If a covered dependent is not Medicare eligible, click here.
If you or your spouse will turn age 65 during the plan year, your Oncor options will change because you become eligible for Medicare. If this happens, take these steps.
If you are already receiving Social Security retirement or disability benefits, the Social Security Administration (SSA) should contact you a few months before you become eligible for Medicare and give you the information you need. If you live in one of the 50 states or Washington, D.C., you will be enrolled in Medicare Parts A and B automatically. You must pay a premium for Part B coverage.
If you opt out of Part B coverage, you will have a gap in coverage, as the Oncor plans will pay as though you have Part B, regardless of whether or not you are actually enrolled in Part B. If you are not already receiving Social Security benefits, contact the SSA to sign up for Medicare about three months before your 65th birthday. Medicare is effective the 1st of the month in which you turn 65. If your birthday is on the 1st of the month, Medicare is effective the 1st of the preceding month. As soon as you get your Medicare card, call ePeople to give them your Medicare Beneficiary Identifier (MBI).
Once you become eligible for Medicare, you will be defaulted into the Indemnity with Rx medical option. You have 30 days from your Medicare effective date to make a change. If you or your spouse is not eligible for Medicare, you will be enrolled in what is known as a “med-separate” option. The participant who is Medicare eligible will be enrolled in one of the options available for Medicare-eligible participants and the participant who is not Medicare eligible will still be eligible to participate in the medical options available to participants who are not eligible for Medicare until he/she is eligible for Medicare.
After you review your medical options, contact the ePeople Service Center within 30 days of becoming Medicare eligible (turning 65). You should be aware that it takes approximately 45 days for your enrollment in SilverScript to become effective, so the sooner you enroll, the better.
During the call, the ePeople representative will answer your questions and enroll you in an option. If you do not call ePeople, you will be enrolled in the Indemnity with Rx Option for Medicare-eligible participants.
Once you start Medicare, you will have to meet a new deductible when you move into the Medicare-eligible Retiree medical option. Click here for details.
What happens to your Retiree HRA or HSA if you become eligible for Medicare and/or reach age 65?
Retiree HRA: You will continue to have access to your HRA funds. If your spouse has not turned 65, he/she will continue to have access to the account and a new account will be established the following year in your spouse’s name if he/she continues not to be eligible for Medicare.
The old account remains until the balance reaches $0 as long as you are enrolled in an Oncor medical option. If you don’t have a covered spouse on the plan or your spouse is already 65 or over, or Medicare eligible, the account remains there as long as you have coverage under an Oncor medical option until the balance goes to $0.
Retiree HSA: After you turn age 65, you have access to the funds in your account for other expenses, not just medical care.
For more information, refer to IRS Publication 969.
When you become eligible for the benefits for Participants Age 65 or Over (Medicare Eligible), you will receive a SilverScript “Welcome Kit” sent to your home. If you want Oncor’s Prescription Drug Coverage, call SilverScript when you receive the Welcome Kit to enroll right away by instructing them that you are waiving the “opt-out” waiting period.
SilverScript follows CMS guidelines in processing Medicare Part D Prescription Drug Plan enrollments. This process can take up to 60 days. Per Medicare rules, you cannot be enrolled automatically in the Medicare Part D Plan for 21 days after Medicare accepts your application unless you call to accept the plan. Otherwise, SilverScript will default you into the Oncor option at the end of the 21-day period.
You should apply for Medicare three months before you reach age 65. As soon as you get your Medicare card with your Medicare Beneficiary Identifier (MBI), call ePeople and give them your MBI so you can be set up in the Oncor Prescription Drug Program. If ePeople does not have your MBI at least 45 days before the month you turn age 65, your enrollment may be delayed.
Your enrollment confirmation and prescription coverage may not be in place on the first day of your Medicare eligibility due to this requirement. However, if you call SilverScript to confirm that you do want to enroll, you may reduce this delay in implementing your coverage.