Nyc Office Of Labor Relations Medicare Reimbursement


Medicare Part B Reimbursement

All About CMS

The City will reimburse retirees and their eligible dependents for Medicare Part B premiums paid, excluding any penalties. You must be receiving a City pension check and be enrolled as the contract holder for City health benefits in order to receive reimbursement for Part B premiums.

For most retirees, the refund is issued automatically by the Health Benefits Program. If you are currently receiving your pension check through Electronic Fund Transfer or direct deposit, your reimbursement will be deposited directly into your bank account. This will be separate from your pension payment. If you dont have EFT or direct deposit, you will receive a check in the mail in June.

Medicare Has Four Parts:

  • Medicare Part A helps pay for inpatient care in a hospital or skilled nursing facility . Part A also pays for some home health care, and hospice care. Part A is typically free if certain requirements are met. Please refer to the Social Security Website for these requirements.
  • Medicare Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services. There is a cost associated with this premium. Please refer to the Social Security Website for the premium information.
  • Medicare Part C are available in many areas. People with Medicare Parts A and B can choose to receive all their health care services through a private insurance company approved by Medicare to provide this coverage.
  • Medicare Part D helps cover the cost of prescription drugs.

Welcome City Of New York Employees And Retirees

As a City of New York employee, non-Medicare-eligible retiree or Medicare-eligible retiree, the plans listed below are available to you and your family. Sign in to get information related directly to your plan and to get plan-related updates including checking claim status and requesting ID cards.

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How This Happened: The Mlc Vote And The Psc Response

This is how we reported in real time to the MLC vote and PSC response.On Wednesday, July 14, the Municipal Labor Committee voted to approve a contract with the NYC Office of Labor Relations to move city retirees, including CUNY retirees, from traditional Medicare with supplemental city insurance to a privatized Medicare Advantage plan. The transition would take effect on The PSC cast a NO vote.

The Medicare Advantage vendor is Alliance, a partnership of Empire BlueCross BlueShield and Emblem Health.

Members can choose to go into the Medicare Advantage plan or stay with traditional Medicare but would have to pay for their own suplementary insurance. Retirees 65 years and older will automatically be enrolled in the new Medicare Advantage Plus program effective , unless they affirmatively opt out. The retiree chapter, to put it charitably, is most unhappy that the City and MLC chose that the default for Medicare eligible retirees would be automatic enrollment in the Medicare Advantage plan.

You can choose to remain on your current NYC plan by opting out of the NYC Medicare Advantage Plus plan during the opt-out period , but you will have to pay a premium to stay on most of the current NYC plans. For retirees who opt out and wish to stay on the GHI/Empire BlueCross BlueShield Senior Care Supplementary plan, you will pay $191.57 a month per person and the plan will have co-pays . Premiums for other plans are on the OLR website here.

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Disability, you/your dependent may become eligible for Medicare before reaching age 65. In this case, you/your dependent must enroll in Medicare as soon as you become eligible. The State will reimburse you and your eligible dependent for the cost of MedicarePartB monthly premiums unless you receive reimbursement from another source. 14.). Here are seven things every veteran should know about Medicare. Medicare covers veterans in the same way as it covers most other Medicare beneficiaries. But there are a few things that veterans of the armed forces should know about Medicare. 1. Medicare and VA coverage do not coordinate benefits. Medicare and VA insurance do. If your doctor or health care provider accepts Medicare assignment for a covered service, you would pay the PartB deductible along with 20% of the Medicare-approved amount for services rendered. Accepting assignment means that your doctor will not charge you more than the Medicare-approved amount for the covered service.

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In addition, all individuals pay a surcharge of $170.10 for PartB, a 14% increase from the previous year. Next, see tier one, which starts at $1 above the base tier. That $1 over the cliff could cost you $816 in surcharges that year! In tier 5, you pay an additional $4898 a year.

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Enrolling In Social Security

The Social Security Administration through helps you prepare for retirement , by providing the information you need to make an informed decision. Social Securitys website offers tools that make you aware of the possibilities available:

  • There is a Retirement Estimator that provides estimates based on your actual Social Security earnings record. You can plug in different numbers, retirement dates, and scenarios to help you decide the best time to begin to collect your benefits.
  • Retirement Planners helps you find the ideal retirement age and estimate life expectancy and the amount of your benefits when you begin to collect. You are able to see what the financial effect of retiring at different ages will be, and how various earning amounts will affect future benefits.

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The city currently reimburses retirees the cost of their premiums for MedicarePartB, which covers outpatient care, and also pays for a supplemental “Medigap” plan to insure for services not covered by traditional Medicare. Premiums for Medicare Advantage are often lower than in traditional Medicare. The fee is 10 percent of your Medicare Part B premium for every 12-month period you went without coverage. So, 1 year equals 10 percent, 2 years equals 20 percent, and so on. You owe the penalty for the entire time you have Medicare. The standard Part B premium is $170.10 in 2022. To calculate the penalty, multiply the standard premium by 10. In 2011, the monthly Part B premium, which is deducted from Social Security checks, is $115.40, although for some higher-income earners, the amount is more. As to your question about taking your Social Security benefits at 66 and continuing to work full time, you are free to do so. Once you have passed your full retirement age, you can earn as. Mayor Bill de Blasio and Labor Relations Commissioner Renee Campion recently announced an agreement with the Municipal Labor Committee to implement the NYC Medicare Advantage Plus Program, a custom program for City retirees, beginning Jan. 1, 2022. The agreement stems from the June 2018 Health Savings Agreement which established a Tripartite.

