If you are a state, higher education or local education retiree, you will be removed from retiree group health coverage when you turn 65. If you still have eligible dependents on retiree coverage at that time, their coverage will continue until they are no longer eligible. An eligible spouse may stay on the coverage until they turn 65. An eligible child can stay on the coverage through the end of the month that they turn age 26. If you are a local government retiree and become eligible for Medicare for any reason, your group health coverage will be terminated. Your eligible dependents may continue retiree coverage until they no longer satisfy eligibility requirements.
The coverage level and premium rate will change to the appropriate level according to how many dependents are still covered on the plan, i.e., spouse only, child only, spouse plus child, etc.
You may view the current retiree premium levels on the Partners for Health website at Insurance Premiums.
Example # 1: You currently have retiree plus spouse coverage on the state retiree group health plan. Your date of birth is 7/15/1960 and you become Medicare eligible on 7/1/2025. You will come off the retiree group health plan effective 07/01/2025 and the policy will change to spouse only coverage. Your spouse’s date of birth is 3/4/1961 so they are not Medicare eligible until 3/1/2026. You may continue spouse only coverage until 3/01/2026.
Example # 2: You have retiree plus child coverage on the state retiree group health plan. Your date of birth is 9/1/1960 so you become Medicare eligible on 8/1/2025. You will age off the retiree group health plan and the policy will change to child only coverage effective 8/1/2025. Your child’s date of birth is 5/22/2000 so they can stay on your medical coverage until 6/01/2026.