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 aren’t 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 the plans work together?

Because Medicare pays first ("primary payer"), there are a few rules that are different for Medicare retirees. These rules are explained in full in the Medicare section of the UMP Classic 2017 Certificate of Coverage, including:

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

Retirees are required to enroll in Medicare Part A and Part B when they become entitled to it to be eligible for PEBB coverage under UMP Classic. You may not enroll in a Medicare Part D drug plan and be covered by UMP Classic. Your monthly premiums will be lower because Medicare pays part of your medical costs. Be sure to tell Medicare you are enrolled in UMP Classic so that they send us your claims after Medicare processes them.

If you are retired but not yet eligible to enroll in Medicare Part A and Part B, Medicare retiree rules do not apply to you. If you think you might be eligible for Medicare and need information on how to sign up, see the Medicare page on the PEBB website.

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

What do I need to do if I'm newly eligible for Medicare?

Eligibility issues, including premiums and which plan you enrolled in, are handled by the PEBB Program. For questions about eligibility, enrollment, or premiums, please call 1-800-200-1004  or visit the PEBB home page.

See the PEBB Preparing for retirement page and the PEBB Medicare page for more information. You may also call the PEBB Program at 1-800-200-1004.

No later than 60 days after you or your covered dependents enroll in Medicare Part A and Part B, you must send the PEBB Program a copy of either the Medicare ID card or a letter from the Social Security Administration that shows the effective date of Medicare Part A and Part B coverage.

Have questions?

Call the PEBB Program at 1-800-200-1004 or Medicare at 1-800-MEDICARE (1-800-633-4227). To learn more about who to contact with different questions, visit the Medicare retirees section of the UMP Contact page.