As a retiree, you or a dependent have a change in your Medicare enrollment (for example, you enroll in Parts A and B).

  Health Insurance & Uniform Dental Supplemental Benefits
Enrollment opportunity?


Change coverage (single-family or family-single)? Yes No
Change health plan? Yes No
Drop a dependent and keep family coverage? No No
Cancel coverage? Yes No
Deadline to submit application  File an application with 30 days of the event. You may submit it up to 3 months early when you enroll for Medicare Parts A and/or B
Effective date Coverage becomes effective on the date Medicare coverage begins (or date of losing coverage, for example due to kidney transplant following ESRD)
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