The first type of reimbursement is for Medicare Part B, which covers doctors' visits. This reimbursement is made by the City's Health Benefits Program and is automatic. Each month a premium is deducted from your Social Security check to cover Medicare Part B. The amount of that monthly Part B premium is either the "standard" premium or a higher amount, if you are fortunate to have income above a set threshold for the year.

Part B premium reimbursement occurs because of union pressure on the City Council more than a decade ago. Reimbursement was initially won by the unions in 1966, but mayor after mayor from 1966 to 2001 said the City was too poor for full reimbursement of Part B premiums and paid back less than the full premium. Legislation was fought for by the unions and passed in 2001 which ever since has mandated the full premium reimbursement.

When you become Medicare-eligible and enroll in Part B, you should submit the form that you can download at the link below, along with a copy of your Medicare Card:

Medicare Part B Premium Reimbursement Form

For those who have automatic direct deposit of their pension payments into a bank account, the Part B reimbursement is likewise made by direct deposit into that account and the deposit timeframe for reimbursement for basic premiums is the end of April of the year following their payment. Those without direct deposit receive a check.

2023 Medicare Part B reimbursements were issued beginning with the third week of April 2024. Please check your bank account/statement (or the mail, if you are receiving a physical check). If you already submitted your Medicare Part A & B card to the Health Benefits Program, this payment is automatic and you will receive it annually going forward.

Medicare-eligible retirees and their Medicare-eligible dependents will be reimbursed annually for the standard Medicare Part B amount of $164.90 per month ($164.90 x 12 months = $1,978.80), excluding any penalties and late enrollment fees, subject to pro-rating if you have been a Medicare enrollee for less than a full year.

If you do not receive the standard reimbursement, you should contact the City's Health Benefits Program, which moved last year to 22 Cortlandt Street.

PLEASE NOTE: the Health Benefits Retiree client service walk-in center remains closed to visitors. However you can be seen by appointment. Information on making an appointment and submitting inquires and documents can be found on the City's Health Benefits Program website on the following page:

Contact the City's Health Benefits Program

The City's Medicare Part B Reimbursement For Higher Income Retirees

When payments are made for the "standard monthly part B premium" for the prior year, the City issues a special form called the IRMAA form for those who have higher incomes and paid more than the standard Part B premium. Forms must be completed and submitted to the City's Health Benefits Program. The forms for 2021 - 2023 are available at the link below.

Payment is processed for the extra money paid and a check issued. Recently that has taken place in October of the year after payment, depending on when you file for the IRMAA reimbursement.

Frequently Asked Questions About Medicare Part B Reimbursement

2021-2023 Medicare Part B Higher Income Reimbursement Form

To view and print out a copy of the New York City Employee Benefits Program's form and instructions for reimbursement of higher Medicare Part B premiums paid by certain beneficiaries who earned beyond certain thresholds in 2021, 2022 and/or 2023 click here. This form is to be filed by those Medicare beneficiaries who paid more than the standard Medicare Part B premiums. You must supply copies of specific documents including the 1099 form for the prior year (2021, for example) you received from the Social Security Administration at the beginning of the following year (January of 2022, for example). You can expect the additional reimbursement sometime in or after October of the following year.

Medicare Part D Premiums for Higher Income Retirees

Starting in 2011, retirees with incomes above a set threshold pay a premium for Medicare Part D, which covers drugs. These higher income individuals see a deduction from their Social Security check each month for Part D premiums, in addition to the monthly deduction for Part B premiums. Unlike Part B, there is no reimbursement for the Part D premiums for higher income retirees.

The OSA Welfare Fund's Partial Drug Rider Reimbursement For Medicare Eligible Retirees

The second type of reimbursement is provided by the OSA Welfare Fund rather than the City and represents a partial reimbursement by the union of drug rider premiums for Medicare-eligible retirees. This reimbursement, which amounts to $50 per month for each covered member ($600 maximum a year) and their covered spouse/domestic partner (another $600 maximum per year) is issued in one of two ways.

If you are enrolled in GHI's Medicare plan, GHI Senior Care, the monthly cost of your Medicare Part D Enhanced drug rider is deducted from your pension check and is reduced by $50 a month for each covered individual. The OSA Welfare Fund's $50 subsidy is paid directly to the City. Since GHI enrollees receive the drug rider reduction of $50 on a monthly basis from the Welfare Fund, they receive no additional payment from the Welfare Fund in the following year.