Retiree Healthcare
Medicare Requirements
When you turn 65, the Cincinnati Retirement System (CRS) requires you to be enrolled in Medicare Part A (only if it is free to you) and in Medicare Part B. You need to sign up for Medicare coverage through the Social Security Administration during your Initial Enrollment Period (IEP). This 7-month period begins 3 months before you turn 65, includes the month you turn 65, and ends 3 months after you turn 65. Eligibility for premium free Medicare Part A depends on if you or your spouse (or former spouse) paid Medicare taxes long enough while working. Everyone pays for Medicare Part B. Your Part B premiums are based on your income reported to the IRS. Medicare Part A (Hospital Insurance) covers inpatient care at hospitals and skilled nursing care. Medicare Part B (Medical Insurance) covers medically necessary services and preventive services. You can only be covered by the Cincinnati Retirement System’s Medicare Advantage (Part C) and prescription (Part D) plans by getting and staying enrolled in Medicare. If you don’t get benefits from Social Security, the most secure methods of paying your Medicare premium bill are by using your bank’s online bill payment service or setting up an automatic deduction of premium payments from your savings or checking account each month (Medicare Easy Pay). Send a copy of your Medicare card to CRS indicating enrollment in Part A and Part B, and we will enroll you in the Cincinnati Retirement System’s Medicare Advantage (Part C) and prescription (Part D) plans. After you provide a copy of your Medicare card to CRS, you can file it away at home in a safe place. When you become enrolled in CRS’s Medicare Advantage and Medicare Part D Prescription plans, the healthcare premiums you pay to CRS are reduced. Currently, CRS is contracted with Anthem Medicare Preferred (PPO) for medical benefits (Part C) and CVS SilverScript for prescription benefits (Part D). Your new insurance cards will be mailed to you. These are the cards you present to your doctor and the pharmacy.
Ways to sign up for Medicare Part A and B:
- Online at Social Security (you will need to create a my Social Security account at https://www.ssa.gov/).
- Call Social Security at 1-800-772-1213.
- Contact your local Social Security office.
Medical and prescription coverage cannot be purchased from CRS separately. Vision and dental coverage will continue as separate selections.
NOTE: Once CRS has received your Medicare card, enrollment into the Medicare Part D Prescription Drug Plan can take up to 8-10 weeks. Continue to use your CVS/Caremark Prescription Drug card until you receive your new Medicare Part D (CVS/SilverScript) card.
Health Care Open Enrollment Takes Place Each Year In Autumn
Open Enrollment is the time of year for CRS retirees to select their health care coverage for the coming calendar year. Retirees may choose to update medical, dental and/or vision coverage. If CRS retirees wish for coverage to remain the same, they do not need to do anything for Open Enrollment.
Select Plan - Retirement date on or before January 1, 2016 - including Group C
Benefit Summary - Select Commercial (pre-Medicare)
Benefit Summary - Select Medicare Advantage
Rx Benefit Summary (pre-Medicare)
2025 Select Plan Enrollment Form
Model Plan - Retirement date on or after February 1, 2016 - excluding Group C
Benefit Summary - Model Commercial (pre-Medicare)
Benefit Summary - Model Medicare Advantage
Rx Benefit Summary (pre-Medicare)
2025 Model Plan Enrollment Form
Secure Plan - Closed Group
Benefit Summary - Secure Medicare Advantage
Cincinnati Retirement System will no longer provide health care benefits to legally separated spouses of City of Cincinnati retirees.
When a dependent no longer meets the eligibility requirements for CRS health care, the pensioner has 60 days to notify CRS of the change in status. The ineligible dependent is removed from CRS health care on the last day of the month following the month of the qualifying event.
Covered Student Verification
Health care coverage for eligible dependent children is available through the end of the month in which they turn age 19, or through the end of the month in which they turn age 24 (must be unmarried and fulltime student at an accredited school). Pensioners who request to purchase health care coverage for eligible dependent children aged 19-24 are required to provide verification of full-time student status each year, by December 15th and once again by August 15th. Failure to provide verification of fulltime student status by the deadlines will result in the termination of the dependent’s coverage.
CVS Caremark & CVS SilverScript Prescription Plans
CVS Caremark (pre-Medicare) 1-888-202-1654
CVS SilverScript (Medicare Part D) 1-888-234-0927
Resources
Anthem (pre-Medicare) 1-855-315-8928
Anthem Medicare Advantage Member Services 1-833-848-8730
Diabetes and Hypertension Coaching Program (Kroger) 1-513-639-9940
EyeMed Benefit Summary / EyeMed Website 1-866-299-1358
Superior Dental Benefit Summary / Superior Dental Website 1-800-762-3159
Health Reimbursement Arrangement
What is an HRA?
An HRA, or a Health Reimbursement Arrangement, is a plan offered through the Cincinnati Retirement System (CRS) which reimburses your out-of-pocket medical expenses, including co-pays, co-insurance, deductibles, and premium differentials, associated with a pensioner’s (and their eligible dependents) enrollment in a non-City sponsored alternate group health plan.
If you are eligible for retiree healthcare, but have waived CRS health insurance because you have access to health insurance under another plan, you may want to consider enrolling in the HRA. The HRA is free!
Mental Health Services Resources and Flyers
Anthem covered services include the following: Inpatient Services in a hospital; Outpatient Services including office visits, therapy, and treatment; and Telehealth Services/Virtual Visits. In-network and out-of-network co-insurance percentages apply.
Examples of providers from whom you can receive covered services include: psychiatrists, psychologists, licensed clinical social workers, neuropsychologists.
Call the number on the back of your Anthem insurance card or click on the links below for more information.
Behavioral Health Case Management