Senior Care members—As you may know, $15 copays for the EmblemHealth-GHI portion of the GHI/Anthem Senior Care Plan were previously suspended by court order. Now, in accordance with a more recent court order, $15 copays will resume on January 1, 2025.
Senior Care members will receive a new ID card before January 1, 2025.
As of January 1, 2025, Senior Care members will be required to pay a $15 copayment each time they use the health services listed below:
Please note, that Senior Care members are responsible for the annual Medicare Part B deductible and $50 GHI Senior Care deductible.
For questions, please call the EmblemHealth Customer Service phone number on the Senior Care member ID card.
See letter from EmblemHealth: $15 Copay Letter
Visit the Plans & Rates page of the Health Benefits Program wesbite to review other City’s health plan options for Medicare eligible retirees and their Medicare eligible dependents.
For members who wish to select another health plan, the New York City Health Benefits Program Annual Fall Transfer Period is from November 1, 2024 through November 30, 2024. Information and instructions on how to change plans during the Annual Fall Transfer Period are located on the Retiree page of the Health Benefits Program website.
2023 Medicare Part B reimbursements will be issued beginning with the third week of April 2024.
Please check your bank account/statement (or the mail, if you are receiving a physical check).
Learn more about Medicare Part B Reimbursement
Medicare-eligible retirees and their Medicare-eligible dependents can submit an IRMAA application if they paid above the standard amount of $164.90 per month ($1,978.80 annually). If you did not pay more than the standard amount then you are not eligible for IRMAA.
IRMAA 2023 annual reimbursements were issued during the 3rd week of October 2024.
Learn More about IRMAA Medicare Part B Reimbursement
IRMAA Medicare Part B Reimbursement Application (for 2023, 2022 & 2021)
Important - Please do not submit your application more than once. Submitting your application multiple times or ways will only delay the processing time. You will receive a confirmation letter in the mail 4-6 weeks from the date you submit your application. Payment will be issued in October 2024.
Please check back frequently for additional information and updates.
Information about Medicare and IRMAA Reimbursement Learn More
The City reimburses retirees and their eligible dependents for Medicare Part B premiums paid, excluding any penalties. You must be receiving a City pension check and be enrolled as the contract holder for City health benefits in order to receive reimbursement for Part B premiums.
For most retirees, the refund is issued automatically by the Health Benefits Program. The reimbursement amount is based on the standard Medicare Part B premiums.
Medicare Part B reimbursements are issued to eligible retirees annually during the month of April. If you are currently receiving your pension check through Electronic Fund Transfer (EFT) or direct deposit, your reimbursement will be deposited directly into your bank account. This will be separate from your pension payment. If you don’t have EFT or direct deposit, you will receive a check in the mail.
The Income-Related Monthly Adjustment Amount (IRMAA) is an additional amount that you are required to pay for your monthly Medicare premiums if you have higher annual earnings.
Medicare-eligible retirees and their Medicare-eligible dependents can submit an IRMAA application if they paid above the standard amount per month. If you did not pay more than the standard amount then you are not eligible for IRMAA. Please do NOT submit an IRMAA application if you are not eligible for reimbursement.
IRMAA reimbursements are issued to eligible retirees annually during the 3rd week of October. If you are currently receiving your pension check through Electronic Fund Transfer (EFT) or direct deposit, your reimbursement is deposited directly into your bank account. This is separate from your pension payment. If you don’t have EFT or direct deposit, you will receive a check in the mail.
The Medicare Part B Reimbursement Program video provides information about the different types of Medicare Part B reimbursements that the City provides, as well as information to help you to see whether you qualify to receive these payments, and how to apply.
It is important that you know how your health plan works and what is required of you. Learn More
Here are some important things that you need to remember:
Who you should contact for assistance and when you should contact them Learn More
Retirees with questions about benefits, services, or claims should write or call their health plan.
When writing to the plan, give your certificate number, name and address.
The Health Benefits Program is also available to provide service and information to City retirees who have questions about or problems with their health benefits or pension check deductions.
Retirees contacting the Health Benefits Program should always include the following information (please print clearly):
Name, Address and Telephone Number
Complete Social Security Number
Pension Number
Inquiries and questions can be emailed to: healthbenefits@olr.nyc.gov
Find out who you should contact after retirement. Learn More
Retirees can contact the Health Benefits Program:
Find out when you should contact your Health Plan. Learn More
(Refer to your health plan identification card or plan booklet for telephone numbers.)
When writing to a health plan, include your name and address, certificate number, date(s) of service, and claim number(s), if applicable. Some plans also allow inquiries through their web sites.
Find out when you should contact your Union/Welfare Fund. Learn More
For information about:
The Health Benefits Program is also available to provide service and information to City retirees who have questions about or problems with their health benefits or pension check deductions.
Retirees contacting the Health Benefits Program should always include the following information (please print clearly):
Name, Address and Telephone Number
Complete Social Security Number
Pension Number
Inquiries and questions can be emailed to healthbenefits@olr.nyc.gov