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Medicare Health Subsidy



The maximum monthly Medicare Health Insurance Subsidy for LAFPP pensioners enrolled in Medicare Parts A and B is&nbsp;decreasing&nbsp;by $35.54 in 2016.



The decrease is in accordance with City of Los Angeles Administrative Code Section 4.1154(c), which limits the maximum amounts for the Medicare Health Insurance Subsidy affecting members and qualified survivors enrolled in Medicare Parts A and B, to the Los Angeles City Employees’ Retirement System (LACERS) plan premiums.&nbsp; Effective 1/1/2016, the highest LACERS Medicare plan premium is $487.71/month; therefore, the LAFPP maximum Medicare Health Insurance Subsidy will decrease from $523.25/month to $487.71/month effective on the 12/31/2015 pension roll.



As a result, LAFPP members may see a reduction of up to $35.54 from their pension check due to the subsidy decreasing on the 12/31/2015 pension roll. If you have further questions please contact the Medical &amp; Dental Benefits Section at (213) 978-4560 or (800) 787-2489, EXT. 84560, and we will be happy to assist you.



Two-Tier Medicare Part B Premium Reimbursement in 2016



Category 1



<ul>
<li>Pensioners who:&nbsp;(1)&nbsp;are already enrolled in Medicare Parts A and B (prior to 2016),&nbsp;(2)&nbsp;have their Part B Premium deducted from their monthly Social Security benefit check,&nbsp;and&nbsp;(3)&nbsp;have yearly incomes of $85,000 or less (or $170,000 or less for joint filers) will continue to pay the same&nbsp;$104.90 per month&nbsp;Part B premium amount as they paid in 2015.&nbsp; LAFPP pensioners meeting all three of these conditions need not take any further action, as they will continue to receive the lower-tier monthly reimbursement of $104.90 in 2016.</li>
</ul>



Category 2



<ul>
<li>Pensioners who enroll in Medicare Parts A and B for the first time in 2016 will pay the higher-tier Part B premium of&nbsp;$121.80 per month. LAFPP pensioners in this category will not be required to provide any documentation beyond that which is requested upon enrollment in a Medicare Health Plan in order to receive the higher-tier reimbursement of $121.80 per month.</li>
</ul>



Category 3



<ul>
<li>Pensioners who are billed directly by Medicare for their Part B premiums and pensioners whose annual incomes are $85,000 or more ($170,000 or more for joint filers) will be charged the higher-tier Part B premium of $121.80 per month in 2016 (NOTE: Pensioners with incomes exceeding the above thresholds may pay a higher amount). LAFPP pensioners in this category must provide supporting documentation in order to receive the higher-tier Part B Premium Reimbursement of $121.80.  Please complete the HIGHER TIER MEDICARE PART B PREMIUM REIMBURSEMENT AGREEMENT  form and return to our office along with applicable documentation by December 31, 2015 in order to request the higher-tier reimbursement of $121.80 per month.</li>
</ul>



Completed forms and documentation may be&nbsp;faxed to (213) 978-4504; scanned and sent by email to:&nbsp;<a href="mailto:PENSIONS@LAFPP.COM">PENSIONS@LAFPP.COM</a>, or mailed to the following address:



Department of Fire and Police Pensions



ATTN: Medical and Dental Benefits Section



360 E. 2nd Street, Suite 400



Los Angeles, CA&nbsp; 90012

Important Changes Regarding Medicare for 2016

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March 2025

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