Medicare Part B Reimbursement

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.

What is IRMAA?

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.

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Here are some important things that you need to remember:

• Complete an enrollment form to add new dependents (newborn, adoption, marriage) within 30 days after the event;
• Notify the NYC Health Benefits Program and your health plan in writing when your address changes;
• Review your pension check to ensure appropriate premiums are deducted;
• Know your rights and responsibilities under COBRA continuation coverage.

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

Retirees can contact the Health Benefits Program:

• For questions concerning eligibility and enrollment
• For questions regarding deductions for health benefits taken from your pension check
• For Transfer Period information
• To obtain applications to make changes to your coverage such as adding/dropping dependents, adding/dropping the optional rider, waiving health coverage and to change plans (excluding Medicare HMOs, which require a special application from the health plan).
• For notification of enrollment in Medicare
• For questions regarding Medicare Part B premium reimbursements
• To obtain information and an application for COBRA benefits
• To change your address
• If health coverage has been terminated for you and/or your dependents

(Refer to your health plan identification card or plan booklet for telephone numbers.)

• If you have questions regarding covered services
• To obtain written information about covered services
• For information about the status of pending claims or claim disputes
• For claim allowances (How much will a plan pay towards a claim?)
• For health plan service areas

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.

For information about:

• Prescription drug coverage (if applicable)
• Vision benefits
• Dental benefits
• Life Insurance (if applicable)

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