When You Retire

Keeping your NYSHIP coverage after you stop working.

If you meet certain requirements, you’ll be able to keep your NYSHIP coverage after you stop working. However, your coverage may change in a few important ways.

As you approach retirement, you may be wondering, "Will I be able to continue my New York State benefits?" The answer is usually yes, but you'll have to meet a few conditions first. In this video, we'll look at these state benefits after you retire: Health coverage through the New York State Health Insurance Program or NYSHIP, Dental and Vision coverage, The Income Protection Plan, and M/C Life Insurance.

To continue NYSHIP health coverage as a retiree, you must meet a few requirements:

  1. You must usually have at least 10 years of benefits eligible service. 
  2. You must qualify for retirement as a member of a retirement system administered by New York State or it's political subdivisions. This is usually referred to as pension eligibility. 
  3. You must already be enrolled in NYSHIP. 

In addition, you and your dependent must be enrolled in Medicare if eligible to keep NYSHIP coverage. Most people become eligible at age 65. If you or your dependent are eligible for Medicare but not yet enrolled, be sure to sign up as early as 3 months before you stop working. If you don't sign up, your health coverage will be reduced or cancelled. 

If you're enrolled in the Opt-Out Program, you must switch to the Empire Plan or a NYSHIP HMO before or when you retire. You may also defer retiree coverage to a later time. 

After you retire, if your dental coverage is with New York State, you have two options to continue it. 

  1. Apply for COBRA. Within 30 days of retirement, you will receive an application to continue coverage through COBRA at group rates for up to 36 months. You must apply within 60 days of losing group dental coverage. 
  2. Enroll in a direct pay plan. After you retire, you will receive an enrollment form and summary of benefits. You must apply when you retire or at the end of COBRA coverage. 

Unlike dental, continued NYSHIP vision coverage is only available through COBRA at group rates for up to 36 months. You must apply for COBRA within 60 days of losing coverage. If you receive dental and vision coverage through a union employee benefit fund, your benefits may be different, so check with your union representatives. 

If you are receiving income protection plan benefits, you will continue to receive them after retirement, but your eligibility for enrollment ends on your last day as an active employee. You may continue your M/C Life Insurance as a retiree if you retire as a member of a New York State publicly administered retirement system or you meet the age and service requirements of the retirement plan appropriate for you.

If you are eligible to continue M/C Life Insurance, you may stay enrolled in the group program or convert to a direct pay policy. You may continue both personal and dependent life insurance. For more information, see your M/C Life Insurance booklet or visit the NYSHIP website. If you have any questions about continuing any of your coverages in retirement, talk to your HBA. 

Retiree Coverage Requirements

To continue NYSHIP coverage in retirement, you must meet the following conditions:

  1. You must have at least 10 years of benefits-eligible service. If you receive a work-related disability retirement, this requirement is waived.
  2. You must qualify for retirement as a member of a retirement system administered by New York State (or its political subdivisions). 

    If you are not in that system or in the SUNY Optional Retirement Program, you need to meet one of these conditions:
    1. You must be old enough for pension eligibility in the New York State and Local Retirement System (NYSLRS) retirement tier in effect when you last entered service 
    2. Or, you should qualify for Social Security disability payments.
  3. You must already be enrolled in NYSHIP through active employee, vestee, dependent or preferred list coverage. If you don't have NYSHIP coverage now, enroll at least 11 weeks before retirement. 

If you don't meet all of the requirements, your NYSHIP coverage will end after you leave payroll. 

You and your dependents must be enrolled in Medicare if eligible to keep NYSHIP coverage. Sign up as early as three months before you stop working. Visit our Medicare and NYSHIP page to learn more. 

Changes to Your Coverage

After you retire:

  • The Department of Civil Service Employee Benefits Division (EBD) will become your new health benefits administrator (HBA).
  • You will be billed monthly for your NYSHIP premium. You will pay the same rate and rate share as an active employee in your salary grade or equivalent.
  • You may change plan options once every 12 months for any reason or when a qualifying event occurs (i.e., you move in or out of a NYSHIP HMO’s service area or you add a new dependent).
  • You may no longer participate in the Opt-Out Program.
  • You and your covered dependents may be eligible to receive reimbursements for the Medicare Part B premium and Medicare Part B IRMAA payments.
  • You and your covered dependents must not enroll in non-NYSHIP Medicare Advantage (Part C) or Part D plans. If you do, your NYSHIP coverage will be terminated.
  • You may see other changes to your New York State benefits—including dental, vision, M/C life insurance and the Income Protection Plan.

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