Q. What are the eligibility requirements for retirees and dependents?
To be eligible for Humana Group Medicare Advantage coverage, your retirees – and their dependents if you offer dependent coverage – must meet these requirements:
- The retiree or dependent must be enrolled in both Medicare Part A and Part B through age or disability (for Medicare Advantage plans, individuals must have both Part A and Part B), and they must continue to pay their Medicare premiums.
- The retiree or dependent must live in the Humana Medicare service area for the Humana Group Medicare plan. An individual who is living abroad or incarcerated isn't eligible because he or she isn't considered to “reside” in the plan's service area.
- The retiree must not actively be working or be eligible for the Commercial coverage through the employer.
- All employer/union group health plan sponsors will be allowed to enroll their Medicare eligibles in an "800 series" Group Medicare MA-Only PFFS plan with a standalone Individual PDP.
- All employer/union group health plan sponsors will not be allowed to enroll their Medicare eligibles in an "800 series" Group Medicare MA Only HMO, LPPO, or RPPO with a standalone Individual PDP.
- All employer/union group health plan sponsors will be allowed to enroll their Medicare eligibles in both an "800 series" Group Medicare MA-Only plan as well as an "800 series" standalone Group Medicare PDP.
As the employer sponsor of a Group Medicare Advantage plan, you can create your own eligibility guidelines – as long as the guidelines are compliant with Centers for Medicare & Medicaid Services rules.
Retirees and dependents approaching age 65 can enroll in a Group Medicare Advantage health plan:
- Three months before their 65th birthday
- The month of their 65th birthday
- Three months after their 65th birthday
