IRMAA
The IRMAA Form for 2024 is now available to download here.
What is IRMAA?
The Income-Related Monthly Adjustment Amount (IRMAA) is an additional amount that you are required to pay for your monthly Medicare premiums if you have higher annual earnings. If you paid more than the standard monthly reimbursement rate for Medicare Part B, as an Income Related Monthly Adjustment Amount (IRMAA), you may be eligible for additional reimbursement. If you submit the required documentation for IRMAA reimbursement, your reimbursement will be deposited directly into your bank account.
Please do NOT submit an IRMAA application if you are not eligible for reimbursement.
CSA Mayoral Forum
CSA will host a NYC Mayoral Forum on Monday, May 12th.
Please note that we are changing venues to accommodate more members. The event will now be held at The Town Hall (123 W 43rd St, New York, NY 10036, off 6th Avenue). We will send new confirmation emails to those already registered.
CLICK HERE TO REGISTER FOR THE MAYORAL FORUM
This in-person event will allow our members to hear directly from these candidates on a wide variety of topics concerning New York City public schools. We will select a handful of submitted questions, and use those questions to guide our conversation at the forum and beyond.
CLICK HERE TO SUBMIT A QUESTION
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Medicare Part D Changes in 2025
This year, if you have Medicare prescription drug coverage (Part D), your maximum Out-of-Pocket (OOP) expense is $8,000 for prescription drugs before entering Tier 3 or the Catastrophic stage. The good news is that in this stage, you no longer have any prescription drug expenses, no matter the actual cost of the drug.
In 2025, the $8,000 amount decreases to $2,000. This huge reduction is due to the Inflation Reduction Act and market trends and will reduce significantly the financial burden for many seniors with chronic ailments who take expensive drugs.
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In short, the Catastrophic Tier disappears in 2025. When the year starts on January 1, you will pay 25% and the plan will pay 75% of the plan for your prescription drugs. Once your OOP reaches $2,000, you are no longer required to pay for your prescription drugs.
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Another major change for prescription drugs is the expansion of Medicare’s ability to negotiate drug prices with the pharmaceutical companies. It is anticipated that the price of many of the more expensive drugs will go down significantly, like Eliquis.
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Question of the Month
Q. I just purchased a set of hearing aids. What do I have to do to submit a claim?
A. 1) Go on the CSA Welfare Fund website, www.csawf.org.
2) Click on the link, Request a Voucher, that is located on the left side. Remember, The Fund will reimburse you $800 every 3 years for a new hearing aid and the CSA Retiree Chapter will reimburse you an additional $800 after you receive the Fund’s reimbursement. You do not have to fill out an additional application.
3) Fill out the form and be sure to indicate in the drop-down menu that you are requesting a hearing aid voucher.
4) In the Notes box, indicate which family member should be issued the voucher.
The voucher has sections for the physician or audiologist, the hearing aid dealer, and yourself to fill out. Please ensure the providers have filled out the sections out correctly and that you have signed the voucher. If you used a non-participating provider, send the completed form to the CSA Welfare Fund Office.
Norm Sherman
NY Court of Appeals Rules that NYC Cannot Defund Retiree Healthcare
December 17, 2024
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THE NEWS, PRESS RELEASE FOR IMMEDIATE RELEASE:
CONTACT: Savannah Larson
NY Court of Appeals Rules that NYC Cannot Defund Retiree HealthcareToday’s Ruling Requires the City to Pay the Entire Cost of Retirees’ Preferred Health Insurance
NEW YORK, December 17, 2024 —
Today, the New York Court of Appeals, the state’s highest court, issued a historic decision in favor of 250,000 Medicare-eligible retired New York City workers and their dependents. The Court held that the City must continue to pay the entire cost of any health insurance plan a retiree chooses, thus preserving retirees’ right to City-funded Medicare supplemental insurance.Rejecting the City’s argument that the City can cease funding retirees’ health insurance, the Court unanimously held that “the City must pay—up to the statutory cap—for each health insurance plan that it offers employees and retirees.” The decision is available here.In 2021, the City announced that it would stop paying for retirees’ Medicare supplemental insurance and automatically switch them into a federally funded—and far inferior—type of insurance called Medicare Advantage.
