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

For Retirees

  Health Insurance & Uniform Dental Supplemental Benefits
Enrollment opportunity?


Change coverage from single (individual) to family? No No
Change coverage from family to single (individual)? 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 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
Documentation required? Yes
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, a  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