Text Size:   A+ A- A   •   Text Only
Find     
Site Image

Answers to Frequently Asked Questions (FAQs) - Medicare Coverage
For more information about Medicare, click here .
 

Does OEBB offer a supplemental insurance plan to Medicare?
At this time, OEBB does not offer a supplemental insurance. You may check with PERS (Public Employees Retirement System) at (888) 320-7377 to see what type of plans they offer. You also may check with your current insurance carrier to find out if you can purchase retirement insurance through them. Your educational entity also is a good source of information and may be able to suggest other alternatives.
What if I am still working even though I’m eligible for Medicare?
An employee may work beyond age 65. If so, and if the employer has 20 or more employees and provides an employer group health plan, the worker over age 65 must be covered under the same group plan with the same benefits as those employees under age 65. The employer plan is primary to Medicare, providing full benefits before Medicare benefits are applied.
Should I also get Medicare Part B? 
You may want to delay enrollment in Part B as long as you or your spouse are working and are both covered by an employer plan. You will qualify for Medicare supplement special enrollment period once you leave the employer plan and start Part B. Consider:
  • How fully your employer plan covers doctor and other health services also covered by Part B.
  • Whether the secondary benefits Part B would pay are worth the cost of the monthly premium.
Can I delay applying for Medicare Part B? 
Yes, but do not do so unless you or your spouse is working and you are covered by an employer plan, or else you face a penalty. To avoid higher premiums for late enrollment in Medicare Part B, notify Social Security that you are still working and covered by your employer plan (not a plan for retirees) and wish to decline enrollment in Part B. Document your conversation by recording the date, name of person you speak with, and notes on what is said.
If I delay enrollment in Part B, what happens when my employer coverage ends? 
If you are 65 or over, you have a Special Enrollment Period for people covered under an employer group health plan. This allows you to enroll in Part B during the eight-month period beginning with whichever of these comes first:
  • The month you or your spouse end employment.
  • The month your group health coverage ends.
Special Enrollment Period rules do not apply to you if you stop working or lose your employer coverage during your Initial Enrollment Period (the time you first are eligible for Medicare).
 
Contact Social Security to discuss the best time to enroll in Part B.
Can I enroll in Medicare Part B while I'm still working and covered by my employer plan? 
Yes, you may contact Social Security and enroll in Medicare Part B at any time while you are working and covered by the employer plan.
 
If you enroll while you are still working, you may start coverage at the first of the month in which you enroll or at the first of any of the three months after that.
 
(Note: Contact your benefits administrator at work to find out whether enrolling in Part B at this time is required or to your advantage.)
If I am still working and I turn 65 or my spouse turns 65, are we eligible to stay on the OEBB active plans?
Yes. If you are actively working (not a retiree) and either you or your spouse turn 65, both are eligible to stay on the active OEBB plans. In this scenario, OEBB coverage would be primary over any Medicare coverage (unless End Stage Renal Disease is applicable, in which case Medicare would be primary after 30 months of eligibility or entitlement to Medicare).
If I am still working and my domestic partner turns 65, is my domestic partner eligible to stay on the OEBB active plans?
Yes, however it is important to understand that the primary/secondary payer rules change. Per Medicare, if a domestic partner is entitled to Medicare on the basis of age (turning age 65) and has group health plan coverage based on the current employment status of his/her partner, Medicare is the primary payer of services. The OEBB active coverage pays secondary to Medicare.
If I am still working and my domestic partner gains Medicare on the basis of a disability, is my domestic partner eligible to stay on the OEBB active plans?
Yes, the domestic partner is eligible to remain on the OEBB plans. Per Medicare, when the domestic partner is entitled to Medicare on the basis of disability and covered by a large group health plan on the basis of his/her own current employment status or that of a family member (a domestic partner is considered a family member), Medicare is generally a secondary payer. This means that the active OEBB coverage is the primary payer of services and Medicare is secondary.
What if I have general questions about who pays first, who can I contact for assistance?
You can contact your insurance company (ODS, Providence or Kaiser Permanente) with questions or the Medicare Coordination of Benefits Contractor at 1-800-999-1118. TTY users should call 1-800-318-8782.


Need more information? Review more Frequently Asked Questions.