PERACare is PERA’s health benefits program that includes health care, dental, and vision insurance plans. Eligible participants may enroll in any or all three types of coverage, and will pay a monthly premium based on the plan(s) selected. Learn more about PERACare or attend a webinar.
Are there options other than PERACare after I retire?
Yes, there are other options for coverage in retirement. You are not required to enroll in PERACare and we encourage you to review all of your options.
For retirees under age 65 and not yet eligible for Medicare:
Connect for Health Colorado or your State’s insurance marketplace
Employer coverage through a spouse who is still working
COBRA coverage – available as a continuation of employer coverage after termination of employment
For retirees age 65+, or under 65 and eligible for Medicare due to disability:
Individual Medicare plans sold directly by insurance carriers
Employer coverage through you or a spouse who is still working
Note: Coverage that is not based on current employment, such as COBRA, is not considered creditable coverage by Medicare past age 65 and could result in Medicare enrollment delays or penalties in the future.
When can I enroll, change plans or add dependents?
You can enroll in PERACare within 30 days of your first retirement benefit payment, or within 30 days of certain Enrollment Eligibility Events as described in the PERACare Health Benefits Program booklets. You may also enroll, change plans, or add dependents during the annual open enrollment period each fall.
Eligibility and Enrollment
Who is eligible to enroll in PERACare?
PERA benefit recipients (retiree, cobeneficiary, qualified child, or dependent parent receiving a monthly retirement, disability or survivor benefit from PERA) and their eligible dependents may enroll in PERACare.
What are my coverage options under PERACare?
For PERA members under the age of 65 (Pre-Medicare), PERACare offers two PPO plan options with UMR, a UnitedHealthcare company, and an Every Day Care Plan (EDCP) and High Deductible Health Plan (HDHP) with Kaiser.
For PERA members 65 and older, PERACare offers three Medicare Advantage plans that combine the benefits of Medicare Parts A and B with Part D prescription coverage into one comprehensive plan. Currently the Medicare plan options are two national PPO plans with UnitedHealthcare and one regional HMO plan with Kaiser Permanente of Colorado (Kaiser).
Do PERACare health plans include prescription drug coverage?
Yes. All of the health plans offered through PERACare include prescription drug coverage. The list of covered medications (Formulary) can be found here.
What happens when I turn 65?
When you turn 65 you will enroll in Medicare and will have different plan options available to you. Visit the PERACare Turning 65 page for more information and be sure to sign up to attend a webinar to learn about enrolling in Medicare and your coverage options.
When can I cancel PERACare coverage?
You may cancel coverage for yourself and/or any dependent at the end of any month as long as the request is received by PERA on or before the 15th of that month. If the request is received on or after the 16th, coverage will be canceled at the end of the next month. PERA may cancel coverage if you and/or any dependents are no longer eligible to participate in PERACare or if your premium payments are not current.
Medicare
What is Original Medicare and how much does it cost?
Medicare Part A Hospital benefits and Part B Medical benefits together are known as Original Medicare.
Everyone pays a premium for Medicare Part B. To see the current cost for Part B, please visit Medicare’s website.
You qualify for Premium-Free Part A if any of the following apply:
You have paid the Medicare tax for 10 or more years.
You are currently married to someone who paid the Medicare tax for 10 or more years and have been married for at least 1 year.
You are divorced, were married for at least 10 years, and your former spouse paid the Medicare tax for 10 years or more. You must be single.
You are widowed and married for at least nine months before your spouse died. You must be single.
If none of the above apply, you do not need to purchase Part A coverage as PERACare’s Medicare plans include replacement Part A benefits.
Will I be eligible for Medicare as a PERA retiree?
Yes, you will be eligible for Medicare when you turn age 65. Medicare is the federal health insurance program for everyone age 65 and older. Please see Social Security’s Medicare booklet (#05-10043) for information about enrolling in Medicare.
Everyone qualifies for Medicare Part B and pays a premium for Part B. Most PERA retirees also qualify for premium-free Medicare Part A, but if you do not, you do not have to purchase it if you are enrolled in one of PERACare’s Medicare plans. Please review the materials listed under the Turning 65: Planning for Medicare page.
What types of Medicare plans does PERACare offer?
PERACare offers three Medicare Advantage plans: a Medicare Advantage HMO plan with Kaiser and two Medicare Advantage PPO plans with UnitedHealthcare.
Kaiser’s Medicare HMO is available to those who live in Kaiser’s Colorado service area, and enrollees can only go to Kaiser facilities or Kaiser’s network of physicians.
UnitedHealthcare’s Medicare PPO’s plans are available nationwide and enrollees have the same cost share when seeing a physician in the UnitedHealthcare network or when seeing an out-of-network physician who accepts Medicare and is willing to accept the UHC plan.
Why does PERA only offer Medicare Advantage, not Medicare Supplement?
PERA has found that Medicare Advantage plans can provide lower premiums for retirees while still providing generous benefits in one coordinated and easy to understand plan.
Why do I have to pay Medicare Part B premiums and PERACare premiums?
Medicare Part B coverage is required for enrollment into a Medicare Advantage plan, and you must pay the Medicare Part B premium directly to Medicare. You will also pay a monthly premium for the PERACare Medicare Advantage plan you have selected. If you are eligible for a PERA subsidy that amount will be applied to the premium for your plan, and anything remaining will be deducted from your monthly PERA benefit check.
