Health insurance eligibility in retirement depends on whether you are a state or local employee and what your employer offers. If you are not certain about what your employer offers, go to the Benefits Available to Me page to search for your benefits by current employer name, or last employer name if you are retired.
Cost of Health Insurance
How much you'll pay for health insurance depends on which program option you're in and which health plan you've selected. Find your program option by visiting the Benefits Available to Me page. Once you've selected your program option, click on the Health Insurance card and look for health care premium rates.
If you have the Group Health Insurance Program when you retire or began your WRS benefit, you can continue your health insurance for life. Your health insurance continues automatically, unless you request a cancellation. If you have sick leave credits, these credits will be used to pay for your health insurance premiums first. When you don’t have sick leave credits, premiums are deducted from your monthly retirement payment unless your payment is too small. See the Accumulated Sick Leave Program page for information about sick leave credits and premiums.
If you have the Local Group Health Insurance Program when you retire and start your retirement payments immediately, your health insurance continues automatically. Contact your employer directly about payment options as some employers will continue to pay for health insurance after you retire. If your employer doesn’t offer this benefit, your premiums are deducted from your monthly retirement payment unless your payment is too small.
If your employer does not offer health insurance through the Local Group Health Insurance Program, you may qualify for the Local Annuitant Health Insurance Program. See the Local Annuitant Health Program (ET-2156) brochure or contact ETF for more information.
If you retire before age 65, ETF will mail you a reminder that you must enroll for Medicare before you become eligible. It is your responsibility to let ETF know when your insured dependents become eligible for Medicare. Fill out the Medicare Eligibility Statement (ET-4307) to let ETF know when you or your dependents become eligible.
- Age 65 and over
- Receipt of Social Security disability payments for 24 months
- End Stage Renal Disease (ESRD)
- Lou Gehrig’s Disease (ALS)
You and/or your insured dependents must enroll for both portions of Medicare (Hospital Part A and Medical Part B). By law, these forms must be filled out to continue with the Group Health Insurance Programs that are designed to integrate with Medicare. You must send these forms to ETF before the first of the month that you become eligible. If you don’t sign up for Medicare when you are eligible, you will be responsible for any claims Medicare would have covered, up to 80% of the cost.
If you have any questions about the Group Health Insurance Program’s requirements to be enrolled in Medicare or what options you are eligible for, contact ETF