Retiree Health Benefits

CalPERS is your Health Benefits Officer and administers health insurance coverage for CSU retirees. You may change your health plan​ online during Open Enrollment by logging onto my|CalPERS and following the instructions.

You may also call CalPERS at 888-225-7377 to make changes. Complete the CalPERS Health Enrollment Retirees (PDF) form before calling.

State Employer Contribution Amounts

The state pays a portion of your health insurance premium. You must pay the difference between the state contribution amount and the premium for the health plan in which you’re enrolled.

The state employer contribution amounts for 2024 are:

Find your plan’s monthly premium in one of these documents to determine your monthly cost:
​CalPERS 2024 In-State Premiums (PDF)
CalPERS 2024 Out-of-State Premiums (PDF)​

New for 2024:

HealthNet Smart Care Removed from the CalPERS Health Program

Effective January 1, 2024, HealthNet Smart Care will no longer be an available health plan to CSU employees. Employees who are in this plan will need to elect a different health plan coverage during Open Enrollment. Employees currently enrolled in HealthNet Smart Care will be administratively transferred to Blue Shield Access+ effective January 1, 2024 if they don't make a plan change. Members in Napa County will be transferred to Western Health Advantage, effective January 1, 2024 if a plan change is not made.

Health Plan Expansions

Blue Shield Access+ EPO plan expansion into Del Norte and San Benito counties.

UnitedHealthcare Harmony HMO plan expansion into Santa Clara and Santa Cruz counties.

Health Plan Exit

Anthem Traditional from Glenn County: Members, and their dependents who live in Glenn County who do not choose another health plan during Open Enrollment, will automatically be enrolled in Blue Shield Access+ effective January 1, 2024.

Understandi​ng Medicare

Medicare is health insurance for people 65 or older, under age 65 with certain disabilities, or individuals with End-Stage Renal Disease (ESRD). The Social Security Administration oversees M​​edicare eligibility and enrollment. For CSU purposes, the CalPERS website and Medicare Enrollment Guide will be your starting point for Medicare related inquiries.

Overview

Medicare is not optional in retirement if you are eligible to enroll in Medicare Part A and B. If eligible, Medicare will become your primary coverage and your CalPERS health coverage will become secondary.

Medicare is made up if four parts; Part A (Hospital), Part B (Medical), Part C (Medicare Advantage plans) and Part D (Prescription drugs). Part C is for HMO's only, and CalPERS health plan members should not enroll in Part D. All CSU retirees (and/or dependents) 65 or older will need to enroll in either Medicare Part A and B or Medicare Part C, depending on your health plan.

If you are eligible for premium-free Medicare Part A, you must enroll in Medicare Part A and Part B and transfer to a CalPERS Medicare health plan. For information regarding eligibility, visit the CalPERS Medicare website or contact your local Social Security Office.

If you are ineligible for Medicare Part A and B, you must complete the Ineligibility of Medicare Certification Form and return it to CalPERS, in order to remain in the CalPERS basic health plan as a CSU retiree (or dependents) over 65.

Below are the various scenarios indicating when you will need to enroll in Medicare Part B:

• If you're active and 65 and over, your CalPERS medical coverage remains your primary health plan while employed.
• If you have a spouse 65 and over AND they are currently enrolled in your CalPERS health coverage, CalPERS will remain their primary health plan as long as you are employed with the CSU – no action is required.
• If you are active and under 65, with a spouse/registered domestic partner who is 65 or older OR has a social security approved disability, you will need to complete a Special Enrollment Period (SEP) application.
• You will need to complete this form. Then, at your direction, the campus will need to complete sections A and B of this form and provide it back to you. Once complete, you will need to submit your and the campus forms to the Social Security Office. The campus will be called to attest to the content on their form.
• If you plan to retire and you and your spouse/registered domestic partner are 65 or older, you must contact your campus benefits office two months before your intended retirement date, or as soon as possible, to prevent a lapse in coverage.
• If you turn 65 in retirement, CalPERS will notify you four months before your 65^th birthday to notify you of the requirements to continue your health plan coverage.

You do not need to enroll in Medicare Part B if you are still working and have active employer group health coverage (ex. CSU health coverage) or if your spouse is still working and you're covered under their active employer group health coverage.

If you or your spouse/register domestic partner are retired and over the age of 65 and had their CalPERS health coverage cancelled, you likely did not provide CalPERS with your Certification of Medicare Status Form within 60 days of your retirement date. If you are Medicare eligible, please enroll in Medicare Part A and B and complete the Certification of Medicare Status Form and submit it via your myCalPERS account or in person at your local CalPERS office.

Cost of Medicare

The cost of Medicare is dependent on your age and your dependents, if applicable. Rates can be found on the CalPERS website. Keep in mind that the CalPERS website does not reflect the employer share.

Reimbursement of Premiums

As a CSU retiree, if you or your dependents are eligible for Medicare Part B reimbursement, CalPERS will automatically reimburse the eligible amount of the standard Medicare Part B premium, beginning the date of your enrollment into a CalPERS Medicare health plan. Your reimbursement will be listed on your warrant as “Medicare Reimbursement."

You can learn more about this reimbursement for high income earners on the CalPERS Medicare website.

You can visit the CalPERS Medicare website, Medicare Enrollment Guide or review the Medicare and Your CalPERS Health Benefits Webcast video for more information.​