Peralta Benefits Information Center
 
 
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Medicare
Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those who have disabilities, permanent kidney failure or amyotrophic lateral sclerosis (Lou Gehrig’s disease). The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.
General Medicare Information
 Medicare FAQ - October 2011  
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These are Medicare Frequently Asked Questions for Peralta Retirees. (Updated 10-18-2011).

  File size: 169 K

 SSA Medicare Booklet  
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This is the Social Security Administration's Medicare Booklet.

  File size: 367 K

 Medicare A & B Enrollment/Re-Enrollment Letter  
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This is the Medicare A & B Enrollment/Re-Enrollment Letter.

  File size: 376 K

Forms
 Direct Deposit Form  
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Attached is the Direct Deposit Form for Benefit Dynamics.  PLEASE NOTE:  All new retirees will be REQUIRED to sign up for direct deposit at the time of retirement in order to begin receiving reimbursement. 

(Updated 2-13-2012)

  File size: 70 K

 Medicare A & B Premium Claim Form  
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Medicare A & B Premium Claim Form - Request for Reimbursement
This form must accompany reimbursements processed on or after January 1, 2012. Complete sections B & C.
(Updated 12-19-2011)
  File size: 122 K

Medicare Forms on CMS.gov
Agreements
 2004-2009 Peralta Benefits Agreement  
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This is the 2004-2009 Peralta Benefits Agreement.
  File size: 2015 K

 2000-2003 Peralta Benefits Agreement  
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This is the 2000-2003 Peralta Benefits Agreement.
  File size: 887 K

 1997-2000 Peralta Benefits Agreement  
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This is the 1997-2000 Peralta Benefits Agreement

  File size: 1758 K


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