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Baruch College | One Bernard Baruch Way 55 Lexington Avenue | New York, NY 10010 646-312-1000 | 646-312-1000.

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Important Update On The Nyc Medicare Advantage Plus Plan For Retirees

EmblemHealth remains committed to supporting you and providing the New York City workforce and its retirees with high-quality coverage.

All City of New York retirees will continue to remain in their current plans until we are informed of any changes by the City of New York and Municipal Labor Committee.

As more information becomes available, we will continue to update this page. Read more updates here.

Questions About Your Irmaa Or Medicare Part B Reimbursements

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Medicare Part B 2021 Reimbursement

Medicare-eligible retirees and their Medicare-eligible dependents will be reimbursed annually for the standard Medicare Part B amount of $148.50 per month , excluding any penalties and late enrollment fees, and subject to be pro-rated.

Medicare Part B reimbursements were issued in April 2022. Please check your bank account/statement .

If you already submitted your Medicare Part A & B card to the Health Benefits Program, this payment is automatic and you will receive it annually.

Medicare Part B 2020 Reimbursement

Medicare Part B 2020 reimbursements were issued in April 2021. Please check your bank account/statement for your payment.

If you already submitted your Medicare Part A & B card to the Health Benefits Program, this payment is automatic and you will receive it annually.

Medicare Part B 2019 Differential Reimbursement

Please note that if you were Medicare-eligible prior to 2016, you must complete the Medicare Part B Differential Form for 2019 in order to receive the Medicare Part B differential payment. The payment was based on the amount that you paid in 2019.

If you were enrolled in Medicare Part B effective after 2016, then you are already receiving the full payment and do not need to complete the Medicare Part B Differential Form.

Medicare Part B 2019 differential reimbursements were issued in March 2021. Please check your bank account/statement for your payment.

IRMAA 2021 Reimbursement

IRMAA 2020 Reimbursement

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Dc 37 Health & Security Plan Benefits

Important Information for DC 37 Members About to Retire

For medicare-eligible* retirees who are eligible to receive a pension from NYCERS/BERS/TRS/NYSERS/CIRS* Medicare-eligible = age 65 and/or disability


You must be a DC 37 member, Medicare eligible, and be pension eligible under NYCERS/BERS/TRS/NYSERS/CIRS.

City Health Insurance

You may wish to refer to the City of New Yorks Health Benefits Program Summary Program Description booklet.

Complete a Health Benefits Application form.

Apply for Medicare Parts A and B at your nearest Social Security office. If you are retiring before or at the age of 65, ` apply for Medicare Parts A and B in the three months before your 65th birthday. You will not be eligible for Medicare Parts A and B until you reach your 65th birthday.

When you retire and are age 65 or over, you must have Medicare Parts A and B to continue your City health insurance. The premium cost of Medicare Part B will be taken out of your Social Security check. When you retire, you and your eligible dependents will be reimbursed for the cost of Medicare Part B once a year.

City of New York40 Rector Street, 3rd FloorNew York, NY 10006 513-0470


Medicare is the primary health insurance for retirees age 65 or over . City health insurance is the secondary health insurance. If you are retired and receiving Medicare Parts A and B, you may choose a supplement to Medicare or a Medicare + Choice health insurance plan.

Social Security

What You Need To Know To Make A Decision




In response to a Temporary Restraining order, the New York City Office of Labor Relations changed the opt out and enrollment dates to the end of March. Leon E. Frank, the judge who issued a Temporary Restraining Order, determined that the original enrollment guides were inaccurate or incomplete in several areas and Instructed the City to notify all municipal retirees of errors in the original MA+ material, telling them how to obtain a corrected enrollment guide.

Below are links to the original guides:






If you opt out of the Alliance Medicare Advantage plan in order to continue with your current NYC health care plan, you will have to pay a monthly premium . Click here to see the rates on the NYC Office of Labor Relations website. Note that you will NOT be paying for prescription drug coverage since that is already covered by the PSC CUNY Welfare Fund.


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How To Contact Olr

Employee Benefit Program client service walk-in centers remain closed to visitors. Retiree Health Benefits, the Deferred Compensation Plan, Flexible Spending Accounts Program and the Managment Benefits Fund can be reached via email. Please see below for additional information.

