THE SENIOR CITIZEN HEALTH PROGRAM — A PROGRAM TO COMPLEMENT YOUR MEDICARE COVERAGE
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Eligibility for the Senior Citizen Program
To help you understand if you qualify for Senior Citizen health coverage, refer to the following chart. It illustrates the earnings requirements necessary to qualify for Individual Plan coverage in each of the Base Years in the left-hand column.
If you are at least age 65 and have 15 or more Qualifying years (or 10 Qualifying years if on January 1, 2003 you were at least age 60) with earnings of at least the amount shown in the middle column, you will be entitled to purchase Individual Health Plan coverage. You may also purchase coverage for dependents, including your spouse, by paying the premium described below. The election to purchase coverage must be made at the time your own Senior Citizen coverage becomes effective. However, an exception can be made if you decline coverage for a spouse or dependent because they have coverage under another plan and lose that coverage, or you acquire a new dependent. In these instances, you can add the new dependent to coverage by providing written notice to the Fund within 30 days of the change in family status.
You will also be eligible for Family Health coverage if you are at least age 65 and have earnings of at least the amount shown in the right hand column and:
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Eligibility for the Senior Citizen Program
To help you understand if you qualify for Senior Citizen health coverage, refer to the following chart. It illustrates the earnings requirements necessary to qualify for Individual Plan coverage in each of the Base Years in the left-hand column.
If you are at least age 65 and have 15 or more Qualifying years (or 10 Qualifying years if on January 1, 2003 you were at least age 60) with earnings of at least the amount shown in the middle column, you will be entitled to purchase Individual Health Plan coverage. You may also purchase coverage for dependents, including your spouse, by paying the premium described below. The election to purchase coverage must be made at the time your own Senior Citizen coverage becomes effective. However, an exception can be made if you decline coverage for a spouse or dependent because they have coverage under another plan and lose that coverage, or you acquire a new dependent. In these instances, you can add the new dependent to coverage by providing written notice to the Fund within 30 days of the change in family status.
You will also be eligible for Family Health coverage if you are at least age 65 and have earnings of at least the amount shown in the right hand column and:
- if you have 20 or more Qualifying years, 15 of which are Family Qualifying years; or
- if you were at least age 60 as of January 1,2003, and had at least 15 Qualifying years, 10 of which are Family Qualifying years.
Earnings Requirements for Senior Citizen Health Coverage
| Base Year | Individual Qualifying Year Covered Earnings |
Family Qualifying Year Covered Earnings |
| 1986 and prior |
$2,000 | $2,000 |
| 1987 | $2,500 | $2,500 |
| 1988 | $3,500 | $3,500 |
| 1989 | $3,500 | $3,500 |
| 1990 | $5,000 | $5,000 |
| 1991 | $5,000 | $5,000 |
| 1992 to 1993 |
$7,500 | $7,500 |
| 1994 to 2001 | $7,500 | $15,000 |
| 2002 | $7,500 | $20,000 |
| 2003 to date |
$10,000 | $30,000 |
| IMPORTANT |
| You
must notify the New York Fund office in writing that you are qualified
and wish to activate your coverage under the Senior Citizen Health
Program. That coverage will only become effective when we receive
your request. |
Special Consideration for those Born Before December 1, 1937
You will be eligible for Senior Citizen Individual Health Plan coverage if, as of December 1, 1992:
- you were vested in a Regular Annuity based on at least 10 years of service credit under the AFTRA Retirement Plan (including at least five Base Years in which covered earnings were $2,000 or more); or
- you had met all the requirements in effect at that time for Senior Citizen health coverage.
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