MonroeCounty.gov; Cheryl Dinolfo, County Executive

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It's Time to Choose Medicare Coverage

  1. The Retiree HRA Plan for Medicare Eligible County Retirees

  2. Medicare Concierge Service

  3. Advantages of the Retiree HRA Plan

  4. How to enroll in Medicare Coverage

  5. 2019 Medicare Annual Election Period - Oct 15 to Dec 7

  6. Monroe Retiree Medicare Assistance Program (MR MAP)

  7. Frequently Asked Questions (FAQs)

  8. Important Documents

  9. Insurance Carrier Contact Information

  10. How to use your HRA Card

  11. More Benefits Information

Medicare Retiree Health Reimbursement Account (HRA) Plan

Medicare eligible County retirees and/or dependents are covered by the County's Retiree Health Reimbursement Account (HRA) Plan, but upon becoming Medicare eligible County retirees and/or dependents are no longer eligible for coverage under the terms of their prior plan and MUST elect Medicare Parts A & B AND enroll in a Medicare plan of their choosing.

Many retirees have asked whether the County could provide more choice for Medicare coverage - and now we do. 

Medicare eligible County retirees and/or dependents have the freedom to choose from any Medicare coverage available in their area so they can select one that best fits their personal medical situation. Many Medicare plans are available for $0 premiums, or they can "buy up" to more expensive coverage using their HRA funds.

In addition to a Medicare plan of their choosing they will be covered by a County funded Retiree Health Reimbursement Account (HRA) Plan. The Retiree HRA Plan is an account and debit card which is administered by a professional third party administrator, Health Economics Group (HEG).

The Retiree HRA Plan provides the flexibility and freedom to choose any Medicare coverage available in their area. They can select the coverage that fits their medical needs, their residence, budget, and any other criteria important to them.

A Retiree HRA is an IRS-approved, County-funded, tax-advantaged health benefit plan that reimburses for insurance premiums, out-of-pocket medical expenses, dental and vision expenses.  HRA funds can be used to “buy up” to more expensive plans or unspent funds can be rolled over from year to year. The HRA moves with the retiree if they relocate out of the Rochester area.

Retirees may continue to obtain insurance through Excellus (including a $0 premium plan), but now have the freedom to pick among plans from MVP, United Healthcare and Aetna, as well as the other insurance carriers offering Medicare coverage where they live. The LifeSpan summary comparison chart lists Medicare Advantage plans available in the Rochester area.

With the new freedom of choice afforded by the Retiree HRA Plan, retirees and/or dependents must take action to ensure continued coverage.

Retirees and/or dependents Must:

  1. Enroll in Medicare Parts A & B
  2. Enroll in a Medicare Plan of their choosing (according to Federal rules the County can not enroll a retiree on their behalf)

Medicare benefit levels are subject to Federal approval and annual change. County health insurance policies are subject to changes in coverage and benefits, and in some instances termination. Monroe County is pleased to be able to provide you with a Retiree HRA Plan, but the County does not guarantee coverage or any specific plan(s) or level of benefits. The County has always selected the post-Medicare coverage for retirees. While County unions do not represent retirees, we have informed the various unions that represent active employees of this new flexible retiree health plan.

Free Medicare Concierge Service

Monroe County knows that enrolling in Medicare and choosing a new plan can be complicated. That is why we have selected Health Economics Group (HEG) and NY Medicare Specialists to provide free Medicare Concierge Services to retirees who are Medicare eligible or who are approaching Medicare eligibility. The free concierge service can be provided in person 1-on-1, in a group, via telephone or online.

Medicare Concierge Services through Health Economics Group (HEG) and NY Medicare Specialists offer the following level of services:

  • INFORMATION on the advantages of the Retiree HRA plan and how it works
  • EDUCATION and guidance in choosing a Medicare plan
  • ADVICE on enrollment in Medicare Parts A & B
  • ASSISTANCE with Medicare claim appeals

Advantages of the Retiree HRA Plan

  • Retiree select the Medicare coverage that's right for them.
  • The County annually funds the HRA ($600* in 2018 & 2019).
  • $0 premium plans are available.
  • The HRA moves with the retiree if they relocate out of the Rochester area.
  • HRA funds can be used to “buy-up” to more expensive plans.
  • If the retiree's plan costs less than the HRA funding amount, they can use the excess to pay for co-pays and other IRS allowable expenses like dental and eye care.
  • Unspent funds in the account may be rolled over from year to year.

