Deferred Enrollment in Medicare Part B

If you're deferring enrollment in Medicare Part B, you must complete and submit the Ineligibility of Medicare Certification (PDF) form or the Certification of Medicare Status (PDF) form indicating the reason for deferral:

You're still working and have active employer group health coverage.
Your spouse is still working and you're covered under their active employer group health coverage.

You must provide supporting documentation showing proof of enrollment in an active employer group health plan through the current employer.

Once this information is received, you may remain in a CalPERS Basic (non-Medicare) health plan until retirement or until you lose your active coverage in the employer group health plan. If you later retire or lose your employer group health coverage through active employment, you'll no longer be eligible to remain in a CalPERS Basic (non-Medicare) health plan. To continue CalPERS health coverage, enroll in Medicare Part A and Part B, provide documentation of enrollment to CalPERS, and transition to a CalPERS Medicare health plan. The SSA will allow you to enroll in Medicare Part B without a late-enrollment penalty if you're eligible to enroll during a Special Enrollment period.