Q: I will be eligible for Medicare in October. How will my HMO medical coverage be affected if I don’t have Medicare Parts A & B? What are my advantages for having Medicare?

A: The city’s medical plans require all eligible members to apply for Medicare. Members should submit their Medicare card showing Parts A & B, or a Declination Letter stating you are ineligible for Medicare. If you are eligible for Medicare but don’t apply, the HMO and PPO plans will not the pay medical expenses Medicare should pay. This means you will pay the HMO copayment or PPO coinsurance plus the amount Medicare should pay. If ineligible for Medicare, you may receive HMO and PPO benefits, but you will pay a higher contribution.

If Medicare covers you, you may enroll in a city-sponsored Medicare Advantage Plan. These attractive plans offer all the benefits Medicare covers, plus more. They compare very favorably with the HMO and PPO plans, but you pay a lower monthly contribution and time-of-service payments than you would under the HMO and PPO for similar services.

See this chart for a plan comparison of contributions and time-of-services fees.