Disability Retirement

NYS employees with a certified disability and awarded disability retirement can access continued NYSHIP coverage.

If you have a disability certification, you may qualify for ongoing NYSHIP coverage and disability retirement. You may also be able to combine Medicare and NYSHIP for the most complete coverage.

If you are applying for a disability retirement, contact your HBA or Agency Contact to discuss your options.

Types of Disability Retirement

There are two types of disability retirement:

Ordinary Disability Retirement

For an ordinary (not work-related) disability granted by an approved retirement system.

Work-Related Disability Retirement

For a work-related illness or injury granted by an approved retirement system.

Paying Premiums

When you get disability retirement, you’ll pay your part of the health insurance premium either through deductions from your pension check or by making monthly payments to EBD.

Eligibility Requirements

The eligibility requirements you must meet depend on the type of disability retirement.

To ensure continued eligibility for NYSHIP coverage after you retire, make sure you maintain NYSHIP coverage while you wait for the decision on your disability retirement by enrolling in vestee or COBRA coverage.

Ordinary Disability Retirement

  1. Complete the minimum service requirement based on the date you last entered State service.
    • If you were last hired on or after April 1, 1975, you need at least 10 years of NYSHIP benefits-eligible State service, or at least 10 years of combined NYSHIP benefits-eligible service with the State and one or more Participating Employers and/or Participating Agencies.
  2. Satisfy requirements for retiring as a member of a retirement system
    • You must qualify for retirement as a member of a retirement system administered by New York State. Employees who are certified with a disability by their retirement system may be eligible to receive a pension prior to satisfying the age and/or service requirements.
    • If you are not a member of a publicly administered retirement system or you are enrolled in an optional retirement program you must meet one of these conditions:
      • You meet the age requirement of the New York State and Local Retirement System retirement tier in effect at the time you last entered service
      • You are qualified to receive Social Security disability payments.
  3. Be enrolled in NYSHIP
    • You must be enrolled in NYSHIP as an enrollee or a dependent at the time of your separation from active employment. Enrollment in NYSHIP may be through The Empire Plan, a NYSHIP HMO or the Opt-out Program.

Work-related Disability Retirement

  1. Satisfy requirements for retiring as a member of a retirement system
    • You must qualify for retirement as a member of a retirement system administered by New York State. Employees who are certified with a disability by their retirement system may be eligible to receive a pension prior to satisfying the age.
    • If you are not a member of a publicly administered retirement system or you are enrolled in an optional retirement program, you must meet one of these conditions:
      • You meet the age requirement of the New York State and Local Retirement System retirement tier in effect at the time you last entered service.
      • You are qualified to receive Social Security disability payments.
  2. Be enrolled in NYSHIP
    • You must be enrolled in NYSHIP as an enrollee or a dependent at the time of your separation from active employment. Enrollment in NYSHIP may be through The Empire Plan, a NYSHIP HMO or the Opt-out Program.

Approval

Once you receive your disability retirement award letter, send a copy to EBD. Your eligibility for NYSHIP retiree coverage will be reviewed. After EBD certifies your eligibility, you’ll get a confirmation letter that will have details about your health insurance enrollment. 

If your disability retirement is not approved, you will be notified in writing that coverage will end. If you did not maintain NYSHIP coverage (while on leave or in vestee or COBRA status), you will not be eligible to reenroll.

Retroactive Retirement 

If you receive a retroactive retirement after your coverage ends, you might be able to reinstate it if you act quickly.

  • If your disability retirement was granted and the effective date is on or before the date your coverage was canceled, you may apply for coverage to be reinstated at any time. Notify EBD of your disability retirement as soon as possible so that your record is updated.
  • If your disability retirement is granted and the effective date is after your coverage was canceled, you must apply for coverage to be reinstated within a year of the disability retirement determination date on your Notice of Determination from the Retirement System. You will be responsible for paying any retroactive premiums missed while your coverage was canceled, up to the effective date of your disability retirement.

No application for reinstatement of coverage will be accepted more than one year from the date of the notice of determination issued by your retirement system.

Social Security Disability Insurance

Because of your disability, you may receive Social Security Disability Insurance (SSDI), a monthly allowance paid to individuals with a disability to replace lost wages under the Social Security system. If you have questions about SSDI, call the Social Security Administration at 1-800-772-1213 or visit www.ssa.gov.

Medicare and NYSHIP

The combination of your health insurance benefits under Medicare and NYSHIP will provide you with the most complete coverage. Eligibility for Medicare begins at age 65, or before age 65 for people certified with certain disabilities. If you are receiving Social Security Disability Insurance, you will be eligible for Medicare after 24 months.

It will be your responsibility to notify EBD of your enrollment in Medicare Parts A and B and provide a photocopy of your Medicare card when you first become eligible due to a certified disability to prevent a reduction of benefits and to begin reimbursement for the standard Medicare Part B premium.

Medicare and NYSHIP

A comprehensive overview of Medicare eligibility, who pays first, and how to apply. 

Medicare and NYSHIP

If You Need Assistance

For more information, call your Health Benefits Administrator or the Employee Benefits Division at 518-457-5754 or 1-800-833-4344

For questions about Medicare benefits, call Medicare at 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov.

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