Medicare Part D and CalPERS Medicare Health Plans

CalPERS participates in a Medicare Part D prescription drug plan for members enrolled in a CalPERS Medicare health plan.

The standard Part D premium is paid through your CalPERS health insurance premium. If your income exceeds a federal threshold as determined by the SSA, you may be subject to an additional Income Related Monthly Adjustment Amount (IRMAA) for Part D prescription drug premiums. You'll either receive an invoice for the additional amount, or it'll be deducted from your Social Security benefits. Non-payment of the additional prescription drug premium will result in cancelation of your CalPERS health coverage.
 
If you enroll in a CalPERS-sponsored Medicare Advantage Plan that includes Part D prescription drug coverage in its benefit package and you are subject to an additional Medicare Part D premium, you must pay the additional Medicare Part D premium, or your health coverage will be canceled. If you re-enroll at a later date, you may incur a federal late enrollment penalty.
 
If you enroll in a CalPERS-sponsored Medicare Supplement Plan and a Medicare Advantage Plan that does not include Medicare Part D prescription drug coverage in its benefit package, you'll also be enrolled in a CalPERS-sponsored Medicare Part D prescription drug plan unless you notify the Medicare Part D prescription drug plan that you wish to opt-out of prescription drug coverage. If you decline coverage, you'll be responsible for all of your prescription drug costs. If you re-enroll at a later date, you may incur a federal late enrollment penalty.
 
Do not enroll in a non-CalPERS Medicare Part D plan. If you do so, CMS will disenroll you from your CalPERS-sponsored Medicare Advantage Plan or Medicare Part D prescription drug plan resulting in cancelation of your CalPERS health coverage and you'll be responsible for your prescription drug costs.

Medicare Resources

Medicare Enrollment Periods

Requirements to Continue CalPERS Coverage

Certifying Medicare Status

Ineligible for Medicare

Deferred Enrollment in Medicare Part B

Cancellation of CalPERS Health Coverage

Medicare Part B Premiums

Late Enrollment Penalty

Reimbursement of Premiums

Transitioning to a Medicare Health Plan

Enrolling through a Spouse Under 65

Medicare Part D and CalPERS Medicare Health Plans

Medicare Requirements Impacting your CalPERS Health Coverage

Optional Benefits for CalPERS Contracting Agencies

Special Enrollment