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Transitioning to a Medicare Health Plan

When you retire, become Medicare eligible, and enroll in Medicare Part A and Part B, you'll have the option to choose a new Medicare health plan. If you do not choose one, CalPERS will enroll you in a CalPERS Medicare health plan.

If... Then...
Your current health carrier offers a CalPERS-sponsored Medicare health plan CalPERS will enroll you in your current health carrier's Medicare health plan
Your current health carrier does not offer a CalPERS-sponsored Medicare health plan CalPERS will enroll you in the UnitedHealthcare (UHC) Group Medicare Advantage PPO Plan.
 

Combination Plans

CalPERS requires all family members to have the same health carrier. A combination plan means at least one family member is enrolled in a Medicare health plan and at least one family member is enrolled in a Basic (non-Medicare) health plan through the same health carrier.

Consider your family's needs when determining which Medicare health plan is right for you. If you or your family member become eligible for Medicare and enroll in a CalPERS Medicare health plan, all members of your family will be impacted by the Medicare member's change in health plans.
 
For example:
  • If the Medicare member enrolls in the UHC Group Medicare Advantage (PPO) Plan, the other family members must move to the UHC Basic Plan, SignatureValue Alliance (HMO).
  • If the Medicare member enrolls in another available Medicare plan, such as Kaiser Permanente Senior Advantage, the other family members will be enrolled in the Kaiser Permanente Basic Plan.
If your current health carrier does not offer a CalPERS-sponsored Medicare health plan, and you do not choose one when transitioning to Medicare, CalPERS will enroll you in a combination plan based on your ZIP code. Refer to the table below:
 
If... Then...
Your health eligibility ZIP code area is within UHC's service area Your family will be enrolled in the UHC combination plan:
  • Medicare members will be enrolled in UHC Group Medicare Advantage (PPO) Plan.
  • Family members enrolled in a Basic (non-Medicare) health plan will be enrolled in UHC SignatureValue Alliance HMO Basic Plan.
Your health eligibility ZIP code area is outside UHC's service area Your family members in Medicare and Basic (non-Medicare) health plans will be enrolled in PERS Choice PPO Plan.
Search the UHC SignatureValue Alliance HMO Network or call (877) 359-3714 to find out if UHC accepts your or your dependent's current providers. If not, and it's a priority to keep your or your family members' current providers, you may consider enrolling in one of CalPERS PPO Plans (PERSCare, PERS Choice, or PERS Select). Both the Medicare and Basic Plans are PPOs, which will allow all family members to retain their current providers but may result in higher costs.
 
You can log in to my|CalPERS and use the CalPERS Find a Medical Plan tool to compare the costs and benefits of different plan options.

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