What changes when Medicare starts
| Before Medicare | With Medicare | |
|---|---|---|
| Who pays first | The State plan | Medicare; the State plan pays second (or first when Medicare doesn't pay) |
| Coverage tier | Individual or family | Medicare I, II or III, with the State's premium for that tier |
| Drug coverage | The State plan | Still the State plan, which DMS says is creditable, so no separate Part D plan is needed |
| New option | None | A State group Medicare Advantage and Prescription Drug (MA-PD) plan, if you choose one |
What to do
- Sign up for Part A and Part B. Your Initial Enrollment Period starts 3 months before your 65th birthday month; DMS suggests contacting Social Security about three months ahead. If you already get Social Security benefits, you're enrolled automatically.
- Send your Medicare card to People First. Upload it or mail a copy to People First, P.O. Box 6830, Tallahassee, FL 32314. That's how the State knows to pay after Medicare and moves you to a Medicare tier.
- Decide about an MA-PD. It's optional and open year-round. People First needs your Medicare card showing Part A and Part B. Requests completed by the 20th take effect on the first of the next month; after the 20th, the first of the second month.
If you don't have enough work history for Medicare, DMS says to ask Social Security for an ineligibility letter and send it to People First so your State coverage continues without interruption.
Special cases
- Still working for the State at 65: you're on active-employee coverage, and MA-PD plans aren't offered to active employees. Medicare's rules let you delay Part B without penalty while you have coverage from current work. See do I need Part B if I'm still working at 65?
- Medicare because of a disability: the same rules apply from the date you're eligible for Medicare.
What to avoid
Don't cancel or add plans in a hurry. A retiree who cancels State Group Insurance can't re-enroll later, and DMS says secondary-plan members should not add a separate Part D plan. DMS also says you will never be called to enroll in an MA-PD. Turning 65 brings a lot of marketing calls; check anything about your State coverage with People First (866-663-4735).
Weighing individual coverage instead? Read State Group Insurance vs. individual Medicare plans, the full guide to Florida state retirees and Medicare, and turning 65 in Florida. You can also request a call from a licensed insurance agent.
Related questions
Do Florida state retirees need Part B?
Why the State plan assumes you have it.
What Medicare options does State Group Insurance offer?
The secondary plan or a State MA-PD.
Can I use the FRS HIS with Medicare?
Medicare counts as coverage.
Sources
- Florida DMS, MyBenefits — Retirees FAQ
- Florida DMS, MyBenefits — Retirees
- Florida DMS, MyBenefits — Medicare Advantage and Prescription Drug (MA-PD)
- Social Security Administration — Sign up for Medicare
More questions in this guide
- Do Florida state retirees need Medicare Part B?
- Can Florida county, city and school district retirees stay on their employer health plan with Medicare?
- What is the FRS Health Insurance Subsidy and can I use it with Medicare?
- What Medicare options does Florida's State Group Insurance program offer retirees?
Part of the guide: Florida state retirees and Medicare · All questions
Frequently asked questions
Will the State automatically move me into a Medicare Advantage plan at 65?
No. DMS says there is no automatic enrollment in a State MA-PD plan. If you do nothing, you stay in your State Group Insurance health plan, which pays after Medicare.
My spouse turns 65 before I do. What changes?
You move to the Medicare II tier, which covers you and your eligible dependents when at least one is eligible for Medicare. Your spouse should sign up for Part B, because the State plan pays after Medicare for Medicare-eligible dependents too. An MA-PD isn't an option until everyone on the family policy has Medicare.
Does the State's Open Enrollment matter when I turn 65?
Not for the MA-PD, which is open year-round, and DMS treats enrolling in Medicare as a qualifying status change. Raising your coverage level, such as adding a dependent, still waits for Open Enrollment or another qualifying status change.
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