July > Special ANNUAL ENROLLMENT Edition for UT System Employees > Know Your Benefits

Know Your Benefits

UT SELECT Medical and Medicare

Should I Enroll In Medicare? Which Parts? And When?
All University of Texas System retired employees and their eligible dependents are urged to enroll in Medicare Part B as soon as they become eligible, either at age 65 or possibly sooner due to disability.* Your application can be made beginning up to three months before turning 65 and should be completed early so that coverage will be effective on the first of the month in which you turn 65.

Upon becoming eligible for Medicare, retirees and their Medicare-eligible dependents do have the option to enroll only in Medicare Part A (inpatient care insurance, available at no cost) and declining or postponing enrollment in Medicare Part B (coverage for physician and outpatient services, which requires a monthly premium). However, it is important to keep in mind that once you do become eligible for Medicare, your UT SELECT benefits will be paid as if you are enrolled in Part B. This means that you will be responsible for either enrolling in Part B or for paying the portion of your medical claims that Part B would have paid.

Once eligible, you also have an option to enroll in a Medicare Part D Prescription plan for an additional premium. Because UT SELECT provides robust prescription benefits and qualifies as credible prescription drug coverage, UT System continues to strongly discourage most eligible retirees from enrolling in a Part D plan. Only a very small number of retirees who qualify for a “low-income subsidy” through Medicare should consider enrolling in Part D. UT System remains committed to providing you with the best possible prescription drug coverage and to helping you make informed choices about your prescription drug benefit.

How Medicare and UT SELECT Coordinate
If you are retired and you (and/or your dependent) are also eligible for Medicare, Medicare is considered the primary payer and pays your medical claims first; UT SELECT pays second. This means that UT SELECT claims will be processed assuming that the Medicare Part B portion has already been paid. Premiums for retirees and their dependents are maintained at the same level as active employees based on this benefit design and taking into consideration the generally higher medical needs that people have as they age. Therefore, no additional benefits can be made available for those retirees (or their dependents) who are Medicare-eligible, but do not enroll in Part B.

As a Medicare-eligible retiree or dependent, if you choose a Blue Cross Blue Shield of Texas (BCBSTX) provider who accepts Medicare assignment, you will not be held responsible for payment of any charges above the Medicare allowed amount. You can keep your out-of-pocket costs down by choosing providers who participate in both plans and you will often pay no out-of-pocket costs for medically necessary services. For more information, please review the UT SELECT / Medicare Coordination information in the Handbook for Retired Employees.

In order to ensure that claims are correctly processed, you should contact BCBSTX immediately upon enrollment in Medicare and report the Medicare Health Insurance Claim (HIC) number for yourself and for any Medicare-eligible dependents on your UT SELECT coverage, along with the effective dates of Medicare Parts A and B. Also, please be sure to provide both your Medicare and UT SELECT enrollment information to any medical providers that you or your dependents obtain services from.

Failure to Enroll
As a retiree, if you (or your Medicare-eligible dependent) do not enroll in Medicare Part B coverage when you first become eligible to do so, you may have to pay a higher premium upon enrollment in Part B coverage. Additionally, without Part B, you will be responsible for paying the part of your (or your dependent’s) medical claims that Part B would have otherwise paid as noted above.

Working Retirees
In most instances, if you are eligible for Medicare and are working in a benefits-eligible position with a UT institution, UT SELECT Medical will be the primary plan for you and your dependents with Medicare paying secondary. There are some instances though where this is not the case due to federal coordination rules associated with particular medical conditions.*

For working retirees who choose to postpone enrollment in Part B because of these coordination rules, you can generally avoid paying higher premiums for Medicare Part B by enrolling promptly as soon as you know that you are no longer going to be employed in a benefits-eligible position at a UT institution. Contact your local Social Security Administration office for additional information about the special enrollment period when ceasing active employment.

*Medicare may be primary for some Medicare-eligible active employees or their spouses who have certain medical conditions. Consult with your local Social Security Administration office to learn what illnesses qualify for Medicare coverage prior to turning age 65.