Eligibility and Enrollment
Medicare is for individuals:
- Age 65 and older
- Under age 65 with certain disabilities
- With End-Stage Renal Disease (ESRD)
Medicare consists of four parts, each covering specific services:
- Medicare Part A (Hospital)
- Medicare Part B (Medical)
- Medicare Part C (Medicare Advantage plans)
- Medicare Part D (Prescription drugs)
The Social Security Administration (SSA) oversees Medicare eligibility and enrollment.
The SSA has three Medicare enrollment periods:
-
Initial Enrollment Period - When you're turning 65, you have a seven-month period to sign up for Part A and/or Part B. This Initial Enrollment Period begins three months prior to the month you turn 65, and ends three months after the month you turn 65.
The date you sign up determines the effective date your Medicare coverage starts.
| If you sign up: |
Your Part A and/or B effective date is: |
| One to three months before you turn 65 |
The first day of your 65th birth month
Or
The first day of the month prior to your 65th birth month, if your birthday is on the first day of the month
|
| The month you turn 65 |
One month after the month you sign up |
| One month after you turn 65 |
Two months after the month you sign up |
| Two months after you turn 65 |
Three months after the month you sign up |
2. General Enrollment Period - If you're not enrolled in Medicare, you have the opportunity to sign up for Part A and/or Part B during a three-month period each year. The General Enrollment Period begins January 1 and ends March 31. Your coverage begins the following July 1.
3. Special Enrollment Period - If you and/or your spouse are currently working and covered by an employer group health plan from that current employer, you may be eligible to sign up for Part A and/or Part B during a Special Enrollment period. Contact the SSA for more information.
Continuing CalPERS Health Coverage After Age 65
A few months before you turn 65, CalPERS will send you notifications of the requirements to continue your health coverage. The notifications request information about your eligibility or ineligibility to enroll in Medicare.
Questions?
For additional information you may visit the CalPERS Retirees page for Health & Medicare.
You may also click "Submit HR Ticket" to speak with an benefits representative.