Public Employee Press

The facts on OTB retirees medicaid coverage


DC 37 won state-funded Medicaid coverage for New York City Off -Track Betting Corp. retirees, and their spouses and dependants under age 21, with vested pension time and credits as of Dec. 7, 2010, who are New York State residents.

The state budget funds this benefit until there are no more DC 37 OTB retirees or vested members.

OTB Medicaid expired Dec. 31, 2013, for OTB retirees and spouses under 65. In 2014, these retirees will enroll in the state health exchange created under the Affordable Care Act. The benefit includes optical, dental and prescription drug coverage.

It is important for OTB retirees who are not Medicare eligible to enroll and participate in the state health exchange until they become eligible for Medicare at age 65. Then they will get Medicare as their primary coverage and full fee-for-service Medicaid as their secondary coverage — what the state Dept. of Health calls "dual eligible."

This level of coverage is usually limited to people with very low incomes, but the OTB retirees receiving Medicare are automatically eligible for Medicare premium assistance coverage at the individual level (Part A, B, C and/or D) plus full fee-for-service Medicaid coverage as secondary coverage.

If OTB Medicaid has cancelled your or your spouse's health insurance, do not call or go to your county-based or borough-based Medicaid office for assistance. Your case is being processed by a small number of state Dept. of Health staff in New York City, not your local social services district (DSS or HRA).

If you have questions about your application status or scope of coverage, call the state Medicaid help line, 1-800-541-2831.

The state DOH periodically cross-checks its database of OTB retirees who have applied for the OTB Retiree Health Benefits with the Social Security Administration to see if any OTB retirees have applied for Social Security benefits.