* Retirees who become Medicare eligible mid-year will receive a prorated amount of full annual HRA allocation. e.g. if a retiree becomes Medicare eligible in April, they would receive 9/12th of the amount ($450 for the remainder of 2018). Retirees who were required to contribute to the cost of healthcare benefit will not receive the full HRA allocation. e.g. The HRA of retiree with a 15% contribution toward the cost of their retiree healthcare would be funded at $510 ($600 minus 15%).

2019 Medicare Annual Election Period - Oct 15 to Dec 7

Your health can change each year, which is why it’s important to examine your health care coverage to make sure it meets your needs. For example, are you taking any new prescription drugs? Do you have wellness goals for this year? Is your doctor in the network? Don’t miss your window to select or change your Medicare plan...

The Medicare Annual Election Period (AEP) runs from October 15th through December 7th. During this time you can sign up for a plan or change plans. ARE YOU... UNSURE of what benefits your current health plan offers? CONFUSED about your Annual Notice of Change letter? INTERESTED in comparing plans from regional and national carriers? There may be a plan that will be even better for you! Attend a Monroe County Retiree information session to learn more about your HRA benefits and meet with an independent licensed agent who can provide you with a one-on-one, no-obligation assistance in choosing a plan that fits your needs. This free service is being offered to you by Monroe County. For more information vist the Medicare Concierge website.

MEDICARE 1-on-1 consultation includes: REVIEW of your current situation - Current medications, including any changes - Frequency of doctor visits - Your preference for regional or national insurer RECOMMENDATION on which plan is best for you ASSISTANCE with facilitating new plan enrollment LEARN ABOUT UPCOMING CHANGES AND ALL YOUR MEDICARE OPTIONS FOR 2019, INCLUDING ONES NOT PREVIOUSLY AVAILABLE.

2019 Medicare AEP Brochure

Information Sessions: 

Stop by through the day and learn about your Retiree HRA and to meet one-on-one with an independent licensed agent. Free Parking.

Location: Rick’s Prime Rib House 898 Buffalo Road, Rochester, NY 14624 Date: October 15th, 9am – 4pm

Location: Monroe Community Hospital 435 East Henrietta Road, Rochester, NY 14620 Dates: October 17th, 10am – 4pm November 2nd, 9am – 4pm November 12th, 9am – 4pm

Location: Greece Canal Park Millennium Lodge 241 Elmgrove Road, Rochester, NY 14626 Dates: October 22nd, 9am – 4pm

Location: Town of Irondequoit Senior Center 154 Pinegrove Avenue, Rochester, NY 14617 Dates: October 18th, 9am – 4pm November 1st, 9am – 4pm

Location: Town of Parma Town Hall 1300 Hilton Parma Road, Hilton, NY 14468 Dates: October 26th, 9am – 3:30pm November 9th, 9am – 3:30pm

Location: Town of Penfield Recreation Center 1985 Baird Road, Penfield, NY 14526 Dates: November 7th, 10:30am – 4pm November 14th, 10:30am – 4pm

Location: Town of Perinton Town Hall 1350 Turk Hill Road, Fairport, NY 14450 Dates: October 24th, 9am – 4pm

    Monroe Retiree Medicare Assistance Program (MR MAP)

    Medicare eligible Monroe County retirees and their eligible spouses facing financial hardship can qualify for additional help with Medicare expenses through the County’s Monroe Retiree Medicare Assistance Program (MR MAP).

    Medicare eligible retirees/spouses can qualify for MR MAP based on financial hardship in one of two ways, either:

    1. Having an Adjusted Gross Income (AGI) of 130% of the Federal poverty guideline (commonly known as the FPL , or Federal Poverty Level), or
    2. Enrollment in a Federal Medicare Savings Program (MSP).

    Retiree HRA Plan FAQs (frequently asked questions)

    Q: What is a retiree HRA?

    A:  A Retiree Health Reimbursement Account (HRA) is an IRS-approved, County-funded, tax-advantaged health benefit plan that reimburses retirees for health insurance premiums, out-of-pocket medical expenses, dental and vision expenses. A Retiree Health Reimbursement Account allows the County to make contributions to a retiree's account and provide reimbursement for eligible expenses. A retiree HRA plan is an excellent way to provide health insurance benefits and allow retirees the flexibility to pay for a wide range of medical expenses.

    Q: What kind of expenses can be paid for with the Retiree HRA Plan?

    A: The Retiree HRA Plan is designed to allow for reimbursement of insurance premium of Medicare coverage chosen by the retiree. In addition, they can use it to be reimbursed for medical co-pays and dental and vision expenses, as well as many other IRS approved medical expenses. Click for a list of eligible expenses.

