Coordination of Benefits Between Medicare and the A&M System Health Plan
Although many factors
dictate whether your A&M System health plan or Medicare will be primary
or secondary, in general, coverage is determined by the status of the A&M
health plan policy holder. |
If
you are: |
And
the Policy Holder is a(n): |
And
you are: |
Which
plan pays first for you? |
The
Employee/Retiree, or the Spouse of an Employee/Retiree |
Active
Employee |
Any
age |
The
A&M System plan |
Working
Retiree* |
Under
age 65 |
The
A&M System plan |
|
Working
Retiree* |
Age
65 or older |
The
A&M System plan |
|
Retiree |
Under
age 65 |
The
A&M System plan; |
|
Retiree |
Age
65 or older |
Medicare; |
|
The
Disabled Retiree
|
Retiree |
Under
age 65 |
The
A&M System plan; |
Retiree |
Under
age 65 and have received Social Security Income for 2 years |
Medicare;
|
|
Retiree
|
Age
65 or older |
Medicare;
|
|
*Working retiree definition: The policy holder is an A&M retiree working for the A&M System at least 50% time (20 hours a week) for at least 4 1/2 consecutive months. |
|||
For coordination of benefits information concerning End Stage Renal Disease (ESRD), click here. |
For more information, you can review the booklet Medicare and Other Health Benefits: Your Guide to Who Pays First, available at: http://www.medicare.gov/Pubs/pdf/02179.pdf or you can contact Medicare to get a copy. You can also review the fact sheets on the System Benefits Administration website at: http://www.tamus.edu/offices/benefits/employee-retiree-benefits/medicare-information/. |
January
2014 |