The Mamaroneck Union Free School District provides Medicare Part B premium reimbursement to retirees and their spouses provided the spouse is not covered by another agency.
MUFSD retirees 65 years of age or older who receive Medicare Part B benefits, please submit the following documents for both you and your spouse (if eligible) to the Mamaroneck School District Business Office on or before February 26, 2021:
1. 2020 Social Security Administration Benefit notice of Medicare Part B Premium – also known as 2020 Social Security Benefit Verification Letter. This form is mailed directly from the Social Security Administration usually in November 2019
Sample SSA Benefit Statement Letter from Social Security Administration
To obtain a replacement SSA Benefit Verification Letter: https://www.ssa.gov/myaccount/proof-of-benefits.html
2. SSA 1099 Tax Form – also known as 2020 Social Security Benefit Statement. This form is mailed out directly from Social Security in January 2021. If you do not collect Social Security and pay for Medicare Part B on your own, please provide proof of your payments (premium statements and/or cancelled checks).
To obtain a replacement SSA 1099 Tax Form: https://www.ssa.gov/myaccount/replacement-SSA-1099.html
3. Notarized Certificate of Eligibility Form signed by both retiree and retiree's spouse:
Notarized Certificate of Eligibility Form
4. Retiree Payment Form for both you and your spouse.
PLEASE SUBMIT THE RETIREE PAYMENT FORM ONLY IF YOUR BANKING INFORMATION HAS CHANGED SINCE LAST YEAR’S PAYMENT:
Retiree Payment Form (ACH Direct Deposit Form)
Upon receipt and review of the above documents, if appropriate, the District will issue a payment to you and your spouse for the standard Medicare Part B Premium. Payments will be issued on or before April 30, 2021. Reimbursements for 2020 will only be paid for documentation received by February 26, 2021.
Please e-mail the required documents to Dquinde@mamkschools.org
or send by mail on or before February 26, 2021, to:
Business Office-Medicare Department
Mamaroneck UFSD
1000 West Boston Post Road
Mamaroneck, NY 10543
The maximum monthly reimbursement for 2020 is $ 144.60
For questions please contact Darwin Quinde, Senior Bookkeeper @ 914-220-3049
SSA Statements & Letters can be obtained online at www.ssa.gov or by calling 1-800-772-1213
Mamaroneck Schools
