For funds that reimburse Part B
Many retirees on your Part B reimbursement qualify for New York’s Medicare Savings Program, which pays the whole premium. Most never apply. Mycelium finds them in your files, enrolls them by text with their yes, and renews it every year. They keep about $100 more a month. Your fund stops paying. You pay a share of what you save.
For union funds and public retiree plans that reimburse Part B. Nothing if nobody is approved.
New York’s Medicare Savings Program pays the whole Part B premium for a retiree with up to about $2,494 a month before deductions, or $3,375 for a couple, and savings don’t count. About 4 in 10 people who qualify aren’t enrolled. When one of them is on your reimbursement, your fund pays a premium the state would cover.
The ruleNew York, 2026
| Who | Who pays the premium now | Who would pay | What the retiree gets |
|---|---|---|---|
| A retiree under the limit, on a 50% reimbursement | Half the fund, half the retiree | The state, all of it | About $101 more a month, and Extra Help with prescriptions |
| A retiree under the limit, on a 100% reimbursement | The plan, all of it | The state, all of it | Extra Help with prescriptions. The premium stays covered. |
| A retiree the state already covers | The state, and the fund again | The state only | Nothing changes |
| A retiree whose income just dropped, after a spouse’s death or a smaller check | The fund | The state | The same as the first row, starting now |
Premium: 2026 standard Part B. Limits: New York QI-1, 2026, gross with the $20 disregard. Take-up: MACPAC. Extra Help comes automatically with a Medicare Savings Program.
In 30 days we show you, in dollars, how much of your Part B reimbursement New York would pay, and how many retirees are behind the number.
How many retirees on your reimbursement likely qualify, what you pay for them each year, and any premiums you reimburse that someone else already pays. No names leave the fund unless you ask.
Your Part B reimbursement file and a few eligibility fields, de-identified, under a HIPAA business associate agreement, and one contact at the fund office.
Nothing. If you want the retirees reached, you mail one letter and pay only a share of what you save.
Our estimate for a fund with 50,000 retirees on a 50% Part B reimbursement and modest pensions: roughly $3–9 million a year in premiums the state would pay. The scan replaces it with your number.
Get a free scanThe phone at the top of this page. The fund mails one letter with our number. She texts, answers two questions, and says yes. The rest happens without her.
What one approval is worth2026 figures
The fund keeps 80% of the savings, every year she stays enrolled.
Approval is the start. Social Security stops deducting the premium, your reimbursement stops the same month, and the state needs a renewal every year. We handle each step, so the retiree never pays twice and never drops off.
What we handleEvery year
If she moves, her income changes or her spouse dies, she texts us and we update it.
Mycelium keeps a live record of where each retiree on your reimbursement stands: watching, likely eligible, contacted, agreed, filed, approved, up for renewal. It reads what changed in your files and in the rules, and moves a retiree forward only when it’s sure. When it isn’t, a person decides.
Plans reimburse Part B when the retiree pays it, not when someone else does. Auditors keep finding plans paying premiums the state or another employer already covers. We make that rule work for every retiree, every month.
No claims system can enroll anyone. The retiree has to confirm their income, agree and sign. We do that with them, from a letter they trust.
Each step a retiree takes is logged with what changed, what the system concluded and how sure it was. Your counsel can review any of it.
A share of what you save, for each year a retiree stays enrolled. Nothing for screening, nothing for denials.
Nothing is filed, sent or signed until the retiree replies YES to exactly what will happen.
The fund sees totals. It learns a retiree’s name only when that retiree agrees, and only what it needs, like a reimbursement to stop.
Retirees keep exactly the plan they have. Only who pays the premium changes. We never sell or recommend a Medicare plan.
Retirees never pay us. We sign a HIPAA business associate agreement before we see a single file.
Pick the retirees on your Part B reimbursement who likely qualify. You send one letter. We screen, file, follow each case to approval and renew it every year.
| What | Our fee |
|---|---|
| A retiree approved for a Medicare Savings Program | 20% of the premium you no longer pay, each year they stay enrolled |
| The yearly renewal | Included |
| A denial, or no answer | Nothing |
If nobody is approved, the pilot costs the fund nothing.
Tell us about your fund. We’ll reply within two business days with the agreement and the data list.
Your request is saved. We'll reply to the email you gave us.
If your fund sent you our number, here’s what we do, and what we never do.
For members