Individual Coverage

Individual insurance plans are available through most health insurance carriers. These policies are issued directly to an individual and premiums are age rated. Applicants will need to complete a health history statement and may be denied coverage due to pre-existing medical conditions.

Medicare Coverage

  • Medicare covers:
    • Individuals age 65 and older
    • Certain younger individuals with disabilities
  • Your initial Medicare enrollment period is the 3 months before your 65th birthday, the month you turn 65, and 3 months after the month you turn 65.
  • Start the process of enrolling in Medicare at least 2-3 months before you need the coverage to begin.
  • When you become eligible for Medicare (except for end stage renal disease), you are no longer eligible to participate in the PEBB Retiree or COBRA plans.
  • A domestic partner may be subject to Medicare penalties if he/she does not enroll in Medicare when first eligible and may not be eligible for the “special enrollment period”. For additional information, please contact Social Security/Medicare directly.
  • If your spouse/partner and eligible dependents are not eligible for Medicare, these family members may continue PEBB coverage if they were enrolled on your coverage when you became Medicare eligible.
  • When you retire and/or are no longer covered by the active employee plans, you may qualify for a “Special Enrollment Period” to add Medicare Part A, B & D.
  • “Special Enrollment Period” is only available if you ARE NOT in your initial Medicare enrollment period (3 months before your 65th birthday, the month you turn 65, and 3 months after the month you turn 65)
  • Enrollment in Medicare Part D depends on your supplemental/advantage plan (e.g., PERS plans include Part D coverage)
  • COBRA is not considered an employer plan for Medicare purposes. If you are Medicare eligible and you enroll in COBRA coverage rather than enrolling in Medicare, you may incur penalties when you enroll in Medicare later and you may not be eligible to enroll in a Medicare Supplemental Plan.
  • Medicare Supplemental Plans are offered by PERS and on the open market (Samaritan Health, Regence BlueCross/BlueShield, Kaiser, AARP, etc.).


* Enroll in Medicare Part D only if your Medicare Supplemental/Advantage Plan does not include it.