Enrollment Instructions for Medicare HMOs
Because of certain rules set up by the Federal Government a retiree wishing to enroll in a Medicare HMO must contact the HMO directly, and request a special application to join that plan. When you enroll directly with a Medicare HMO make sure that you inform the health plan representative that you are a "City of New York" retiree. If your spouse is also covered by you for health benefits, make sure that he/she also completes an enrollment application. Both the retiree and the covered dependent(s) must be enrolled in the same plan under the City's program. Send a copy of that application to the City of New York Health Benefits Program, 40 Rector Street, New York, New York 10006. A copy of the application is needed by the Health Benefits Program (HBP) in order for HBP to update its files and to make sure that the correct deductions, if applicable, are taken from the retiree's pension check.
Medicare HMOs are those in which medical and hospital care is only provided by the HMO. Any services, other than emergency services, that are received outside the HMO, that have not been authorized by the HMO, will not be covered by either the HMO or Medicare. Any costs incurred would be the responsibility of the enrollee.
You cannot enroll in any of the Medicare HMOs listed below through the Health Benefits Program. You must obtain a special enrollment application directly from the health plan.
The following plans are approved Medicare HMOs:
|New York Metropolitan Plans
||Plans Available Outside the New York Metropolitan Area
|Aetna Golden Medicare 10 Plan
||Aetna Golden Medicare10 Plan
|AvMed Medicare Plan
|HIP VIP Premier Medicare
||BlueCross BlueShield of Florida Health Options, Inc.
|Health Net SmartChoice
||CIGNA HealthCare for Seniors
MediBlue HMO Plus 2007
(Formerly Empire Senior Plan Direct Plus)
|Humana Gold Plus Plan
|Secure Horizons/Oxford Health Plans
(Formely Oxford Medicare Advantage)
- Medicare-eligible retiree premium costs (if any) for each plan are listed on the rate page.
- If a Medicare-eligible retiree is enrolled in a Medicare HMO or a Medicare supplemental plan and has non-Medicare eligible dependents, the corresponding plans in the Health Maintenance Organization Section and the Exclusive Provider Organization, Participating Provider Organization, Point of Service Sections provide benefits for those dependents.
- Medicare-eligible retirees should refer to "City Coverage For Medicare-Eligible Retirees." This section contains additional information about Medicare enrollment rules, regulations, and guidelines.
- Medicare-eligible retirees who are enrolled or wish to enroll in a Medicare HMO should refer to "Special Provisions for Medicare Eligible Employees" for important enrollment information.
See the rate page
Learn more about City Coverage for Medicare-Eligible Retirees