Coordination with Medicare
Medicare Parts A and B
For most individuals, Medicare Parts A, B and D benefits currently become available at the beginning of the month in which a person reaches age 65, whether or not he or she is retired. Medicare Parts A, B and D benefits usually become available to individuals before age 65 if the individual has received Social Security disability benefits for two years, or if the individual has chronic kidney disease.
If you or one of your covered dependents becomes entitled to Medicare due to age or disability while you are an active employee, the benefits of your Company-sponsored medical plan will be paid before Medicare Parts A and B benefits, except for individuals who are entitled to Medicare due to chronic kidney disease (End Stage Renal Disease, or ESRD), your Company-sponsored medical plan will pay benefits before Medicare for the first 30 months of Medicare entitlement. After 30 months, Medicare Part A and Part B will become the primary payer and the Company-sponsored plan will become the secondary payer. Please notify Anthem Blue Cross or your HMO as soon as ESRD is diagnosed.
Medicare Reduction Applies Even If You Have Not Enrolled
If you or a covered dependent fall into one or both of the exceptions listed, that individual must apply for and enroll in Medicare Parts A and B. The Company-sponsored medical plan's level of benefit coverage will not change but, because Medicare is the primary payer, the Company-sponsored plans will reduce its payment by the amount Medicare pays or should have paid had the individual enrolled for Parts A and B. Therefore, if you do not enroll in Medicare when eligible, you will be responsible for the portion of claims Medicare would have paid. The Company will reimburse the Standard Medicare Part B premium each month to eligible disabled retirees and up to two disabled dependents who are under age 65, enrolled in Medicare Parts A and B, and enrolled in a PG&E-sponsored medical plan. If you are 65 or over you will receive a $15 monthly Medicare credit. You must notify the PG&E Benefits Service Center and provide a copy of your Medicare card showing Part A and B effective dates to qualify and initiate the monthly reimbursement.
If you're under age 65 and you believe you or any of your dependents qualify for Social Security due to disability, contact Allsup, Inc., at 888-339-0743. PG&E has contracted with Allsup, Inc., to provide Social Security enrollment assistance at no cost to potentially eligible disabled retirees or dependents.
Medicare Part D — Prescription Drug Benefits Provided through PG&E-Sponsored Medical Plans
Retirees and/or their dependents who are eligible for Medicare may not elect to enroll in Medicare's prescription drug benefits outside the Company — known as Medicare Part D Plans — and continue coverage under a Company-sponsored medical plan. The Company-sponsored medical plans all provide a prescription drug benefit equal to or better than Medicare's basic Part D benefit. Enrolling in a Medicare Part D Plan outside of the Company will result in your losing all medical and prescription drug coverage under the Company-sponsored plans. Every year, the Company provides a Creditable Coverage notice to all medical plan participants. The notice attests that the Company-sponsored medical plans' prescription drug benefits are actuarially equal to or better than the Medicare Part D basic benefit. You should keep the notice because it provides protection against Medicare Part D late enrollment penalties should you at some time in the future drop Company-sponsored medical plan coverage and enroll in a Medicare Part D Plan. For a copy of the notice or additional information, you can contact the PG&E Benefits Service Center at 866-271-8144 (open weekdays from 7:30 a.m. to 5 p.m. Pacific time).