To Update Your Part B Reimbursement For Premiums Paid During The 2021 Calendar Year:


Please submit a copy of your:

  • Social Security New Benefit Amount statement for 2021 or
  • Form SSA 1099 for 2021 or
  • First Medicare monthly or quarterly billing statement for 2021

We recommend that you redact or avoid providing any personal identifiable information such as your address, birthdate, and all but the last four digits of your Social Security Number from the documents before you submit them. If the document does not have the last four digits of your SSN, please include that at the top of your documents. Please send all documents to LAFPPs Medical & Dental Benefits Section via:

  • Email to:
  • Fax to: 628-7782 or
  • Mail to: Department of Fire and Police Pensions, Attn: Medical & Dental Benefits, 701 E. 3rd Street, Suite 200, Los Angeles, CA 90013

Due to the anticipated high volume of submissions, it may take at least two to three months to process your Part B documentation and update your reimbursement amount on your LAFPP pension payment.

As a reminder, Part B reimbursement only applies to Retired Members or Qualified Survivors who are eligible for an LAFPP health subsidy and are enrolled in both Medicare Parts A and B. Any additional Part B fees or penalties charged by CMS are not eligible for reimbursement.

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Court Rules Retirees Can Keep Current Insurance Free Of Charge As Alternative To A Planned Cost

Retired municipal workers workers celebrate outside City Hall a legal victory protecting their healthcare benefits.

Ben Fractenberg/THE CITY

A years-long fight over a planned cost-cutting change to retired city employees health coverage reached a critical juncture Thursday with a judges decision that allowsretirees to choose to keep their current plan.

The ruling from Judge Lyle Frank in Manhattan state Supreme Court allows a joint city-union effort to shift retired municipal workers health coverage from traditional Medicare to a privatized Medicare Advantage program by April 1 to proceed. But the city must now let current and future retirees opt out of the shift and maintain their current health care free of charge.

The ruling was a partial win for the city, which under former Mayor Bill de Blasio reached agreement with municipal unions to pursue the Medicare switch and other cost savings as existing workers sought raises.

But its also a victory for the group of retirees who sued to stop the switch, citing fears of higher costs, smaller networks, and greater administrative obstacles to accessing health care and preferred doctors under the new plan.

Especially for retirees at the lower end of the citys pension scale, which bottoms out around $15,000 a year, that cost threatened a significant financial burden.

A spokesperson for City Hall said We are reviewing the courts decision and evaluating our options.

Medicare Part B Premium Reimbursement For 2022

SPECIAL NOTICE: This article only applies to Retired Members and Qualified Surviving Spouses/Domestic Partners of the Los Angeles Fire & Police Pension Plan.

The Centers for Medicare and Medicaid Services has increased the standard Medicare Part B monthly premium to $170.10 effective January 1, 2022 however, you may pay a different amount determined by CMS.

  • If you are a new Medicare Part B enrollee in 2022, you will be reimbursed the standard monthly premium of $170.10 and will only need to provide a copy of your Medicare card.
  • If you received a Medicare Part B reimbursement of $148.50 or less on your pension check in 2021, you will need to provide documentation to update your Part B reimbursement amount for 2022.
  • If you have been receiving a Part B reimbursement that is lower than your basic Part B premium, you may be retroactively reimbursed for your Part B premiums for up to 12 months.

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Nyc Health Benefits Program

Welcome to the Employees Benefits Program Secure File Upload. You can use this service to send documents securely. All transfers are confidential and SSL encrypted. Once you select the topic below you will be able to enter your information on the next page and to attach your document for submission to the Employee Benefits Program. Please allow 30-45 days from the day you submit your document for them to be processed. Coverage will be retroactive to the effective date of retirement. Please do not submit your forms more than once, as that will only slow down the processing of all forms.Please note: Employees should contact their agency health benefits/payroll office or 1) NYCAPS Central by Phone 487-0500 or email at or or 2) Department of Education employees can contact HR Connect at 935-4000 or email: HRCONNECTBENEFAX@SCHOOLS.NYC.GOV, or 3) H + H employees can contact Shared Services at 458-5634 or

If you are having problems uploading please see the tutorial HERE.

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Retiree Health Benefits Program

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Retiree Client Service Center Update: The Retiree Health Benefits Program is happy to announce that it has overhauled its Direct Customer Service Department in order to improve the call center and re-establish the walk-in center as follows:

Effective Immediately: Retirees can speak with a Client Service Representative between 10am and 4pm, Monday through Friday, except holidays, by calling 513-0470. Additional staff have been added to assist callers.

Effective November 2022: The Health Benefits Retiree Client Service Walk-in Center will open in November by appointment only. It remains closed to walk-in visitors. Please check back for updates on how you can make an appointment and for further information.

Please submit your documents as follows:

1) Forms and documents can be submitted electronically using the following link:

For detailed instructions on how to submit your form/document securely through LeapFile and to view a short video, click here.

Please do not submit your form/document more than once. This will only delay processing.

You will immediately receive notification stating “Success! Your file has been received” upon completion of your document upload. You will not receive a separate email confirmation.

2) Forms and documents can also be mailed to:

NYC Office of Labor RelationsHealth Benefits Program22 Cortlandt Street, 12th FloorNew York, NY 10007

3) Forms and documents can also be faxed to: 306-7373

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