MEDICARE

ALL PARTICIPANTS, SPOUSES AND COVERED DEPENDENTS MUST SUPPLY THE FUND OFFICE WITH A COPY OF THEIR MEDICARE CARD WITHIN 30-DAYS OF RECEIPT OF SAME.

  1. Coverage for medical procedures for retirees eligible for Medicare shall be restricted to those procedures approved by Medicare.
  2. If You are 65 years or over, or if You qualify at an earlier age under one of the special provisions of the Medicare law (such as Social Security Disability pensioners), You are eligible for Social Security health benefits – Medicare. The same rules apply to Your spouse.
  3. To be sure that You are eligible for Medicare benefits as soon as You reach age 65, You must register for Medicare Benefits at Your local Social Security Office within the 3 months before Your 65th birthday, whether or not You expect to continue to work after 65. No benefits will be paid for expenses incurred to the extent those expenses would have been reimbursable through Medicare Part A. If you are retired, no benefits at all will be paid for under the Fund unless You are covered under Part B of Medicare.
  4. Medicare Hospital Insurance (Part A) is provided without cost to You and helps pay Your hospitalization services. Medicare Medical Insurance (Part B) is provided at a monthly premium cost to You and helps pay for doctor’s services and many other health care services. Medicare does not provide nor was it designed to accomplish total and complete protection.
  5. No benefits will be paid for expenses incurred to the extent those expenses would have been reimbursable through Medicare Part A. If You use a physician who does not participate in Medicare, reimbursement will be based on the Medicare approved amounts rule.
  6. A Medicare eligible participant who wishes to terminate coverage under the Fund in order to participate in a Medicare Advantage Plan of his/her choosing, will be allowed one year from the date of termination to return to Fund coverage. However, after this one year anniversary date, a terminated participant will no longer be eligible to return to Fund coverage.In addition, when a participant, eligible for retiree health coverage, chooses to terminate coverage in order to enroll in a Medicare Advantage Plan, the participant will be entitled to keep the death benefit as provided for in the current Plan.