As a retiree, you or a dependent have a change in your Medicare enrollment (for example, you enroll in Parts A and B). This life event does not apply to Active Employees.

For Retirees and Survivors

In the table(s) below, supplemental benefits refer to supplemental dental insurance (Select, Select Plus and Preventive), vision insurance, and Accident Plan. You may not be eligible for all supplemental benefits. Visit the Dental Insurance, Vision Insurance and Accident Plan pages to learn about eligibility.

  Health Insurance & Uniform Dental Supplemental Benefits
Enrollment opportunity?

No

 No
Change coverage from single (individual) to family? No No
Change coverage from family to single (individual)? Yes No
Change health plan? Yes Not applicable
Drop a dependent and keep family coverage? No No
Cancel coverage? Yes No
Deadline to submit application  File an application to ETF (ET-2331) within 30 days of the event. You may submit it up to 3 months early when you enroll for Medicare Parts A and/or B Not applicable
Documentation required? Yes Not applicable
Effective date

Coverage becomes effective on the date Medicare coverage begins (or date of losing coverage, for example due to kidney transplant following ESRD)

Rarely, new retirees will enroll in Medicare on the first of a month, but employment terminates later in the month. In this case, the retiree can change health plans one month after Medicare begins

 Not applicable