What the PEBB rule says
The Public Employees' Benefit Board (PEBB), part of the Oregon Health Authority, offers retiree medical plans only to retirees who are not Medicare eligible (OAR 101-050-0005). Under OAR 101-050-0010, coverage ends when you become Medicare eligible: "the last day of the month before the month of Medicare eligibility." The rule's own example: if your 65th birthday is May 15, you're Medicare eligible May 1, and PEBB retiree coverage ends April 30.
- The exception is Medicare eligibility because of end-stage renal disease.
- A spouse, domestic partner or dependent child who isn't Medicare eligible may stay on the PEBB retiree plan while they remain eligible.
- If you become Medicare eligible earlier through disability, coverage ends then.
What replaces PEBB
Most state retirees move to one of three kinds of coverage:
| Option | What to know |
|---|---|
| PERS Health Insurance Program (PHIP) | For PERS retirees. You must enroll within 90 days of first becoming Medicare eligible and have both Part A and Part B. PHIP Medicare plans include Part D drug coverage. |
| Medigap plus a Part D plan | Oregon's six-month Medigap open enrollment starts the month your Part B begins; companies can't use your health to deny you then. |
| Medicare Advantage | Sign up during your Initial Enrollment Period. Plan availability varies by county; see your county. |
Steps before your PEBB coverage ends
- Sign up for Parts A and B. If you aren't getting Social Security yet, apply at SSA.gov or 1-800-772-1213 about three months before the month you turn 65 so Medicare starts the day after PEBB ends.
- Decide about PHIP. PHIP says that if you don't enroll when you're first eligible for Medicare, in most cases you lose any future chance to join a PHIP medical plan. Call PERS Health at 1-800-768-7377.
- Compare other options. If PHIP isn't your choice, compare Medigap and Medicare Advantage in your area; you can request a call from a licensed insurance agent.
- Don't add a separate Part D plan to PHIP. PHIP Medicare plans already include it.
Retiree coverage isn't coverage from current employment, so it never lets you put off Part B. More in our PEBB and Medicare guide.
Related questions
What is PHIP for Medicare retirees?
PERS's retiree health program.
How does the PERS RHIA subsidy work?
Who gets it and how it's paid.
Do I need Part B if I have retiree coverage?
Almost always, yes.
Sources
- OAR 101-050-0010 — Retiree plan enrollment and termination (PEBB)
- OAR 101-050-0005 — PEBB retiree health plan eligibility
- PERS Health Insurance Program — Enrollment opportunities
- PERS Health Insurance Program — Medicare enrollment
- Medicare.gov — Working past 65
More questions in this guide
- Do I need Medicare Part B if I have retiree health coverage in Oregon?
- How does the PERS RHIA subsidy work with Medicare?
- What happens to my OEBB coverage when I get Medicare?
- What is the PERS Health Insurance Program (PHIP) for Medicare retirees?
Part of the guide: PEBB retirees and Medicare in Oregon · All questions
Frequently asked questions
Can my spouse stay on PEBB after I go on Medicare?
Yes, if your spouse or dependents aren't Medicare eligible and still meet PEBB eligibility rules, they may keep PEBB retiree coverage until they become Medicare eligible or lose eligibility.
What if I'm still working for the state at 65?
Active employee PEBB coverage is coverage from current employment, so you can delay Part B while you work and sign up within eight months after the job or coverage ends.
Does the ESRD exception apply?
Yes. PEBB's rule makes an exception when Medicare eligibility is because of end-stage renal disease; ask PEBB how your coverage continues.
Medicare in your Oregon county
Plans, local agents and help, county by county: Multnomah · Washington · Clackamas · Lane · Marion · Jackson · Deschutes · Linn · Douglas · Yamhill · Benton · Polk · Josephine · Umatilla · Klamath · Coos · Columbia · Lincoln · Clatsop · Malheur · All 36 counties →
