Health Insurance

About your health insurance in retirement

Health insurance for retired members of the MTRS is not provided by the MTRS, but, rather, is a local contractual benefit. Most school districts offer continued health insurance to their retirees and either:

participate in the Retired Municipal Teachers’ (RMT) Program (see list below) or
offer their own group insurance plan (see Local district coverage below).

How this insurance will be administered depends upon which school system you are retiring from. Since health insurance coverage is a very important issue for you as you consider your retirement, you may want to investigate your options several years prior to your actual retirement.

Three notes to recent and soon-to-be retirees

While you are an active educator, your health insurance premiums may have been withheld on a pre-tax basis. Please note, however, that the IRS requires that retirees’ insurance premiums be withheld on an after-tax basis.
Regardless of the group insurance program you may be offered after your retirement, you should contact your local insurance coordinator approximately three months prior to your effective date of retirement in order to obtain the necessary forms for coverage. Likewise, please review our information on Medicare.
An important notice for charter school employees and inactive members: Be aware that school districts have different rules for providing insurance coverage to active members and retired members, and your district may or may not provide you with insurance benefits in retirement. Accordingly, if you are either an employee of a charter school, oryou are not employed by a school district, as soon as you start thinking about retiring, investigate your eligibility for retiree health coverage, as your district’s rules may affect your retirement decisions.

Retired Municipal Teachers' Program

Local district coverage

If your school district is not listed in the Retired Municipal Teachers’ Program (above), your health care coverage after retirement will be administered by your local employer. (Note: Your city or town may participate in the “GIC Municipality Program.” If so, you should still contact your local insurance coordinator as he or she will administer your coverage, which is provided through the GIC.)

The health insurance options available to you under this plan will vary according to the insurance plans negotiated within your local community. In most cases, your local community will give you the option of an indemnity plan or a choice of an HMO.

An important notice for charter school employees and inactive members: Be aware that school districts have different rules for providing insurance coverage to active members and retired members, and your district may or may not provide you with insurance benefits in retirement. Accordingly, if you are either an employee of a charter school, or you are not employed by a school district, as soon as you start thinking about retiring, investigate your eligibility for retiree health coverage, as your district’s rules may affect your retirement decisions.

Enrollment

Since your health care will be administered by the same community from which you are retiring, there should be no reason for you to experience a lapse in coverage. Approximately three months prior to your date of retirement, you should inform your local benefits coordinator of your intention to retire. At that point, he or she will provide you with the necessary paperwork to enroll for coverage as a retired teacher. At that point, you will determine the type of coverage that will best meet your needs. If you are married, you should consider the need to cover your spouse or dependent children, if any.

If you choose to forego any coverage at the time of your retirement, you should ask your insurance coordinator whether you will be able to enroll for coverage at some later date. You should also ask:

What will my insurance premiums be when I retire? Some towns pay a different portion for active members than they do for retirees.
What happens to my coverage at age 65 if I am eligible for Medicare? If I am not eligible for Medicare?

Costs and method of payment

Since the administration of local health care coverage is negotiated on the local level, costs will vary from town to town. The percentage of the premium that you pay as a retiree may remain the same or even go down. However, we would suggest that you contact your benefits coordinator in order to find out what your costs will be when you retire.

The MTRS will be able to deduct your monthly premium from your retirement allowance. In turn, we forward your premium to your local community on your behalf. If, however, you wish to make the payments yourself, you will be responsible for making arrangements with your local coordinator to ensure that you meet your town’s monthly payment dates. By having the MTRB deduct your insurance payment, your insurance will be automatically paid on a monthly basis.

Local plan coverage of a retired teacher’s spouse after the retiree’s death

Note: When thinking about coverage, you should always consider the needs of your spouse and/or dependent children in the event that you should predecease them.

When it is time to enroll for coverage with your local community, you should ask your benefits coordinator several questions about the coverage of your spouse. Specifically, you should determine your local community’s policy regarding the coverage of your spouse in the event that you predecease him or her. Questions you should ask your local benefits coordinator include:

Can I enroll my spouse at the time that I enroll myself?
If I do not enroll my spouse now, can I enroll him or her at some point in the future?
Does my retirement option (A, B or C) have any bearing on the eligibility of my spouse to enroll in health care insurance?
If I predecease my spouse and he or she is covered at the time of my death, can he or she continue coverage as a survivor?
If I predecease my spouse and he or she is not enrolled at the time of my death, can he or she enroll as a survivor?
How much will it cost my spouse for health care coverage?

Since the local communities have jurisdiction over all of the questions listed above, we suggest that you contact your local coordinator prior to your retirement to ask these very important questions. About a year from your effective date of retirement, you should once again ask for clarification of the eligibility of your spouse to participate in your insurance program. Since your health care coverage is negotiated within your own town, coverage and eligibility may change by the time you retire.

