1. I’m turning 65 in a few months. What should I be doing?
Be on the alert for important notifications from CalPERS. Before you turn 65, you’ll need to enroll in Medicare through the Social Security Administration to keep your CalPERS health coverage. If you are not eligible for Medicare through your work history or through a qualifying spouse who is 62, including a current, former, or deceased spouse, you can stay enrolled in a Basic plan. That’s why, a few months before you turn 65, CalPERS begins mailing you notification letters with steps to complete so you can continue your health coverage with us.
Carefully follow the notifications’ directions in a timely manner. Make sure your address is current to ensure you receive these notifications and, if you have questions about these notifications or what you need to do, call CalPERS at 888 CalPERS (or 888-225-7377) right away.
2. What changes can I expect when I transition to a CalPERS Medicare health plan?
When you enroll in Medicare and become eligible for a CalPERS Medicare health plan, several changes may occur, including:
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- Health plan — You can elect to keep your current health carrier’s CalPERS-sponsored Medicare health plan or change your plan. If your current plan doesn’t offer a CalPERS-sponsored Medicare health plan, you’ll need to change plans or CalPERS will automatically transfer you into a CalPERS Medicare health plan.
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- Health benefits — The coverage provided by CalPERS Medicare health plans are Medicare-approved services. Additionally, most plans provide coverage for some benefits not covered by Medicare, such as chiropractic and acupuncture. The plans also provide coverage for medically necessary services and supplies when benefits under Medicare are exhausted or when charges for certain services and supplies exceed amounts covered by Medicare. These benefits vary by plan. To learn more about each individual plan’s coverage, review the plan’s Evidence of Coverage booklet (plan booklets are available online).
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- Health plan changes — You can change your health plan and add or delete dependents during Open Enrollment in the fall. You can also make changes within 60 days of a qualifying life event, such as Medicare enrollment.
3. I’m turning 65 and will coordinate with Medicare, but my spouse is younger and won’t be on Medicare. What can we do?
A CalPERS combination health plan may be the answer for you and your spouse. A combination plan means at least one family member is enrolled in a Medicare health plan and at least one family member is enrolled in a Basic health plan through the same health carrier. All family members on the same CalPERS plan as dependents must have the same health carrier.
4. I’ve received mailers about enrolling in non-CalPERS Medicare Part D prescription programs. Should I enroll in one of these programs?
No. All CalPERS Medicare plans include Medicare Part D. As a CalPERS member, you should not enroll in any Medicare Part D plans outside of CalPERS. If you do, you may lose your CalPERS health coverage.
5. I have more questions. What should I do?
Don’t wait — contact CalPERS. Call us at 888 CalPERS (or 888-225-7377), send us a secure message through your myCalPERS account, or make a virtual or in-person appointment. Plus, be sure to review helpful information on our website as well as in our Medicare Enrollment Guide (PDF).