CSA RETIREE CHAPTER
CENTRAL NEW JERSEY
Information from Norm Sherman,
Florida CSARC SE Florida Liaison & Outreach Coordinator,
Council of School Supervisors and Administrators (4/15)
Hi everyone! Hope all is well...
1. IRMAA – The Office of Labor Relations (OLR) has begun to issue 2013 IRMMA checks. Some members have already been reimbursed. If you are eligible and submitted an application in a timely fashion BUT have not yet received your 2013 IRMMA check, please be patient. Most likely it will arrive before the end of the month or the beginning of May. If not, call or email me.
If you have not filed for 2013 IRMMA you can still do so by downloading the application from the CSA Welfare Fund website, www.csawf.org, and following the instructions listed on it. Keep in mind, however, it will be awhile before you receive your reimbursement.
I have received several inquiries about when to file for 2014 IRMMA. In August, you will receive automatically your 2014 Part B standard amount reimbursement check. With the check, will be enclosed a letter informing you that you may now apply for 2014 IRMMA. The application will on the CSA Welfare Fund Website.
2. Enhanced Benefits – Recently, the CSA Welfare Fund notified you of the enhancement of two of their benefits.
§ Home Health Aide – This benefit is now $8,000 per year, an increase of $2,000 per year, with a lifetime max of $24,000, an increase of $6,000. Also, the Retiree Chapter reimburses 15% of the Welfare Fund payment. So the increase of $2,000 per year actually will be $2300 ($2,000 x 15%), and the lifetime increase of $6,000 actually will be $6,900 ($6,000 x 15%). Remember, there is an annual $100 deductible and coverage is 80% of the cost. Also, any part of the yearly benefit not used can be carried over to the following year. For example, if you receive a $4,500 benefit for a given year, the remaining benefit of $3,500 can be carried over to the next year or any subsequent year.
§ Physical Therapy Benefit – Previously, the benefit was for 20 visits per year. But, Medicare’s dollar reimbursement was always able to pick up the 20 visits and, as a result, the Welfare Fund benefit became moot for Medicare retirees. Now, the enhanced benefit is $2,000 plus an additional $300 or ($2,000 x 15%) from the Retiree Chapter. In short, Medicare Retirees are now covered for 20 visits per year through Medicare plus the additional visits (approximately, another 20) using the enhanced benefit. Non-Medicare retirees will be covered for the $2300 or approximately 20 visits.
3. Outpatient Mental Health Services Coverage – In the past two years Medicare began to coveroutpatient mental health services to help beneficiaries with depression and other needs.
Once you have met your $147 Part B deductible, original Medicare Part B will pay 80% of the cost of certain outpatient counseling and therapy services such as group therapy and family counseling. Part B also covers services for treatment of beneficiaries who struggle with inappropriate alcohol and drug use. GHI or whatever secondary you have should pay for the other 20%.
Medicare will also cover getting treatment through a variety of mental health professionals such as psychiatrists, psychologists, clinical social workers and clinical nurse specialists. However, keep in mind if you decide to see a non-medical doctor (such as a psychologist or a clinical social worker), you’ll need to make sure that he or she is Medicare-certified and takes Medicare & GHI assignment.