Ineligible for Medicare
If you're ineligible for Medicare Part A at no cost, you must complete and submit the Ineligibility of Medicare Certification (PDF) form or the Certification of Medicare Status (PDF) form with the reason for your ineligibility:
- Did not work in employment covered by Social Security/Medicare
- Do not have 40 quarters in Social Security/Medicare-covered employment
- Do not qualify through the work history of a current, former, or deceased spouse
You must include supporting documentation such as a copy of the Social Security statement or letter from the SSA indicating that you're not eligible for Medicare based on your work record and/or the work history of a current, former, or deceased spouse.
You may remain in a CalPERS Basic (non-Medicare) health plan until you later become eligible for Medicare Part A at no cost. If you later become eligible for Medicare Part A at no cost, you'll no longer be eligible to remain in a 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.