In 2016, CalPERS moved to a single, non-Kaiser Medicare option for HMO subscribers to provide our members with more extensive Medicare coverage and reduce costs. The new option - the UnitedHealthcare (UHC) Group Medicare Advantage PPO plan - has HMO-like pricing and the geographic freedom of a PPO. It allows members to receive care from any provider who accepts Medicare. Members can use it in all 58 California counties and anywhere in the United States and its territories.

Review the information below for specific details regarding plan availability, your status, and any actions you need to take. Visit Retiree Plans & Rates to view your health plan options, and review each plan's Evidence of Coverage, and Summary of Benefits and Coverage with Uniform Glossary.

Medicare Health Plan Availability

Effective January 1, 2016

New Enrollees

When you retire, turn age 65, and become Medicare eligible, here is what you need to know about your transition to a CalPERS Medicare health plan.

State Medicare Retirees (Without Non-Medicare Dependents)
If Then
You are currently enrolled in a CalPERS Basic health plan that does not have a corresponding Medicare health plan available. CalPERS and UHC will work together to enroll you into UHC’s Medicare health plan.
You want to change your health plan. You may do so when you provide your Medicare eligibility information.
Public Agency Medicare Retirees (Without Non-Medicare Dependents)
If Then
You are currently enrolled in a CalPERS Basic health plan that does not have a corresponding Medicare health plan available. CalPERS and UHC will work together to enroll you into UHC’s Medicare health only plan.
You want to enroll in UHC dental and vision coverage. You may do so when you provide your Medicare eligibility information. This option comes with an additional expense that you will pay out of pocket.
You want to change your health plan. You may do so when you provide your Medicare eligibility information.
Medicare Members with Non-Medicare Dependents (Combination Plans*)
If Then

You are currently enrolled in a CalPERS Basic health plan that does not have a corresponding Medicare health plan available, have a dependent enrolled in a non-Medicare (Basic) plan, and your dependent's provider accepts UHC Basic coverage.**

CalPERS and UHC will work together to enroll you into UHC’s combination plan. Both you and your dependent will be able to keep your current providers. To find other options available in your area, use the Health Plan Search by ZIP Code.

You are currently enrolled in a CalPERS Basic health plan that does not have a corresponding Medicare health plan available, have a dependent enrolled in a non-Medicare (Basic) plan, and your dependent resides outside of UHC's Basic coverage area.**

CalPERS and Anthem will work together to enroll you into the PERS Choice Medicare Supplement PPO combination plan. To find other options available in your area, use the Health Plan Search by ZIP Code.

You are currently enrolled in a CalPERS Basic health plan that does not have a corresponding Medicare health plan available, have a dependent enrolled in a non-Medicare (Basic) plan, and you want to change your health plan.

You may do so when you provide your Medicare eligibility information.
Current Retirees

As of January 1, 2016, the following health plans are no longer available:

  • Anthem Blue Cross Medicare Preferred
  • Anthem Blue Cross Senior Secure
  • Blue Shield 65 Plus
  • Blue Shield Access+
  • Blue Shield Access+ EPO
  • Blue Shield NetValue
  • Health Net Seniority Plus
  • Sharp Performance Plus

If you were previously enrolled in a health plan that is unavailable in 2016, here is what you need to know about the changes to your Medicare coverage.

State & Public Agency Medicare Retirees (Without Non-Medicare Dependents)
If Then
You were enrolled in a CalPERS Medicare health plan that is no longer available. CalPERS and UHC worked together to enroll you into UHC's Medicare health plan, effective January 1, 2016.
You want to change your health plan. Find more information on special enrollment opportunities by visiting Retiree Plans & Rates or reviewing the Health Program Guide (PDF).
Medicare Members with Non-Medicare Dependents (Combination Plans*)
If Then
You were enrolled in a CalPERS Medicare health plan that is no longer available, have a dependent enrolled in a non-Medicare (Basic) plan, and your dependent's provider accepts UHC Basic coverage.** CalPERS and UHC worked together to enroll you into UHC's combination plan, effective January 1, 2016. Both you and your dependent will be able to keep your current provider.
You were enrolled in a CalPERS Medicare health plan that is no longer available, have a dependent enrolled in a non-Medicare (Basic) plan, and your dependent resides outside of UHC's Basic coverage area.** CalPERS and Anthem worked together to enroll you into the PERS Choice Medicare Supplement PPO combination plan, effective January 1, 2016.
You want to change your health plan. Find more information on special enrollment opportunities by visiting Retiree Plans & Rates or reviewing the Health Program Guide (PDF).

* 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 health plan through the same health carrier. CalPERS requires all family members to have the same health carrier. View more on Combination Plans.

** Use the UHC Search Tool to determine if your dependent’s provider accepts UHC Basic coverage, if your dependent resides outside of UHC’s Basic plan coverage area, or to find providers by name, location, or medical groups/networks.

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