For Medicare retirees

For complete information, read the Medicare section of your certificate of coverage (COC).

Medicare section of your COC

Am I a Medicare retiree?

You are considered a Medicare retiree if all of the following apply:

  • Enrolled in Public Employees Benefits Board (PEBB) retiree coverage; and
  • Age 65 or older (or younger and eligible for Medicare due to medical disability); and
  • Enrolled in both Medicare Part A (hospital) and Part B (medical).

Alert: If you are the subscriber and are an employee, see When UMP pays first for coverage when UMP Classic pays before Medicare. This also applies to retired dependents enrolled in UMP Classic under an employee's account.

If you are not a Medicare retiree as defined above, UMP Classic pays first and Medicare pays second. You or your provider must bill Medicare after UMP pays. See how to submit a claim.

How do UMP Classic and Medicare work together?

Because Medicare pays first, a few rules are different for Medicare retirees. These rules are explained in full in the Medicare section of the UMP Classic 2019 Certificate of Coverage, including:

  • How UMP Classic and Medicare work together.
  • What UMP Classic covers that Medicare does not cover.
  • What your choices for providers are.
  • How billing works.
  • How your prescription drug coverage works.
  • Where to go for more information.

Retirees and their eligible dependents are required to enroll in Medicare Part A and Part B when they become eligible to enroll in PEBB retiree insurance coverage under UMP. Enrollment in Medicare Part A and Part B must be maintained to remain enrolled in a PEBB retiree health plan. You may not enroll in a Medicare Part D drug plan and be covered by UMP.

Your monthly premiums will be lower because Medicare pays part of your medical costs. Be sure to tell Medicare you are enrolled in UMP so that they send us your claims after Medicare processes them.

If you are retired but you or an eligible dependent are not yet eligible to enroll in Medicare Part A and Part B, the Medicare section in your certificate of coverage does not apply to you. If you think you might be eligible for Medicare and need information on how to sign up, see the "Medicare entitlement" section in your certificate of coverage. 

Note: Medicare accepts claims directly from enrollees only under certain circumstances.

What do I need to do if I am newly eligible for Medicare?

As you approach age 65, the PEBB Program will send you a personalized letter explaining  what you need to do to keep PEBB health plan coverage and apply for Medicare Part A and Part B.

Eligibility, enrollment, and premiums are handled by the PEBB Program.  Call 1-800-200-1004 (TRS: 711) with questions, or visit the Preparing for retirement or Medicare pages for details.

Have questions?

For questions about eligibility, enrollment, or premiums: Call the PEBB Program at 1-800-200-1004 (TRS: 711).

For questions about what Medicare covers or your claims: Call Medicare at 1-800-633-4227 (TTY: 1-877-486-2048). Get more contact information on the Medicare retirees section of the UMP Contact page.