Eligibility and Enrollment

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Medicare eligibility and enrollment are managed by the Social Security Administration (SSA), while the Medicare program is administered by the Centers for Medicare and Medicaid Services (CMS). See the Contact Social Security and Medicare page for agency phone numbers, operating hours, and website and email links.

County Employee Eligibility

  • Employees hired prior to March 31, 1986, do not contribute to Medicare but might still qualify for Medicare through other means, such as through a spouse/ex-spouse, Social Security disability, or Social Security-covered outside employment.
  • Employees hired after March 31, 1986 contribute toward Medicare benefits through a deduction known as the federal Health Insurance Tax (H.I.T). and may be eligible for benefits.
  • Plans G and Safety C contribute toward and are required to sign up for Medicare benefits at age 65.

Enrollment Deadlines

You should apply for Medicare as soon as you are eligible to avoid late enrollment penalties. Medicare late enrollment penalties are 10 percent of your premium for each year that you are over age 65 and did not enroll.

65th Birthday

Social Security requires you to enroll in Medicare three months before or after your 65th birthday. Three months before your and/or your eligible dependent’s 65th birthday, LACERA will send you notification of the requirements to enroll in a LACERA-administered Medicare plan. The notification will request information about your eligibility (or ineligibility) to enroll in Medicare, which you will need to obtain from Social Security.

If you enroll in Medicare within your 65th birthday time window, your coverage is effective the first day of the month that you turn 65. If you don't enroll during that period, you must wait until the general enrollment period, which is January 1 to March 31 each year, and Social Security will assess the late enrollment penalties.

General Enrollment Period

According to Social Security, if you are over 65 you can sign up between January 1-March 31 each year. This is called the General Enrollment Period. Your coverage starts the month after you sign up. You might pay a monthly late enrollment penalty, if you don’t qualify for a Special Enrollment Period.

Late Enrollment Penalties

Medicare late enrollment penalties are substantial: 10 percent of your premium for each year that you are over age 65 and did not enroll.

When you enroll in Medicare Part A, you will be automatically enrolled in Medicare Part B unless you decline it. If you decline Part B coverage when eligible and decide to enroll later, according to Social Security you may have to pay the late enrollment penalty for as long as you have Part B coverage, unless you qualify for a special enrollment period.

The County reimburses members and/or their eligible dependent for Medicare Part B premiums (up to the standard rate only, as set by Social Security) on a tax-free basis, provided they meet the requirements. However, if you are a late enrollee in Medicare Part B and pick one of the plans eligible for reimbursement, the County will not reimburse the penalty portion of the Part B premium.

How to Enroll

Visit the Contact Social Security and Medicare page for website links to check your eligibility, set up an account, and enroll, if eligible. LACERA will also send you notification before your or your eligible dependent's 65th birthday with further details on how to sign up.