Human Resources

Benefits-Medicare

  • I am a pre 97/98 hire. Do I retain the same retiree health benefits when I retire?

    Yes, you currently retain the same benefit provided by contract. However, the actual benefit plan design is subject to future changes that may take place during labor negotiations with the bargaining units. Upon retirement, employees hired prior to 97/98 are not required to enroll in Medicare but are strongly encouraged to do so. If Medicare is primary to your Washoe County Health Plan, it helps defray future claims costs, which in turn helps to keep premium rates down. Increased premiums impact plan design which could result in increased out-of-pocket expenses to employees and retirees.
  • How do I find out more information about the Medicare Advantage Plan?

    You may contact the Chris Gourlay at Senior Care Plus, at 775-982-3134. Inform him that you are a retiree of Washoe County.
  • What is the Medicare Advantage Plan?

    The HMO Medicare Advantage Plan was added to the Washoe County Retiree Health Benefits Program in FY 10/11. The coverage is provided through Senior Care Plus, and is available only to those retirees and their dependents with both Medicare parts A and B. Please note that enrollment occurs only on the first of each month.
  • I am over 65 and covered under a COBRA policy. Is COBRA considered creditable coverage?

    No. Regardless of your insurance coverage, you must enroll in Medicare within the 8-month Special Enrollment Period immediately following termination of your employment.
  • Who do I contact for more information on Medicare?

    Information is available on the Medicare website http://www.medicare.gov or you can contact the local Social Security Office at 1-888-808-5481; 1170 Harvard Way, Reno, NV 89502.
  • How much does Medicare cost?

    In general, there is no premium associated with Medicare Part A. There is a premium associated with Medicare Part B. Please contact Medicare for information on Medicare Part A and B premiums.
  • How do I know if I’m eligible for Medicare?

    You are eligible for Medicare if you are 65 or older and you OR your spouse worked and paid Medicare taxes for at least ten years. When an individual who has not paid Medicare taxes applies for Medicare (assuming the spouse has), they simply provide their spouse’s information in addition to their own.

    Federal employees began paying the Medicare payroll tax in 1983 and all newly hired state and local employees (including Washoe County) began doing so in 1986. Thus, most government employees and retirees are now eligible.

  • Can I enroll in Medicare at any time?

    If you did not sign up when you were first eligible because you are still working and covered under the County’s group plan, you can enroll anytime. After your employment ends, you can enroll anytime during the 8-month Special Enrollment Period or during Medicare’s regular Open Enrollment Period which runs from January – March each year for a July 1st effective date.

    Please note: if your active employment ends and you do not enroll during the Special Enrollment Period you may have to pay a higher premium for late enrollment.

  • How does Medicare pay for medical services?

    Hospitals and community mental health centers are paid a set amount of money (called the payment rate) to give some outpatient services to people with Medicare. The payment rate includes:

    • Medicare’s payment amount for the service you receive
    • Your yearly Medicare Part B deductible if you haven’t already paid it for the year. This amount can change each year.
    • Your co-payment amount or co-insurance

    The payment rate is not the same for all hospitals and community mental health centers. The payment rate for a hospital or community mental health center is a national rate adjusted to reflect what people are paid to work in hospitals in the area where you get services. Each January 1, Medicare updates the payment rates to keep up with changes in the cost of providing services.

  • I have a spouse who qualifies for Medicare. If I retire at 66 or older, will I be penalized for not enrolling in Medicare at age 65?

    No, because the County’s insurance is creditable coverage. Medicare provides an 8-month Special Enrollment Period in which you can sign up for Parts A and B after your employment ends. If you enroll after the 8-month period, you will face late enrollment penalties.
  • Do I need to notify you when I am eligible and enroll in Medicare?

    Yes. If you notify us upon receiving your Medicare identification card and providing us with a copy, it may lower your premium rate. In addition, we will notify the plan administrator (Homeown Health or Prominence Health Plan) which could alleviate issues relating to the payment of claims.
  • Is there another Plan option available if I have Medicare?

    Yes. The Medicare Advantage Plan was added to the Washoe County Retiree Health Benefits Program in July, 2010. Coverage is provided through Senior Care Plus and is available to those retirees and their dependents with both Medicare parts A and B. This HMO plan is a great option for those retirees who are receiving only a partial premium benefit from Washoe County or who are covering dependents, as premiums are considerably lower. Please note that enrollment occurs only on the first of each month.
  • I am curious about what Medicare Parts A and B will cost me when I retire. Is there some where I can go to research this?

    You can either contact the Medicare’s customer service at 800-633-4227, or you can access one of their premium or eligibility tools on their website: www.medicare.gov
  • Should I enroll in Medicare Part A at age 65 even if I am still employed?

    Yes. Part A is available at no cost, and employees and retirees both should always take advantage of this coverage as soon as you are eligible.
  • What are some of the advantages of enrolling in Part B?

    • Lowers your monthly premium
    • Lowers your out-of-pocket costs over time by eliminating, or greatly reducing, co-insurance/co-payments.
  • Should I enroll in Medicare Part B at age 65 even if I am still employed?

    No, because the County’s insurance is creditable coverage. Medicare provides an 8-month Special Enrollment Period in which you can sign up for Part B after your employment ends. If you enroll after the 8-month period, you will face late enrollment penalties.
  • Do I need to sign up for Medicare Part D (Prescription) coverage?

    No, the Washoe County Plans are equal to or better than Medicare Part D.
  • Do I need to sign up for Medicare when I turn age 65?

    Depending on your original hire date with the County, enrollment in Medicare may or may not be required, and the decision to elect or reject Medicare may impact the way your claims are paid. We strongly encourage all retirees who are eligible for Medicare to take Parts A and B. If you are uncertain about whether or not to elect Medicare coverage, please feel free to contact our office.
  • I have a spouse who will eventually qualify for Medicare, but currently is only 62. I am 65 and want to retire. Can I enroll in Medicare now, even though my spouse is not yet eligible?

    You are eligible to enroll in Medicare A and B if your spouse has paid Medicare taxes for at least ten years.
  • I am already retired from the County and am enrolled in the Retiree Health Benefits Program, but I am still working full-time in the private sector. Do I still need to enroll in Medicare when I turn 65?

    If you are covered under your current employer’s group health plan in the private sector, you may want to delay enrollment in Medicare Part B.  If you are only enrolled in the Washoe County Retiree Health Benefits Program, then you should not delay enrolling in Medicare.  Retiree insurance is not considered “creditable” coverage by Medicare, so if you do not enroll in Part B at age 65 and decide to enroll later, you will be subject to a late enrollment fee of 10% for each 12-month period beyond your original Part B eligibility date.
  • What is Medicare?

    Medicare is a national social insurance program, administered by the federal government since 1965 that guarantees access to health insurance for Americans who are:

    • Age 65 years and older

    • Under age 65 on Social Security Disability Income (SSDI) or diagnosed with certain diseases including End-Stage Renal Disease (ESRD) and Lou Gehrig's Disease (Amyotrophic Lateral Sclerosis or ALS) The original program included:

    • Part A – Hospital Care. Part A is premium-free for most people.

    • Part B – Doctor and Outpatient Care. Part B requires a monthly premium.

    In 2006, the program was expanded to include:

    • Part D – Prescription Drug Coverage. Part D is optional and requires a monthly premium.

Call 311 to find resources, ask questions, and utilize Washoe County services. Learn More »
Call 311 to find resources, ask questions, and utilize Washoe County services. Learn More »