Q: I am in my 50s and receive a monthly pension. I also receive a monthly Social Security disability payment. After I receive those disability payments for 24 months, I will become eligible for Medicare A & B. How am I covered under the city’s medical plan before Medicare starts? Does it change after Medicare starts, including my prescription drugs?

A: During the 24-month wait: Your HMO or PPO is your only health plan. You use the plan as you used it before retirement. In the HMO, your PCP directs your healthcare; in the PPO, you self-select your health-care provider. If you use network providers, the plan pays higher benefits.

With Medicare: The HMO and PPO plans require you to enroll in parts A and B. In 2006, Part B costs $88.50 per month. Medicare is your primary health plan and pays on your medical bills first. Your HMO or PPO pays second. To receive HMO or PPO benefits and prescription drugs, you follow the plan’s rules. Medicare has approved the city’s prescription benefits as “creditable,” which means the benefits are equal to or better than Medicare D plans. You don’t have to pay a monthly premium for a Medicare D prescription drug plan.

Without Medicare parts A & B:Medicare will not pay any of your medical bills. You will pay your deductibles, some coinsurance plus the amount of your medical bills that Medicare would have paid.

Examples:

The HMO requires you to pay a $20 copayment when you visit your PCP. If you are not enrolled in Medicare B (outpatient), you will pay Medicare’s outpatient annual deductible of $124 plus at least 80 percent of the doctor’s bill.