When coverage begins

Your health coverage as a retired teacher will generally begin when your coverage as an active teacher ends. It is important to give your local benefits coordinator several months’ advance notice of your retirement so that you do not have a lapse in coverage. We suggest that you notify your benefits coordinator at least three months prior to your effective date of retirement so that you have sufficient time to gather information on your health care options.

For more information

You should contact your local payroll or benefits department coordinator or your Town Treasurer’s office. Also, be sure to review our information on Medicare.

Medicare

Please note: This page was compiled using information from the Social Security Administration and the Commonwealth’s Group Insurance Commission. The MTRS is not responsible for its accuracy.
The MTRS does not administer your health insurance or Medicare benefits. While we may deduct your health insurance premiums from your monthly check and forward them to either the GIC or your city or town treasurer, that service and bookkeeping function is our only involvement. For more complete information about Medicare, please go to www.ssa.gov , www.medicare.gov or call 1-800-MEDICARE.

A federally funded health insurance program, Medicare is the largest health insurance program in the world. Each year Medicare assists millions of older Americans and disabled Americans in meeting the costs of health care coverage. Medicare is run by the Health Care Financing Administration (HCFA) of the U.S. Department of Health and Human Services. You apply for Medicare through your local Social Security office.

Medicare pays for many health care expenses, but it does not cover all of them. It is very important to understand what will be covered by Medicare, what will be covered by supplemental insurance and how the two insurance programs interact.

When you’re 64…you should contact your local Social Security office approximately three months before your 65th birthday. At that point, you will be able to determine your eligibility for Medicare coverage. If you will be able to participate in Medicare, you should contact your insurance administrator—not the MTRS—to adjust your existing coverage.

As a retiree of the MTRS, you may or may not be eligible for health care coverage through Medicare, but you should be sure to investigate your eligibility at least three months before your 65th birthday.

Generally, you will be eligible for health care coverage through Medicare (Part A) when you reach the age of 65 and you meet one of the following conditions:

you will be eligible to receive a Social Security benefit, or
you are married to someone who will be eligible to receive a Social Security benefit, or
you are a public employee, hired on or after April 1, 1986 and you paid the 1.45% Medicare tax for the required period (usually 10 years).

If you do not meet the eligibility criteria for Medicare, your health care coverage will remain with your local employer.

Medicare as your primary health care coverage

Once you become eligible to receive health care coverage through Medicare, you may be required to enroll in Medicare. (Whether you are required to switch depends on whether you are covered under the Commonwealth’s Retired Municipal Teachers (RMT) program or under locally provided insurance , and on whether your municipality has accepted the provisions of M.G.L. c. 32B, § 18. Please check with your local benefits coordinator or the Group Insurance Commission to see if you are required to switch to Medicare upon becoming eligible.)

If you enroll in Medicare, you may want to obtain “Medigap” insurance to supplement Medicare’s coverage. If, prior to enrolling in Medicare, you were covered under:

the local municipality’s program, you should make arrangements with your local insurance coordinator to continue coverage through your group insurance program. The local insurance program will then serve as a supplement to Medicare. You should contact your local benefits coordinator for Medigap options.
the RMT program, you will be required to enroll in Medicare, if eligible; you should then apply for Medigap coverage through the Group Insurance Commission. For your Medigap options, contact the Group Insurance Commission .

Cost and method of payment for Medicare

Coverage for Medicare Part A is free to eligible retirees. There is a charge for Medicare Part B. Once you have established coverage with the Medicare program, the MTRS will withhold the monthly premium for your Medigap coverage.

Starting in 2007, the Medicare Part B premium is based on retirees’ income: In the past, all Medicare-eligible retirees paid the same premium for their Medicare Part B coverage. Starting in 2007, the Medicare Part B premium is higher for retirees whose income exceeds certain limits. The standard Medicare Part B premium in 2007 is $93.50/month. For retirees whose total earnings exceed $80,000 (for a single person) or $160,000 (for a married couple filing jointly), the Part B premiums increase on a sliding scale, up to a maximum of $161.40/month for those retirees whose income exceeds $200,000 (single) or $400,000 (married filing jointly).

For more information and the new scale of premiums by annual income, please see Medicare’s web page on Part B monthly premiums .

For more information

For additional information on Medicare, please contact your local Social Security office or call the Social Security Administration at 800-772-1213.

Retirees

Health Insurance

Retirees

About your health insurance in retirement

Three notes to recent and soon-to-be retirees

Districts participating in the Retired Municipal Teachers’ (RMT) Program

Enrollment

Costs and method of payment

Local plan coverage of a retired teacher’s spouse after the retiree’s death

When coverage begins

For more information

Medicare as your primary health care coverage

Cost and method of payment for Medicare

For more information