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Who is Eligible?

To be eligible for Medicare health insurance coverage, you must be at least 65 years old, a resident of the United States and a U.S. citizen or an alien who has been lawfully admitted for permanent residence.

Already Eligible?

Many educators qualify for free Medicare Part A coverage either through their prior employment or that of their spouse.

Ways to determine if you already have free Medicare Part A coverage:

  • If your spouse is eligible for a Social Security pension, you qualify for free Medicare Part A coverage at age 65 OR
  • You can call Social Security Administration at 1-800-772-1213
  • You can check your Social Security annual statement, which is sent to you each year about three months before your birth month. (You can call Social Security for a copy of your statement if you no longer have it.) Look in the Medicare portion of page two in the "Your Estimated Benefits" section of the statement to see if it reads "you have enough credits to qualify for Medicare".

How to Enroll

For persons who are turning 65: To enroll in Medicare, you must call Social Security at 1-800-772-1213 during your Initial Enrollment Period (a seven-month window around your 65th birthday).

For persons who are 65 and have just retired: To enroll in Medicare, you must call Social Security at 1-800-772-1213 during your Initial Enrollment Period, an eight-month window around your 65th birthday that begins when your group health insurance ends.

For persons who are older than 65: To enroll in Medicare, you must call Social Security at 1-800-772-1213 between January 1 and March 31. This window is called the General Enrollment Period. Medicare coverage for persons enrolling during the General Enrollment Period will begin on July 1.

Enrollment Process for All

During your first call to Social Security, you will make an appointment to start the enrollment process. Visits to a Social Security office are allowed for enrollment, although Social Security prefers people to enroll by telephone.

During the enrollment telephone call, a customer service representative will interview you and complete a computer-generated form, a copy of which will be mailed to you to confirm details. Before the enrollment process is complete, additional telephone interviews and the mailing of proof of age, citizenship and residency documents between you and Social Security may be necessary.

Once you enroll, Medicare will send you a comprehensive handbook on Medicare benefits.

Already Participate in an HMO?

Some members have asked CalSTRS if they should cancel their HMO coverage and sign up for the Medicare Part A coverage. If you have these questions, CalSTRS cannot advise you on this decision. You need to consult with Medicare and your health care provider to determine what changes to your medical coverage you will have if you enroll in Medicare.

For More Medicare Information

Medicare is a complicated and multifaceted federal program. CalSTRS would always like to be able to answer any member's questions. However, at Medicare's request, we must defer Medicare enrollment questions to the Social Security Administration, which handles Medicare enrollment.

General information about Medicare coverage is available toll-free from Medicare at 1-800-633-4227. (This is not the number to call to enroll. You call 1-800-772-1213 to enroll.)

You may also access information about the Medicare web site at www.medicare.gov.

In addition, general information about Medicare and other health insurance programs is available from the California Health Insurance Counseling and Advocacy Program, toll-free at 1-800-434-0222.


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