GIC Health Insurance for Retired State Employees

(Annual Open Enrollment: Early April – Early May, Coverage Effective July 1)

Retired State employees eligible for Medicare:

  • The Group Insurance Commission (GIC) offers Medicare supplements to retired State employees who are eligible for Medicare Part A.*
  • If eligible, they are required to have Medicare Parts A and B in order to have a GIC Medicare Supplement.
  • GIC Medicare Supplements provide coverage for some services that Medicare does not cover.
  • The Medicare Supplements offered by GIC include:

- HMOs(members are restricted to “networks” of providersand have co-pays for most services).

- Indemnity plans (which do NOT have networks and allow members to use any provider or hospital that accepts Medicare). This style plan is similar to a Medigap policy

  • All plans include either “creditable” prescription drug coverage, or an actual Part D Plan.

Some important points to keep in mind about drug coverage:

  • For most GIC Medicare enrollees, the drug coverage through their GIC plan may be better value than the Medicare drug plans being offered. Therefore, they should not enroll in a Medicare drug plan. (GIC’s Medicare Advantage plans – Fallon Senior Plan or Tufts Medicare Preferred – automatically includeMedicare Part D coverage and members may not join an additional Part D plan.)
  • If someone has limited income and assets, the federal government offers extra help (LIS) paying for Medicare prescription drug coverage and this may be the one case where signing up for a Medicare Part D plan may be beneficial. GIC plan members will not be disenrolled from their GIC plan if they sign up for a Medicare Part D plan, unless they are in the Fallon Senior Plan or Tufts Medicare Preferred.

Retired State employees NOT eligible for Medicare(those under age 65 OR those of any age with an insufficient work history)

  • If aretiree (or the retiree’s spouse or other covered dependent) is younger than age 65, the person or people under age 65will continue to be covered under a Non-Medicare plan until they become eligible for Medicare.
  • Plans offered include HMOs and an indemnity plan.

For additional information, forms, and “Benefit Decision Guides” visit or call GIC at 617-727-2310 (TTY 617-227-8583)

* Generally, you will be eligible for Medicare PartA when you reach the age of 65 and you meet one of the following:

  • you will be eligible to receive a Social Security benefit, or
  • you are married to someone who will be eligible to receive a Social Security benefit or,
  • you were married to a former spouse for at least 10 years and are either divorced or widowed, or
  • you are a public employee, hired on or after April 1, 1986 and you paid the 1.45% Medicare tax for the required period (usually 10 years).

Revised 7/2013

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