What Criteria Determine Who Is Eligible for Health Insurance for Retirees?


Quick Answer

A federal retiree is eligible for health insurance if the retirement is entitled to an immediate annuity within a retirement system designed for civilian workers, states Office of Personnel Management. A retiree must have uninterruptedly enrolled for health insurance five years prior to the annuity starting date.

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Full Answer

If the period between the first annuity enrollment opportunity and retirement is less than five years, then the enrollment should have been continuously during this time, Office of Personnel Management explains. The five-year period is also calculated as a period during which the retiree was covered by another person’s insurance, such as a family member. It also includes the period covered under the Uniformed Services Health Benefits Program.

If eligibility for retirement is due to age, years of service or disability, a retiring state employee is eligible for health insurance, explains South Carolina Public Employee Benefit Authority. The minimum retirement age is 60 years, while the years of service requirement in some departments is 28 years. An employer’s participation in a state health insurance program qualifies a retiree for health insurance. If the last five years of service were on a full-time basis, with eligibility for health insurance under an employer participating in state insurance program, then the retiree qualifies for health insurance. Other exceptions include if a former employee of a county or municipal council is allowed by the council to participate in such health insurance plans, but the retiree must have served for at least 12 years.

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