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 2026 are:

Find your plan’s monthly premium on the CSU Retiree Rate Sheet.​​

Additional CalPERS health plan information can be found here:

• 2026 In State Health Plan Rates
• 2026 Out of State Health Plan Rates
  

New for 2026​:

​Health Plan and Dental Rate Changes

Effective January 1, 2026, rates for most health and dental plans will change.

Health Plan Changes

Effective January 1, 2026, CVS Caremark (CVS) will replace OptumRx as the new pharmacy benefits manager (PBM) for the following CalPERS health plans: Anthem Blue Cross Traditional HMO, Anthem Blue Cross Select HMO, Health Net Salud y Más, PERS Gold PPO, PERS Platinum PPO, Sharp Health Plan Performance Plus, UnitedHealthcare Alliance, UnitedHealthcare Harmony and Western Health Advantage HMO. Members will receive a welcome kit from CVS that includes ID cards as well as information to access Caremark.com and the CVS Health app prior to January 1, 2026. This will be used for all prescription services starting January 1, 2026

Heath Plan Expansions and Exits

Blue Shield Access+ will expand to Monterey County. Blue Shield Trio plan will no longer be offered in Monterey County. Members that do not elect a health plan change will be automatically enrolled in Blue Shield Access + , effective January 1, 2026.

Health Benefit Design Changes

PERS Gold will continue with deductible in-patient credits of up to $500 for completing preventive care activities, while adding the following activities: participation in the Diabetes Prevention Program, if eligible, as well as depression or anxiety screening.

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 the Application for Medicare Part B form. Then, at your direction, the campus will need to complete sections A and B of the request for Employment Information 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.​