    Q: How does the HRA Card work with the Retiree HRA Plan?

    A:  The Retiree HRA Plan is administered by a professional third party administrator, Health Economics Group (HEG). The retiree and/or dependent will receive an HRA Card linked to their account that works like a credit card for medical costs. The HRA Card can be managed online.

    Q: What is my deadline to enroll in Medicare Past A & B and enroll in a Medicare Plan?

    A: County Retirees and/or dependents MUST be enrolled in Medicare Part A & B AND enroll in a Medicare plan of their choosing prior to their Medicare Effective Date. For information about Medicare Effective dates, please visit   Medicare's "Getting Started with Medicare" link.

    Q: How do I enroll in Medicare Part A & B?

    A:  Please visit the Medicare.gov for information on how and when to enroll in Medicare Part A & B. Their link "Getting Started with Medicare" contains useful information for Medicare eligible retirees and/or dependents. For assistance with understanding the enrollment process the County's free Medicare Concierge Service is available to you. 

    Q: How do I enroll in a Medicare Advantage Plan?

    A:  The Retiree HRA Plan gives you the freedom to choose any federally approved Medicare coverage available in your area. You MUST enroll in Medicare Parts A &B first and then you choose extra coverage in 3 easy ways:

    1. Enroll online or in person through th County's free Medicare Concierge Service.
    2. Enroll through the official Medicare website and choose from all available plans in your area.
    3. Enroll online or in person with any Medicare insurance carrier doing business in your area.
    4. Enroll with a Federally licensed Medicare enroller. The choice is yours!

    Q: How do I get help choosing the right Medicare coverage?

    A: With the freedom to choose comes the responsibility to make a selection and enroll in the coverage that is right for you. Monroe County is providing many options to help you choose.

    1. The County provides a free Medicare Concierge Service to help you enroll in Medicare and select the coverage that's right for you.
    2. Medicare.gov has a step-by-step process for choosing the coverage that’s right for you.
    3. Lifespan provides a side-by-side Medicare coverage comparison chart and offers education and assistance in person, online and over the telephone.
    4. Insurance carriers can be contacted directly for assistance.
    5. Federally licensed Medicare enrollers can answer questions for you.

    Q: What happens if I don't enroll in Medicare Parts A & B?

    A: When a County retiree and/or dependent becomes Medicare eligible they are no longer eligible for coverage under the terms of their prior medical plan and MUST elect Medicare Parts A and B AND enroll in a Medicare plan of their choosing. If the retiree and/or dependent fails to enroll in Medicare Parts A & B they will be without health insurance coverage.

    Q: What happens if I don't enroll in a Medicare Plan?

    A: If a retiree and/or dependent enrolls in Medicare Parts A & B but fails to enroll in a Medicare plan of their own choosing, the Federal government will default them to traditional Medicare, which does not include drug coverage. Federal regulations prevent the County from enrolling a retiree/dependent on their behalf. They will not be enrolled in a Medicare Advantage plan if they do not choose a plan.  They are receiving HRA funds from the County but the County is not enrolling them in an insurance coverage. 

    Q: Is the County retiree dental insurance changing?

    A:  No. The County retiree dental insurance is not impacted by the Retiree HRA Plan. Your dental coverage is not changing. If you presently have retiree dental insurance through the County, this benefit continues.

    Q: What if I still have questions?

    A:  Call our Benefits Unit at 585-753-1732 (M-F, 9-5) or our free Medicare Concierge Service.

    Important Documents

     

    Insurance Carrier Contact Information

    You can enroll in Medicare coverage directly with any insurance company you choose.

    If you have additional questions, please contact our Benefits Unit at 585-753-1732 (M-F, 9-5) or email HRbenefits@monroecounty.gov.

    How to Use Your HRA Card

    More Benefits Information

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    County Holiday Schedule

    Please plan accordingly

    Monroe County will observe the following holidays.

    • New Year's Day
      Tuesday, January 1, 2019
    • Martin Luther King, JR. Day
      Monday, January 21, 2019
    • Presidents Day
      Monday, February 18, 2019
    • Memorial Day
      Monday, May 27, 2019
    • Independence Day
      Thursday, July 4, 2019
    • Labor Day
      Monday, September 2, 2019
    • Columbus Day
      Monday, October 14, 2019
    • Election Day
      Tuesday, November 5, 2019
    • Veterans' Day
      Monday, November 11, 2019
    • Thanksgiving Day
      Thursday, November 28, 2019
    • Day After Thanksgiving
      Friday, November 29, 2019
    • Christmas Day
      Wednesday, December 25, 2019