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Medicare Part B Premium Reimbursement FAQs

When Medicare is primary to NYSHIP coverage, NYSHIP reimburses you for the standard Medicare Part B premium you pay to SSA, excluding any penalty you may pay for late enrollment

Q. When will reimbursement begin?

A. NYSHIP automatically begins reimbursement for the standard cost of original Medicare Part B when Medicare becomes primary to NYSHIP coverage at age 65 for retirees, vestees, dependent survivors, and enrollees covered under Preferred List provisions, and their dependents who turn 65.

Q. How will I receive reimbursement?

A. If you receive a pension, any reimbursement for Medicare Part B will be added to your pension check. If you pay your NYSHIP premium by direct payments to the Employee Benefits Division, Medicare Part B reimbursements will be credited toward your monthly NYSHIP premium payments, and if your Medicare reimbursement exceeds your health insurance premium, you will receive a quarterly reimbursement check from the Office of the State Comptroller.

Q. My dependent is over 65, how will they be reimbursed for Part B?

A. If you have family coverage under NYSHIP, NYSHIP will also reimburse you for the standard Part B premium (and any Part B IRMAA) paid to SSA for any Medicare-primary dependent, provided the dependent is not reimbursed by another source or the premium is not paid by another entity.

Q. I am (or my dependent is) Medicare-eligible prior to age 65, how will I/they be reimbursed for Part B?

A. Reimbursement is not automatic for any enrollee or covered dependent who is under age 65 and is eligible for Medicare due to disability, ESRD, or ALS. You must notify the Employee Benefits Division in writing and provide a photocopy of your (or your dependent's) Medicare card to begin the reimbursement in these cases.