cases, your Social Security benefit could be affected by other income sources defined by Social Security, such as railroad pensions or pensions from non-Social Security covered employment (like PSRS). In addition, if you are eligible to receive Social Security benefits as a spouse or surviving spouse, there may be a reduction of your spousal Social Security benefit, depending on your individual situation. We recommend that you contact your local Social Security Office, call the Social Security Administration at 1-800-772-1213 or visit www.socialsecurity.gov for further information.
Medicare benefits may be payable under special circumstances that are not explained here, such as with the occurrence of a disability. We recommend you contact the Social Security Administration at 1-800-MEDICARE (633-4227) for specific information about your entitlement to Medicare benefits.
There are four components to Medicare - Part A, Hospital Insurance; Part B, Medical Insurance; Part C, Medicare Advantage Plan; and Part D, Prescription Drug Coverage. You may choose to participate in any or all parts.
Medicare Components Explained
Part A - Hospital Insurance
Medicare Part A, Hospital Insurance, pays for inpatient hospital expenses, hospice care and skilled home health services for homebound patients, and helps with short-term in-patient care in skilled nursing facilities if the patient is there for rehabilitation.
You can receive Part A free, if:
- You have 40 Medicare units from your own employment
- You qualify through an eligible spouse or ex-spouse
If you do not qualify to receive Part A free, you can pay a monthly premium.
Part B - Medical Insurance
Medicare Part B helps pay for doctors' services, outpatient hospital care and some medical equipment and supplies. Everyone must pay a premium to receive Part B coverage regardless of the number of Social Security units they have. Premiums for Part B are deducted from your monthly Social Security benefit. If you are not eligible to receive Social Security benefits, you will be billed quarterly for Part B coverage.
Part C - Medicare Advantage Plans
Medicare Advantage Plans are health plan options approved by Medicare and run by private companies. Medicare Advantage Plans provide all of your Part A (hospital) and Part B (medical) coverage and must cover medically-necessary services. They generally offer extra benefits, and many include Part D coverage.
Part D - Prescription Drug Coverage
Beginning January 1, 2006, new Medicare prescription drug plans are available to people with Medicare. Insurance companies and other private companies work with Medicare to offer these drug plans. They will negotiate discounts on drug prices.
Medicare prescription drug plans provide insurance coverage for prescription drugs. Like other insurance, if you join you will pay a monthly premium (generally around $35 in 2006) and pay a share of the cost of your prescriptions. Costs vary depending on the drug plan you choose.
Drug plans may vary in what prescription drugs are covered, how much you have to pay, and which pharmacies you can use. When you join a drug plan, it is important for you to choose one that meets your prescription drug needs.