Unlike Medicare supplemental insurance, Medicare Advantage plans limit access to medical providers and regularly deny coverage for necessary care. Under the leadership of Marianne Pizzitola and the NYC Organization of Public Service Retirees, retirees banded together and sued to protect their right to Medicare supplemental insurance.This is another resounding victory for the NYC Organization of Public Service Retirees (one of the lead plaintiffs in the case) and the entire retiree community. In the past three years, they have brought three separate lawsuits regarding their healthcare rights and have obtained landmark victories in each case at both the trial and appellate levels.
Marianne Pizzitola, President of the NYC Organization of Public Service Retirees, states, “The City’s plan to defund retiree healthcare has now been analyzed by 13 different judges across all three levels of the state court system. Every single judge—all 13 of them—have concluded that the City’s plan is unlawful. We once again call on the City and the Municipal Labor Committee to end their ruthless and unlawful campaign to deprive retired municipal workers of the healthcare benefits they earned.”
Jake Gardener, a partner at Walden Macht Haran & Williams LLP, counsel to the retirees, says, “We are grateful to the Court of Appeals for affirming the healthcare rights of hundreds of thousands of elderly and disabled retired City workers. Because of today’s decision, countless senior citizens and disabled first responders will be able to continue receiving the medical care they desperately need and to which they are entitled.”
Steve Cohen, a partner at Pollock Cohen LLP, which also represents the retirees, states, “We are thrilled that the Court of Appeals agrees that City retirees deserve what they were promised: payment for the health plan of their choice.”
Medicare Part B Premium and Deductible
Medicare Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A. Each year, the Medicare Part B premium, deductible, and coinsurance rates are determined according to provisions of the Social Security Act. The standard monthly premium for Medicare Part B enrollees will be $185.00 for 2025, an increase of $10.30 from $174.70 in 2024. The annual deductible for all Medicare Part B beneficiaries will be $257 in 2025.
GHI Senior Care members are responsible for the $50.00 annual deductible as well.
Prescription Co-Pay Reimbursements for Pre Medicare-Retirees
If you are not yet on Medicare, and you are a GHI or HMO retiree, one of the benefits is prescription co pay reimbursements. You can log onto the Express Scripts website, log onto your secure site and download all prescriptions filled for the calendar year 2024. Even if you filled them at your local pharmacy, Express Scripts has a record. Make a copy and submit it to the CSA Retiree Welfare Fund. After $100 deductible, the Welfare Fund will reimburse 80% of your co pays with an annual maximum of $10,000. The Retiree Chapter will then reimburse another 20%, with a maximum of $2000.
Turning 65
If you or your partner/spouse are turning 65 this year and are retired, the city requires you to sign up for Medicare Part A and Part B. Once you are on Medicare, the world of medicine opens to you as about 94% of all medical providers in America accept Medicare. Medicare will become your primary provider, covering 80% and your city coverage (Medigap or secondary coverage) covers the remaining 20%. Prescription coverage with Express Scripts remains the same. If you are still working for the DOE when you turn 65, you may apply for Part A, as that is free, if you have worked 10 years paying into social security.
If you are collecting social security, approximately 90 days prior to your turning 65, social security will generally send you your A and B card asking if you wish to keep part B. If you have not received a card, you need to log onto SSA.gov and register for Medicare Part A and B only. You can also visit your local social security office and register there. If you delay in enrolling, generally 90days after you have turned 65, you may be assessed a penalty.
Once you get your card, you need to make a copy and submit it to the NYC office of Labor Relations. They are located at 22 Cordtlandt St, 12th floor, NY, NY, 10007, and their phone number is 212-513-0470.
The Welfare Fund encourages members to reach the Fund office when applying for Medicare to ensure that proper communication is made between the member and Office of Labor Relations. Please call the Fund office at (212) 962-6061 or email the Fund’s administrator, Susan Barone (sbarone@csawf.org) for assistance.
Elections
CSA’s Retiree Chapter Executive Board is in the midst of its election for Executive Board members. Ballots have already gone out. You are asked to vote for no more than 20candidates out of a field of 32 retirees vying for a seat. The RC Executive Board makes policy for the Retiree Chapter following its constitution and CSA’s constitution as well. The voting is being conducted by the AMERICAN ARBITRATION ASSOCIATION. Your ballot must be received by the American Arbitration Association by close of business on Monday, January 27, 2025, in order to be counted. If you have not received your ballot, please call the AAA at 212 484-4136.
