What PHIP is
The PERS Health Insurance Program (PHIP) is run by Oregon's Public Employees Retirement System for retirees who receive a PERS benefit. It offers non-Medicare plans for retirees under 65 and Medicare plans for those on Medicare, plus separate dental plans. PERS lists a hearing benefit and a vision benefit with its Medicare coverage. Specific plans and rates change each year and are posted at pershealth.com.
Rules for Medicare members
- Parts A and B required. PHIP requires all Medicare-eligible members and eligible dependents to be enrolled in both Medicare Part A and Part B, and to keep them.
- Part D included. Enrolling in a PHIP Medicare plan includes automatic enrollment in PHIP's Medicare Part D plan.
- Residence. You need a permanent residence in the United States within the plan's service area.
- Proof of Medicare. PHIP asks for a copy of your Medicare card or a Medicare letter of entitlement with your enrollment form.
When you can join
PHIP enrollment opportunities are set by OAR 459-035-0070 and are the only times you can enroll:
| Event | Deadline |
|---|---|
| New PERS retirement | Within 90 days of your PERS retirement date |
| First Medicare eligibility | Within 90 days, with Parts A and B. Apply before your Medicare date so coverage starts the same day. |
| Losing employer group coverage | Within 60 days, after at least 24 months in a row of employer group coverage |
If you're still working at 65 with employer coverage, that later loss of coverage is your chance to join. Becoming 65 after an earlier disability-based Medicare start doesn't open a new window.
How PHIP compares
PHIP is one choice, not a requirement. Some retirees compare it with an individual Medigap policy and Part D plan, or a Medicare Advantage plan sold to the public. Tier One and Tier Two retirees with eight or more years of service get the RHIA subsidy only on a PHIP Medicare plan, which matters when comparing costs. To compare Medicare options from the companies they work with, you can request a call from a licensed insurance agent. For PHIP questions, call PERS Health at 1-800-768-7377 (TTY 711).
Related questions
How does the PERS RHIA subsidy work?
Who qualifies and how it's applied.
What happens to my PEBB coverage at 65?
State retiree coverage ends.
What happens to my OEBB coverage?
For school and college retirees.
Sources
- Oregon PERS — PERS Health Insurance Program
- PERS Health Insurance Program — Medicare enrollment
- PERS Health Insurance Program — Enrollment opportunities
- Oregon PERS — About supplementary plans
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 happens to my PEBB coverage when I turn 65?
Part of the guide: PEBB retirees and Medicare in Oregon · All questions
Frequently asked questions
Do I need a separate Part D plan with PHIP?
No. Enrolling in a PHIP Medicare medical plan automatically enrolls you in PHIP's Part D prescription drug plan, so you shouldn't buy a separate one.
What if I miss the 90-day window?
PHIP says that in most cases, if you don't enroll when you're first eligible for Medicare Parts A and B, you give up any future chance to enroll in a PHIP medical plan.
Can I change PHIP plans each year?
Yes. PHIP holds an open enrollment each fall, October 1 to November 15, when members can change plans for the next year.
Does the PHIP plan cover me if I move out of Oregon?
PHIP requires a permanent U.S. residence inside a plan's service area, so a move can limit your choices. Call PERS Health before you move.
Medicare in your Oregon county
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