Medicare Information
While you are an active employee you and your spouse/partner* are eligible to enroll in the PEBB medical benefit plans, regardless of Medicare eligibility status.
It is recommended that you enroll in Medicare Part A when you are first eligible, but it is not required. You and/or your spouse do not need to enroll in Medicare B & D while enrolled under your active employee plan (unless eligibility for Medicare is due to End Stage Renal Disease).
When you retire or lose benefit eligibility and are no longer covered by the Active Employee plan, you and/or your Medicare eligible spouse will qualify for a “Special Enrollment Period” to add Medicare Part B & D (add Part D only if the Supplemental/Advantage plan you/they enroll in does not include Part D coverage).
The “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).
You and/or your Medicare eligible spouse will need to have Medicare A/B/D coverage and a Medicare Supplemental/Advantage policy in place and effective when your active employee coverage terminates (Part D only if the Supplemental/Advantage policy you enroll in doesn’t cover it).
You should begin the Medicare enrollment process 2-3 months prior to your retirement or loss of benefits eligibility date.
Medicare Supplemental Plans are offered by PERS, if you are a PERS or OPSRP member, and on the open market (Samaritan Health, Regence BlueCross/BlueShield, AARP, etc.).
*Note: A domestic partner may be subject to Medicare penalties if they do 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.
Additional Resources:
- Medicare Home page
- Medicare & You Handbook
- Social Security website
- Albany Social Security Office, Phone: (877)-405-9196, Location: 1390 Waverly Drive SE, Suite 110, Albany OR 97322
- State of Oregon – Senior Health Insurance Benefits Assistance Program (SHIBA). Provides assistance with general Medicare questions and with comparing Medicare medical and drug plan coverage.